Study Finds Universal Coverage Could Reduce Health Disparities

New America Media, News Report, Paul Kleyman, Posted: May 01, 2009

Medicare for all -- not only for those 65 and over -- appears to be the answer to dramatically reducing the level of poorer health among African American, Latino and low-income Americans, say researchers at Harvard University in research published in the April 21 issue of the Annals of Internal Medicine.

Their research team, led by J. Michael McWilliams, M.D., Ph.D., sifted through medical data for 6,000 people ages 40 to 85 with diabetes or cardiovascular disease. They tracked their conditions from 1999 to 2006.

The researchers found that despite overall improvements in controlling the diseases, black, Hispanic and poor patients under 65 -- those not yet old enough for Medicare -- fared no better, or got worse.

However, at age 65, when people become eligible for Medicare coverage, the differences in health by race, ethnicity, and socioeconomic status declined significantly.

McWilliams and his colleagues note American healthcare providers have engaged in widespread efforts in recent years to enhance medical quality. “However,” they wrote, “quality of care may not necessarily lead to more equitable care, especially if improvements occur among providers who serve fewer disadvantaged patients . . ..”

The researchers emphasize that their findings echo earlier studies, such as one published in 2008 that showed that eliminating racial differences in blood pressure might save the lives of 7,500 African American adults each year.

McWilliams and his coauthors points to universal health care coverage as a likely means of reducing health disparities in the United States. They conclude that “expanding insurance coverage before age 65 years may reduce racial, ethnic and socioeconomic differences in important health outcomes” for those coping with diabetes and cardiovascular conditions.

The study is available online from The Commonwealth Fund, which sponsored the research, at http://www.commonwealthfund.org/Content/Publications/In-the-Literature/2009/Apr/Differences-in-Control-of-Cardiovascular-Disease.aspx






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