Health and Wealth

Today, 41.2 million Americans are without health insurance coverage and 8 million of these are children. The United States outspends the world on medical care but still remains the only industrialized country that does not offer health coverage to all its citizens. The World Health Organization ranked the United States 37th in the world in overall health system performance and 72nd on population health in its 2000 WHO report.

So, what is wrong with this picture? First, socioeconomic status is inextricably linked to health. Eight out of ten of the uninsured are in working families that cannot afford health insurance and are not eligible for public programs. Low-wage workers infrequently receive health care through their employers and only 43% of workers earning less than $7 an hour are offered health insurance by their employers. For these uninsured workers, the cost of individually purchased coverage typically runs $1200-$3600 annually per person and is simply too costly. Beyond that, 20% of low-wage workers decline their employer’s health care insurance when offered because they cannot afford the high premiums.

Health and Race and Ethnicity

Though the face of this country is changing and we are poised to become a “majority minority” nation, there is significant evidence of disparities in healthcare. In fact, the health gap between minority and non-minority Americans has increased in recent years. African Americans are 8% more likely to be uninsured than whites and Hispanics are more than twice as likely to be uninsured. Even for the minorities that do have access to health care services, there exists a great divide. This year Congress requested the Institute of Medicine (IOM) to do a study to assess the racial and ethnic differences in healthcare that are not otherwise attributable to known factors such as access to care. The findings show that bias, stereotyping, prejudice, and clinical uncertainty on the part of the health care providers may contribute to racial and ethnic disparities in health. These disparities in health exist when insurance status, age, income, and severity of conditions are comparable. And because death rates from cancer, heart disease, and diabetes are significantly higher in racial and ethnic minorities than in whites, these disparities are unacceptable. In addition, racial and ethnic minorities among U.S health professionals are extremely underrepresented and need to be increased, while all health care providers need to have better cross-cultural education in their training.

Our Vision

America’s HealthTogether knows that to confront and correct the disparities in health status and access to health care will require a broad and sustained commitment from our political leaders, our health care providers and financers, and from all people. The consequences for our nation if we do not do this are severe. The columnist Matt Miller wrote that “the fact that societies concerned with social justice are also medically healthier shouldn’t come as a surprise…”and we here at AHT are committed to rolling up our sleeves and going to work to create just such a society.

*The full text of the IOM report can be read at www.nap.edu