Financial Barries to Health Care
Lack of Insurance
Incrase in government insured and increase in total uninsured
Why People Lack Insurance
Change in the US economy means more unskilled low wage jobs
Rapid increase in health care costs
Use of experience rating makes it unpredicaable for for small employers
Who are the Uninsured?
More minorities and poor people uninsured
3/4 of unisured are employed
Does Health Insurance Make a Differnce?
Health Insurance and the Use of Health Services
Unisured use/get many fewer health services
Health Insurance and Health Outcomes
Insured people have a 25% reduced risk of dying
Does Midicaid Make a Difference?
Medicaid and Use of Health Services
better off than the uninsured, but still not nearly as good as the insured (in terms of untilization)--often refused care
Medicaid and Health Outcomes
a tad bit better than the uninsured--still a lot of emergency room utilization for things that could have been treated easily earlier
Underinsurance
Lack of Coverage for Catastrophic Expenses
lifetime limits on expeditures
Exclusion of Coverage for Preexisting Illnesses
switching jobs often brings old conditions to pre-exsiting status preventing new healthcare
Services Not Covered
preventetive services not well covered
Insurance Deductibles and Copayments
Gaps in Medicare Coverage
Lack of Coverage for Long-term Care
Insecurity About Insurance Coverage
The Effecst of Underinsuracne
Nonfinancial Barriers to Health Care
Location of Health Care Services
Rural use is less than urban
Gender & Access to Health Care
Differences in access: female phsyicians provide more preventative care
Femalse get more tranquilizers (2.5 times)
Some operations are less likely (but no mortality difference)
Race & Access to Health Care
there is discrimination--anelgisics
Some operations are less likely (but no mortality difference)
The Relation Between Health Care & Health Status
Health Status & Income
pooerer people are sicker and tend to get less care and die sooner
Health Status & Race
very different illness and death rates
whites are lower
Access to Health Care & Health Status
health status is better the higher up you are--not dependent purely on insurance