In April of 2015 a group of ear, nose, and throat doctors published a study of chronic sinus infection patients at the Memorial Hospital at the University of North Carolina at Chapel Hill. They reported that people who "sinus allergies" tended to differ in surprising ways from people who have "sinus fungus," a more serious condition.
The people who had problems with sinus allergies tended to come from wealthy counties (such as Orange County, the location of Chapel Hill). The people who had the more serious problems with fungal infections of the sinuses tended to come from poorer counties (such as Robeson county, in the southeastern corner of the state). People who had allergies tended to be employed and to have professional jobs that paid good wages. People who had fungal infections tended to be disabled, earning minimum wage, or on Social Security. The symptoms of both diseases are the same. One is simply a lot easier and a lot less expensive to treat than the other.
Getting In A Car Crash Costs More If You Are Poor In The USA
The US state of Nebraska keeps track of data about the victims of non-fatal car crashes. From 2007 through 2012, they kept track of the cost of hospital care for the victims of car crashes. The study found that it costs a lot more to be poor and uninsured (that is, not to have health insurance) when you are in a car crash than it costs to be employed, in a good job, and fully insured.
Not only did poor people wind up getting much bigger bills for their treatment after they were in a crash, they were less likely to get follow-up care. They usually were forced to go to the emergency room for visits that cost thousands of dollars rather than to their primary care providers for visits that cost a few hundred dollars. Minor injuries were far more likely to result in hospital stays for poor people, while wealthier people were usually treated in the ER or in their doctors' offices and sent home. That was because poor people could only get coverage to be seen on an emergency basis, and otherwise got no medical care at all.
Cancer Is Less Survivable If You Are Poor In The USA
Breast cancer is still the most common kind of cancer among American women. American females in the top 20 percent of incomes have an 87.8 percent chance of living at least five years after diagnosis. American females in the bottom 20 percent of income have a 71.5 percent chance of living at least five years after diagnosis. Put another way, women who have money have a 23 percent higher chance of living five years when they get breast cancer. Women who have money have a 69 percent higher chance of living ten years after they are diagnosed with breast cancer in the USA.
Poor people are sicker people in the United States, but why should wealthier Americans care? Aside from the fact that the second-rate healthcare poor people actually gets costs more, it also is usually paid for with tax dollars. Inequality adds to the tax burden of middle-income Americans, too.
Just How Bad Is Healthcare Inequality in the USA?
Americans probably just don't know how poorly they are doing relative to many other advanced countries. Longevity in the USA is about the same as in Cuba. Infant mortality rates in the USA are twice what they are in Western Europe. Seven times as many unmarried, teenage girls get pregnant in the United States as in France. Single jails house more prisoners in the United States than all the jails in most European countries, and nearly one out of every 100 Americans is currently behind bars. Over half of all African-American men are either in jail or on probation, or otherwise limited by their criminal histories.
Whiz-Bang Technology Isn't Enough
The natural result of inequality is illness. Poor people get sicker than rich people. The answer would seem to be figuring out a way everyone has access to seeing a doctor, but Americans have resisted that idea. Even after the full implementation of the Affordable Care Act, many poor Americans still have to seek their health care at emergency rooms.
Under federal law, no emergency room can turn away patients. They can make patients wait for hours (waits of 18 hours are not unusual). They can make patients very uncomfortable. They can limit the doctor's visit to a minute or less. However, if you are sick, and you show up in an emergency room, you will get the minimum treatment you need at that very moment.
Let's say you are an American diabetic who uses insulin, which costs $1000 to $3000 a month for the modern, more effective brands, you have high blood pressure, you have a family history of heart disease, and you don't have money or insurance. You run out of insulin and your blood sugar levels climb to 400 mg/dl (22 mmol/L). You go to the ER.
The emergency room will take your medical history, measure your blood sugar levels, and give you just enough insulin to get your blood sugar levels back to normal. However, they won't give you the insulin or blood pressure medications you cannot afford, and they probably won't even give you the prescriptions you need so you can buy them with your own money.
If you are just as sick 24 hours later because you don't have insulin, they will take you back. There are Americans who have had to go to emergency rooms weekly after developing kidney disease, heart disease, or diabetes, costing the system hundreds of thousands or even millions of dollars, when a fair system could be treating them for a few thousand dollars. However, Americans don't want to dole out those small amounts. It would be coddling the poor.
The disability system is even worse.
What Is The Solution For American Healthcare?
"From each according to his abilities, to each according to his needs" isn't ever going to be an American campaign slogan (at least not of any party that gets even one percent of the vote). Americans probably will only reform their system when they realize it costs less to keep people healthy than it does to respond to emergencies when they are sick. From all the reports about Americans and Obamacare, unfortunately, this realization is not taking place very quickly.