Thursday, March 6, 2008

Health Care: It's All About Access

Access: noun, The right or opportunity to use or benefit from something.

Jeanne M. Lambrew, Senior Fellow at the Center for American Progress and an associate professor of public affairs at the Lyndon B. Johnson School of Public Affairs at the University of Texas, is a specialist in health care and policy. She conducts research on the uninsured, Medicaid, Medicare, and long-term care. On March 5, she delivered a stirring and fact-laden testimony before the United States House of Representatives on the subject of health care access. (Full text of the testimony along with a downloadable PDF version is available on American Progress.)

One wonderful thing about the Lambrew testimony is her ability to put things into realistic terms. For example, we often hear the statistic "47 million uninsured Americans" quoted throughout the media and the web (including here on this blog), but her testimony provides illustrations of just how much of the population that represents:
Nearly one in five of all Americans reports needing health care but not being able to access it due to cost. This largely results from lack of health insurance. About one in six Americans lacks health insurance at any point in time. To put this into perspective, 47 million uninsured Americans is double the number of people with diabetes. It is also more the number of people who live on the entire west coast of the United States or in Canada (Figure 1). This estimate does not capture all the people affected by gaps in coverage. Looking over a two-year period, a government study found that 82 million – one-third – of all non-elderly Americans experienced a gap in coverage (Figure 2). Research suggests that access for people with short gaps in coverage is more similar to the long-term uninsured than insured population.

The entire testimony is well worth the read. As you can see from the slideshow above, she covers a lot of ground dispelling misconceptions such as the demographics of the uninsured. (Did you realize that four out of five uninsured are not below the poverty line, but rather are from working families?) She covers economic and racial disparities, analyzes trends that have contributed to to these "grim statistics," and examines the differences the issue takes on as you cross state lines.

She closes with three comments on approaches to reform which I will summarize here:
  1. The paramount importance of addressing coverage and cost issues together.

  2. To be effective, any solution must be national in scope. 50 different reform efforts would add hopeless complexity to an already complex situation.

  3. The perfect should not be the enemy of the good. Purism should not be stressed over pragmatism.
My own summation of this moving and erudite assessment of our current health care "non-system" is that it is well worth the read. Drop us a line and let us know what you think about it.

SOURCE: "Access to Health Care: Testimony Before the House Committee on Appropriations, Subcommittee on Labor, Health and Human Services, and Related Issues" 03/05/08
photo courtesy of Ben Zvan, used under this Creative Commons license

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