January 13, 2006

Two-Tiered Healthcare System

The NYTimes has an article about the increasing plight of the rural poor in getting healthcare. According to the story, when someone without health insurance goes into a hospital, they are asked how they will pay for the treatment. For those not covered by health insurance, the story is bleak:

Even the ... news media are regularly filled with accounts of the desperate choices people are forced to make over health care, of brothers who must draw lots to see whose serious disease will be treated because their family cannot afford to treat both, or of a father who sells a kidney to treat an ill son.

As the reporter says:

The failure of the government to provide decent health care for [the rural poor] has reinforced the idea [of the country] as two separate nations: one urban and increasingly comfortable, the other rural and increasingly miserable.

Much of the problem can be traced to the the emphasis in the medical community on having to make a profit.

The recent emphasis on profit, meanwhile, has led doctors and other well-trained health care workers to abandon the countryside, with a result that [the rural poor] are left at the mercy of unqualified caregivers and outright charlatans who peddle expensive, improperly prescribed drugs and counterfeit medicines.

...Unable to afford proper care, the first recourse of most [rural poor] when they fall ill is to take whatever drugs they can find on the market to relieve their symptoms and hope that their ailment goes away. Often, of course, they merely get worse or, if their illness is communicable, spread it to others. Once a [person's] illness becomes debilitating, his relatives can face a double catastrophe: the serious decline of a breadwinner, and medical bills steep enough to bankrupt the family.

Would you be surprised to know that this article about the plight of the rural poor is actually an article about the Chinese rural poor, aka the peasants?

Reading this story created a deja vu moment for me because is sounds like the stories I've heard of from our first world country.

Rural residents are less likely to have employer-provided health care coverage or prescription drug coverage, and the rural poor are less likely to be covered by Medicaid benefits than their urban counterparts.

This piece talks about the problems that American's rural areas face in healthcare:

  • Many small rural hospitals have closed, while other health care facilities are in financial straits. Unavailability of resources and transportation problems are barriers to access for rural populations.
  • The supply of primary care practitioners and other health care providers in rural areas is decreasing. Some are leaving rural areas to join managed care organizations elsewhere.
  • Rural hospitals show a greater shift toward outpatient services, and greater declines in admissions and lengths of stay than urban hospitals. Economic pressures have driven rural hospitals to shift rapidly to outpatient care.
  • Rural and urban residents are equally likely to lack health insurance. Underinsurance is as much of a problem for rural residents as being uninsured.

Furthermore we know that lots of people end up bankrupt (or used to end up bankrupt before it was made harder to do so by our corrupt congress) because they can't afford to pay for their illnesses.

The NYTimes article about China's problem with their rural poor finding health care missed reporting the fact that Americans are facing much the same problem.

Posted by Mary at January 13, 2006 10:02 PM | Health/Medicine/Health Care | Technorati links |