Desperate Inequality, Disparate Health

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Desperate Inequality,Disparate Health

• Jeff Singer
• Health Care for the Homeless
• June 8, 2004

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Of all forms of inequality, injustice in health
care isthe most shocking and inhumane.    The
Reverend Dr. Martin Luther King, Jr.
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African Americans and Health, Joint Center
DataBank Briefs, www.kaisernetwork.org/health_cas
t/uploaded_files/052504_jc_disparities_healthbrief
.pdf
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Death and Homelessness

• Homeless women 1844 years of age were 10 times
  more likely to die than women in the general
  population.
• Angela M. Cheung and Stephen W. Hwang
  http//www.cmaj.ca/cgi/content/full/170/8/1243
• The death rate among homeless men was more than
  five times the rate in the general population.
• Stephen W. Hwang JAMA. 20002832152-2157

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Health Injustice

• Racism
• Incomes
• Insurance

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Incomes and Health

• The poor suffer rates of death and disease 50
  higher than others.
• Lantz, et.al., Socioeconomic factors, health
  behaviors, and mortality, JAMA, 1998 June
  3279(21) 1703-1708

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Incomes and Health
While the richest 1 of the U.S. population saw
its financial wealth grow 109 from 1983 to 2001,
the bottom 40 watched its wealth fall 46.
The Congressional Budget Office, Historical
Effective Tax Rates, 1979-1997, Preliminary
Edition, May 2001. http//www.cbo.gov/ftpdoc.cfm?i
ndex2838type1
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Incomes and Health

• Every 1 decline in economic inequality is
  accompanied by a 1 decline in mortality rates.
• Kennedy, Kawachi, and Prothrow-Stith, Income
  distribution and mortality test of the Robin
  Hood Index in the United States. British Medical
  Journal Vol. 312 (April 20, 1996), pgs. 1004-1007

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Poverty Rate by Race/Ethnicity, 2002
U.S. Census Bureau, Poverty in the United States
2002, P60-222, Tables1 and 2.
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Insurance and Health

• Uninsured children and adults are sicker and die
  more often, as cancer and other diseases are
  diagnosed too late.
• Uninsured persons injured in an automobile
  accident get less services in hospitals and have
  a 37 higher death rate than those with health
  coverage.
• Lack of health insurance causes 18,000
  unnecessary deaths every year in the U.S.

Insuring America's Health Principles and
Recommendations , Institute of Medicine, 1/14/2004
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One out of Seven

• 43.6 million Americans had no health insurance in
  2002
• This represents approximately one out of seven of
  our neighbors.

Health Insurance Coverage in the United States
2002. , U.S. Bureau of the Census, 9/30/2003
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18,314 Adult Deaths Annually Due to Uninsurance
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Health Insurance by Income and Housing Status
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Health Insurance and Poverty

• 30.7 of the poor were uninsured in 2001
• 30.4 of the poor were uninsured in 2002
• http//www.census.gov/hhes/hlthins/hlthin02/

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Rate of Nonelderly Uninsured by Race/Ethnicity,
1999-2000
Kaiser Family Foundation, Health Insurance
Coverage in America, 2002 Update
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Legislative Vehicle Health Care Access Campaign

• Health Care Access Resolution
• (H. Con Res. 99)
• 79 co-sponsors from 27 States as of 4/21/04

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Universal Solutions Health Care Access Campaign

• Resolved by the House of Representatives (the
  Senate concurring), that the Congress shall enact
  legislation by October 2005 to guarantee that
  every person in the United States, regardless of
  income, age, or employment or health status, has
  access to health care
• Information www.uhcan.org

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U.S. National Health Insurance Act HR676

• Proposal of the Physicians' Working Group for
  Single-Payer National Health Insurance published
  in the Journal of the American Medical
  Association on 8/13/03, endorsed by gt 8,000
  physicians
• Introduced by Rep. John Conyers (D-MI) on 2/11/03
  with 33 co-sponsors

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HR676 Features

• Access to comprehensive health care is a human
  right.
• The right to choose and change one's physician is
  fundamental to patient autonomy.
• Pursuit of corporate profit and personal fortune
  have no place in caregiving and they create
  enormous waste.
• In a democracy, the public should set overall
  health policies. Personal medical decisions must
  be made by patients not by corporate or
  government bureaucrats

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Single Payer Superiority

• According to U.S. Congress' General Accounting
  Office, administrative savings from a single
  payer reform would total about 10 of overall
  health spending. These administrative savings,
  about 100 billion annually, are enough to cover
  all of the uninsured, and virtually eliminate
  co-payments, deductibles and exclusions for those
  who now have inadequate plans - without any
  increase in total health spending.
• www.pnhp.org/hcinfo/?gowhy_needed

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Single Payer Superiority

• The single payer model would cover all Vermont
  residents, including the estimated 51,390
  uninsured persons in the state, while actually
  reducing total health spending in Vermont by
  about 118.1 million in 2001 (i.e., five
  percent).
• These savings are attributed primarily to the
  lower cost of administering coverage through a
  single government program with uniform coverage
  and payment rules."
• Analysis of the Costs and Impact of Universal
  Health
• Care Coverage Under a Single Payer Model for the
  State of
• Vermont, Office of Vermont Health Access August
  28, 2001

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