Two controversial opinions exist regarding the US health care. On the one hand, the American health care is considered as one of the best systems in the world because of constant improvement of medical equipment and generous research funding. On the other hand, the US is a country without a publicly financed universal health system. A socioeconomic status (SES) also implies inequalities in the availability of health insurance, proper medical care, and sharps contradictions between medical personnel and patients. Moreover, studies show that people with a low SES get more general medical prescriptions, as they are perceived by hospital personnel as less responsible persons. At the same time, the situation is constantly getting worse each year because of the dramatic increase in the racial and ethnic diversity. Thereby, people with a low SES face two main problems – availability of cheap health care and high medical spends, and unconscious biases that medical personnel has towards them. Despite of the fact that the U.S. stood out as a top investor in health researches and as a constant consumer of sophisticated medical technology, people with a low SES are more likely to get not sufficient health care because of unaffordable medical spends and prejudices among hospital personnel.
Health Care Disparities and Social Inequality
People of lower SES usually experience disadvantage due to their baffling social and economic conditions, which are based on their relatively low position in social hierarchies (Fiscella, & Sanders, 2016). Across the world, the correlation exists between the health status of the entire population and the income inequality. The greater the inequality is, the worse health status of the population is. “In general, standard measures of health correlate with the extent of income discrepancy between rich and poor, and the extent of income inequality appears to explain more of the variation in health than is explained by other socioeconomic factors, even the absolute level of income” (Cheng, & Goodman, 2015). Data shows, that US is not an exception to this statistics.
Thus, the health care quality can vary according to SES. Nevertheless, some physicians insist that health care should be adopted to a patient’s socioeconomic circumstances. That will improve patient compliance and health outcomes in general. However, the inability to provide proper care and the conditions’ adaption should not be confused.
Obstacles to the Care Access
Among the obstacles witch aggravate access to proper health care one can name distance, time and costs. The majority of them are outcomes of the lower SES. Persons with a low SES are likely to delay or avoid seeking care because of not affordable spends. “Despite spending more on health care, Americans had poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions.” (Squires, & Anderson, 2015).
Opposite point of view declares that in general, US citizens have relatively few hospital admissions and physician visits per year, but they are greater users of expensive technologies like MRI machines. That is the reason why person gets better diagnostics and health care during the first visit. Nevertheless, such position does not explains high prices for the routine services, which do not require utilization of medical technology. Available cross-national pricing data proves the fact, that US health care bills are the world’s highest (p.4). At the same time, other research has shown that many doctors are confident that the financial and coverage restrictions faced by citizens with low SES, limit access to care and leads to worse health outcomes. (Long et al., 2015).
Financial challenged people also report on difficulties they faced in finding health care. The limited number of physicians and hospitals treating patients of low SES indirectly is a barrier itself. Patients have to spend hours to find hospitals that would cure them and sometimes they have to wait months for getting primary appointment. That is why emergency treatment is almost impossible for people with low SES.
Biases Towards People of Low SES
According to recent studies, physicians are likely to perceive low SES patients as more lazy, dependent, irresponsible, or irrational. They also believe that such patients are less likely to follow doctors’ advices and return for follow-up visits (Arpey, Gaglioti, & Rosenbaum, 2017). These biases manifest themselves in numerous diagnostic testings’ delays, prescribing more generic drugs and avoiding to recommend specialty care for the low SES patients versus other patients. As a result, financially challenged patients percept health quality as a lower and stop to be confident in the health system in general. They quit visiting physicians, who percept them as a “second-class people” and do not seek for better treatment elsewhere (p.172). Patients with a low SES also percept cheaper or generic medication as a less effective, than expensive well known or specific medications. Problem of unconscious biases should be taken under control by the state government. Measures to overcome patients’ discrimination and disbelief in medical care should be undertaken across the country.
Conclusion
People of low SES suffer from inequality in health care. They cannot get proper medical care in time and they suffer from unconscious biases towards them. Financially challenged people usually wait several months for the appointment of physician, cannot get needed tests and specific medications. Thus, despite of the fact that the U.S. stood out as a top investor in health researches and as a constant consumer of sophisticated medical technology, people with a low SES are more likely to get not sufficient health care because of unaffordable medical spends and prejudices among hospital personnel.
References
Arpey, N. C., Gaglioti, A.H., Rosenbaum M.E. (2017). How Socioeconomic Status Affects Patient Perceptions of Health Care: A Qualitative Study. Journal of Primary Care & Community Health. Vol. 8(3) 169–175. doi:10.1177/2150131917697439
Cheng, T. L., Goodman, E. (2015). Race, Ethnicity, and Socioeconomic Status in Research on Child Health. Pediatrics, Vol.135, 225-237. doi: 10.1542/peds.2014-3109
Fiscella, K., & Sanders, M. R. (2016). Racial and Ethnic Disparities in the Quality of Health Care. Annual Review Of Public Health, 37(1), 375-394. doi: 10.1146/annurev-publhealth-032315-021439
Long, B., Chang, J., Ziogas, A., Tewari, K., Anton-Culver, H., & Bristow, R. (2015). Impact of race, socioeconomic status, and the health care system on the treatment of advanced-stage ovarian cancer in California. American Journal Of Obstetrics And Gynecology, 212(4), 468.e1-468.e9. doi: 10.1016/j.ajog.2014.10.1104
Squires, D., & Anderson, C. (2015). US health care from a global perspective: spending, use of services, prices, and health in 13 countries. The Commonwealth Fund, 15, 1-16.
