WHO IS AT GREATEST RISK FOR RECEIVING POOR-QUALITY HEALTH CARE?
March 17, 2006
The conventional wisdom among health experts across the ideological spectrum is that people need health insurance to get good health care. Indeed, to some politicians the terms "no health care" and "no health insurance" are interchangeable. Almost as widely accepted is the view that some health plans deliver better health care than others.
But a new study in the New England Journal of Medicine shatters those assumptions. The main focus confirms previous results: Americans are getting only about half the care from their physicians as experts recommend. But the study also finds that:
- Among people who seek care (actually see a doctor), there is virtually no difference in the quality of care received by the insured and the uninsured.
- There is also very little difference in the care provided by different kinds of insurance -- Medicaid, managed care, fee-for-service and so forth.
- Although the differences are quite small, blacks and Hispanic patients who seek care get better care than whites and women get slightly better care than men.
Although the authors don't say so, an implication is that public policies that make it easier for people to see physicians (such as Health Savings Accounts) may be a lot more important than policies designed to insure people (such as Medicaid), says John C. Goodman, president of the National Center for Policy Analysis.
Source: Steven M. Asch et al., "Who Is at Greatest Risk for Receiving Poor-Quality Health Care?" New England Journal of Medicine, vol. 354, no. 11, March 16, 2006.
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