Even if Congress passes universal health coverage, poor people in urban areas won't receive adequate medical care for reasons unrelated to insurance, Emory University researchers said last week.
Interviews with 3,897 emergency room patients at Atlanta's Grady Memorial Hospital found that while lack of insurance is a major reason people put off seeing physicians, other critical factors include living in dangerous areas, lack of transportation and low literacy rates.
"We have shown that an indigent urban population faces a variety of obstacles to medical care which will not be overcome by the adoption of universal health insurance alone," said Kimberly J. Rask, lead author of the study.
Nearly 54% of the Grady patients had no insurance, and almost all who did have coverage were Medicaid recipients. Only 5% had private insurance.
Most patients had put off treatment for at least two days, usually for reasons other than lack of insurance or money, Ms. Rask said. Reasons included:
Lack of child-care help.
No private transportation.
Lack of telephones.
A lack of physicians or medical clinics nearby.
"Many people in public housing don't want to go to a pay phone on the corner because it's simply too dangerous, they told us, so they will wait until morning," Ms. Rask said. "And many delay treatment because they can't afford to miss work, because 60% who had jobs didn't get sick leave or get paid when they didn't work."
She said the most important conclusion of the study was that "national health insurance will not cure poverty."