I found the recap in this post at The Hill on the rise in healthcare inequality eye-opening:
In the bad old days of the 1960s—before Medicare and Medicaid—the wealthy got twice as much care as the poor. But those programs changed things. By 1977, the poor were getting 14 percent more care than the wealthy— an appropriate difference since the poor are sicker and need more care.
The pattern changed again in 2004. Over the next eight years, use of care by the wealthiest fifth of Americans grew by 19.7 percent, outpacing growth for the middle class by 57 percent. Meanwhile, care for the poorest fifth actually fell.
By 2012 the wealthy were getting 40 percent more doctor visits than other Americans. Overall, after adjusting for differences in age and health, the wealthy got 43 percent more care than the poor— $1,743 per person— and left the middle class in the dust too; the latter got $1,082 less care than the rich.
The authors attribute the change to rising copayments and deductibles.
Immigration is undoubtedly another factor and not one easily remediated unless we decide we can afford to pay for the healthcare of the entire world.
Unless it’s actually banned or stigmatized ultimately there’s no way to have complete healthcare equality. The discrepancy between Medicaid and Medicare reimbursement rates also “bake in” a considerable level of inequality.
Back in the early days of the Affordable Care Act, I pointed out that as structured it institutionalized a tiered healthcare system. Clearly, that’s reaching its fruition.
The pattern changed again in 2004. Over the next eight years, use of care by the wealthiest fifth of Americans grew by 19.7 percent, outpacing growth for the middle class by 57 percent. Meanwhile, care for the poorest fifth actually fell.
Hmm, did anything significant happen between 2004 and 2012? Anything that might have significantly impacted people’s incomes, wealth, and the availability of health insurance? You know, any minor economic blips?
I’m sure the factors mentioned have played not only a part but a big part in what has happened, but it seems somewhat likely that the economy going into the crapper in 2008, and that the wealthy were those that Bush, Obama & companies decided to bail out has had more than a small impact on this, too.
Putting to one side the fact the wealthy have the time, funds and physicians willing to cater to them, would be interesting to see what services the rich are getting the bottom rung is not, e.g. cosmetic surgery, full length psychiatric visits, dental procedures, etc.
Don’t see immigration as a big factor since we also import many MDs and nurses.
As an aside, at some point, we (taxpayers and Congress) need to have a talk about setting equal payments between medicaid and medicare.
You think illegal immigrants who are ineligible for public services (like Medicaid), can’t buy insurance, and don’t have the cash to pay out of pocket receive the same level of healthcare that everybody else does? A large proportion of the uninsured are illegals.
For the illegals, yeah, I’ll agree they are part of the bottom health care tier seeking medical care only when an EMT scrapes them off the sidewalk or are otherwise in a situation they can’t avoid medical care.
However, even we crank up Ellis Island (and other such places) medical care has to be provided if for no other reason to prevent the staff taking say drug resistant TB home and keep the airline willing to fly them back home.
We can’t make it equal so I wouldn’t spend a lot of time working on it. Just make sure that everyone has access to decent, basic care. Those with more money will always get more care. If you have a secure job you can take the time off to get your knee fixed. If you don’t, you just put up with it and keep going to work.
I suspect the change in 2004 is at least partially related to the rise in wealth and income inequality.