Medical apartheid: an American perspective
Article Abstract:
The US and the Republic of South Africa are the only two industrialized countries that continue to maintain the view that medical care is a privilege. In South Africa, the polices and practices of apartheid have played a part in preventable death and illness in black Africans. In the US, as the result of socioeconomic segregation or 'functional apartheid', non-white Americans also have an excessively high rate of death and disability. The current fragmented method of health care delivery has failed to respond to the needs, or identify the barriers to care, that exist. There are often areas of overlap and gaps in health care delivery. Frequently, health services are provided by a variety of city, county, and private agencies. For example, frequently a well baby is seen at one location, but immunizations are given at another location. Sites of comprehensive health care are almost nonexistent for those of low socioeconomic status. Changes are needed to improve health care delivery to black South Africans; similar changes are needed in the US. Some of the inadequacies of both the South African and American systems of health care delivery may be corrected by a comprehensive community-based approach. Such an approach is currently in operation at the Community-Oriented Primary Care Program in Dallas, Texas. This model assesses the health status and needs of a defined community, and then designs and implements a health care plan based on that assessment. The approach combines epidemiology, individual patient care, and public health. Ironically, the basic structure and philosophy of this program originated in South Africa 40 years ago. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Does health insurance make a difference?
Article Abstract:
A review of 24 studies by the Office of Technology Assessment found that individuals who have no health insurance may not have adequate access to health care. The agency found that individuals with Medicare and Medicaid coverage may have slightly better access, but still not as complete access as those with private insurance. Uninsured individuals also tended to have worse outcomes. However, some studies have shown no association between level of insurance and health care access. One study found that uninsured patients were more likely to die in the hospital than insured patients, but it is possible that some of the uninsured patients were sicker.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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