The performance of health care systems interests me greatly, as it is my job to help my local health care system be the best. Recent evidence suggests we are not getting better. In fact, one study suggests the disparity in health outcomes is getting worse. That is, some people benefit more than others from our health care system in the US. The income inequalities translate directly into health outcome inequalities. And racial differences also are getting worse. How can we tolerate a society where we apply our resources so unfairly?
The researchers in this study looked at health outcomes by county in the USA and then looked at race, gender, and socioeconomic class. The results are very disturbing. “If you look at the extremes in 2000, men in the most deprived counties had 10 years’ shorter life expectancy than women in the most affluent counties (71.5 years versus 81.3 years).” The difference between poor black men and affluent white women was more than 14 years (66.9 years vs. 81.1 years).
Of course people with lower incomes have less access to health insurance. I don’t think this is fair or reasonable, but even more disturbing is that among people with health insurance, there are still racial disparities. I cannot help facing the terrible likelihood in all this — that racism persists in health care workers.
There is some hope here. Between 1966 and 1980, disparities in health outcomes actually got better in the US. It’s since 1980 that the gap is widening. What really worries me now is that the economy is in tough shape and government will have trouble finding the resources to do the right thing. What homeowner and voter will support more taxes this year? What politician would suggest it?
But health care needs to be like education- we should all have access to a basic set of benefits. So where do we get the funding? I have a simple idea — we are now spending $5,000 a second in Iraq. We can’t afford to further mortgage our kid’s future, so we better figure out a way to pay as we go. According to forensic psychiatrist Marc Sageman's book Leaderless Jihad: Terror Networks in the Twenty-First Century, our current policy is likely creating more terrorists anyway. We could fund a lot of health care for the uninsured with $5,000 a second.