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Economic Disparities Drive Widening Rift in Health Care Access and Quality
Health Affairs Article: Americans Willing to Pursue Health Care Excellence for Some, While Tolerating the Deterioration of Care for Others
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"Increasingly, America is turning into a country of health care haves and have nots, driven primarily by the type ofor lack ofhealth coverage people have," said lead author Robert E. Hurley, Ph.D., an HSC senior consulting researcher and associate professor at Virginia Commonwealth University. HSC is a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.
Many recent health care investments and initiatives are focused on affluent communities and are accessible mainly to people with employer-based or Medicare coverage, while access to basic care for people with Medicaid or no coverage at all is worsening in the wake of stalled coverage expansions and service cuts, according to the article.
The Health Affairs article, titled "A Widening Rift in Access and Quality: Growing Evidence of Economic Disparities," is based on HSCs 2005 site visits to 12 nationally representative communitiesBoston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking change in these markets for the past 10 years.
"A clear hierarchy of access to care is emerging in many communitiesthere is growing evidence that U.S. society is willing to tolerate almost limitless access to care for some and deteriorating access to basic care for others," said Hoangmai H. Pham, M.D., M.P.H., an HSC senior researcher and study coauthor, along with HSC Consulting Researcher Gary Claxton of the Kaiser Family Foundation.
Two perspectives written by Eric Book, chief medical officer of Blue Shield of California, and Timothy Ferris and David Blumenthal of Harvard Medical School, accompany the article. Book advocates universal coverage to address coverage gaps, while Ferris and Blumenthal support strengthening safety net providers.
Other key findings of the HSC study include:
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.
Health Affairs, published by Project HOPE, is the leading journal of health policy.