Thursday, July 26, 2012

Aaron Carroll of The Incidental Economist Documents How the U. S. Rations Health Care – Low Income People Get Less than High Income People

Not the Situation in Other Countries

There are two conflicting attitudes about the cost of and access to health care services.  One view, we will call it the humane view, is that basic health care is a basic human right, that everyone has basic health care in advanced countries as a matter of entitlement.  The second view is that health care is just another consumer good.  Those who have high incomes and can afford basic health care do so, those who have lower incomes have to do without.

The Incidental Economist is a great health care Forum, and Aaron Carroll frequently writes on health care economics.  Here he writes on an OECD study that looked at whether or not income inequality produced health care inequality, that is did various countries limit basic health care for people based on their incomes.

The results were not surprising,

The first thing to note is that the average rate of a visit to the doctor varies among all these countries from a high of 91% in France to a low of 68% in the United States. Think about that the next time someone tells you how our problem is that we consume too much health care.
The second thing to note is how much variation there is between those at the upper and lower end of the economic spectrum. In the UK, for instance, there is almost no difference in utilization between the rich and the poor. All see the doctor equally. In most other countries, though, there is some inequality based on income.
None as great as the United States, though. The difference between the probability of seeing the doctor for the poor and wealthy is greater in the US than in any of the other measured countries.
People like to believe that we don’t ration care in the US. We do. More than just about any other country, we ration by cost.

So the people who make the argument that health care is not a right, that if you cannot afford health care too bad, you should just make more money are winning.  And if Republican are able to implement their “market based” health care insurance philosophy, well the anti-health care forces will be routing the pro-health care forces.  But that will be okay to Republicans, the market rules. So if a five year old with pneumonia has to go without a doctor's visit because her parents are too poor to afford it, well that's a market working just fine.  She should have chosen wealthier parents.

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