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Desperate Inequality, Disparate Health

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Title: Desperate Inequality, Disparate Health


1
Desperate Inequality,Disparate Health
  • Jeff Singer
  • Health Care for the Homeless
  • June 8, 2004

2
Of all forms of inequality, injustice in health
care isthe most shocking and inhumane.    The
Reverend Dr. Martin Luther King, Jr.
3
African Americans and Health, Joint Center
DataBank Briefs, www.kaisernetwork.org/health_cas
t/uploaded_files/052504_jc_disparities_healthbrief
.pdf
4
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

5
Health Injustice
  • Racism
  • Incomes
  • Insurance

6
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

7
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
8
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

9
Poverty Rate by Race/Ethnicity, 2002
U.S. Census Bureau, Poverty in the United States
2002, P60-222, Tables1 and 2.
10
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
11
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
12
18,314 Adult Deaths Annually Due to Uninsurance
13
Health Insurance by Income and Housing Status
14
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/

15
Rate of Nonelderly Uninsured by Race/Ethnicity,
1999-2000
Kaiser Family Foundation, Health Insurance
Coverage in America, 2002 Update
16
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

17
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

18
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

19
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

20
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

21
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

22
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