Racial, Socioeconomic Health Disparities Erased by
Medicare; U.S. Needs Universal Coverage
Improving the quality of care without improving
access to care does not seem to reduce gaps
April 21, 2009 - Obtaining Medicare coverage is
associated with significant reductions in racial, ethnic, and
socioeconomic health disparities in adults with diabetes and
cardiovascular disease according to a new Commonwealth Fund-supported
study in todays Annals of Internal Medicine.
The study, by J. Michael McWilliams and colleagues
at Harvard University, points to universal coverage as a possible means
of reducing these types of health disparities in the general population.
The authors reviewed health data from more than
6,000 people aged 40 to 85 with diabetes, high-blood pressure, and high
cholesterol. They found that while overall improvements have been made
in controlling the diseases, racial, ethnic, and socioeconomic
differences have remained the same or in some cases worsened in the
pre-Medicare population.
However, at age 65 when people become eligible for
health care coverage under the Medicare program, differences in health
by race, ethnicity, and socioeconomic status were reduced significantly:
● For systolic blood pressure, racial
disparities decreased by 60 percent
● For blood sugar levels with diabetes,
educational disparities decreased by 83 percent, while racial and ethnic
disparities fell by 78 percent
● For total cholesterol levels, educational
disparities disappeared altogether
Improving the quality of care without improving
access to care does not seem to reduce gaps in the outcomes experienced
by different racial and ethnic groups, according to the results of this
study.
All racial or ethnic groups get better to the same
degree. On the other hand, providing universal access to health
insurance seems to narrow gaps in care that minority racial and ethnic
groups receive.
The findings imply that to narrow gaps in the
outcome of health care that minority racial and ethnic groups receive,
the United States will have to provide universal access to health care.
The results of this study make it clear that
guaranteeing access to affordable insurance for all Americans is the
essential first step toward a high performing health care system and a
healthier America, said Commonwealth Fund President Karen Davis.
As our leaders look toward health reform it is
critical that they take into account the value of health care coverage
for everyone and assure that all Americans have the ability to obtain
insurance for themselves and their families.
