In a special themed issue, the Journal of the American Medical Association last week weighed in on the emotional debate on access to care with studies that found predictable holes in the safety net, and offered editorial comment suggesting how to reweave it.
One study found that financial barriersor at least perceived financial barriersare a risk factor for heart attack patients just as high cholesterol and blood pressure are, while another found that the uninsured often receive less medical care and take longer to improve after a sudden change in health.
They are new studies but the underlying theme of less access, less care, worse outcomes and worse health status is a theme that is re-affirmed in these reports and an important reminder that a payment system of some kind makes a difference, said James Tallon, president of the United Hospital Fund of New York, a health services research and philanthropic organization. But a second reminder is that universal insurance coverage is necessary but not sufficient to improvements in healthcare.
In an editorial, JAMA editors noted that the U.S. healthcare system ranks first in the world only in the overhead costs of running this chaotic enterprise, and is mediocre at best when compared with other industrialized countries in some broad measures of health.