Does Wealth Equal Health in America?

June 26, 2009 05:30 PM
by Sarah Amandolare
Some say Steve Jobs' liver transplant indicates that wealth equals better health care. What's the answer to bridging the "health gap" in America?

The High Price of Health Care

Steve Jobs, CEO of Apple, received a liver transplant at a Memphis hospital. According to Marilynn Marchione, writing for the Associated Press, it's against federal law to buy an organ transplant and there's no evidence to suggest that the doctors who treated Jobs "bent any rules to show him favor." But the fact that Jobs could afford to travel to a transplant program with a shorter waiting list, both for preliminary evaluation and again when a liver became available, indicates his wealth did influence the situation.

According to Marchione, the online Scientific Registry of Transplant Recipients provides "average wait times, success rates and other details on every transplant program in the nation." The system allowed Jobs, whose home is in Palo Alto, Calif., to find a short waiting list in Tennessee. "It is even conceivable," reported The New York Times, for a patient to take the time and pay the money to register for "the waiting lists of several transplant centers around the country."

Citizens continue to seek the truth behind the numbers. Karen Sternheimer of Everyday Sociology debunked a December 2008 article in Self magazine that ranked the healthiest cities in the U.S., based on factors like prenatal care and cancer. Sternheimer noticed that the healthiest localities also happen to be wealthy.

"Low-income communities are notorious for lacking large grocery stores stocking healthy choices like produce," she wrote. In addition, those who live in the "'unhealthy cities' also experience higher rates of racial/ethnic segregation." And highly segregated areas "often provide fewer basic services like health care for residents," Sternheimer wrote.

Although Jobs' case raises questions "about the system for allocating scarce organs to the many people who need them," as The Times pointed out, the looming question remains: How can we fix the disparity in American health care?

Opinion & Analysis: Evaluating public vs. private health care

Ed Leefeldt of BNET, addressing the "health gap" that exists between rich and poor in the United States, pointed out that universal care is hardly a foolproof option. Even in Canada and Great Britain, where the universal care system is in place, "those who can afford it buy private insurance to avoid long waits, minimal care," and other negative aspects of the system, such as denials for surgery. 

But in the U.S., wrote Ezra Klein of the Los Angeles Times, "we've got waiting lines too," plus tens of millions of uninsured people and the most expensive system, by far, of any country in the world. Remarkably, Klein reported, surveys by the Organization for Economic Cooperation and Development found neither long lines nor uninsured people in most countries, including Germany, France, Sweden and Japan, "all of which have more of a mix of public and private options."

Background: The pitfalls of universal care

In Canada, universal health care has not necessarily diminished the gap in quality of care. According to a 2000 study by the University of Toronto, reported by Science Blog, "Canadians with higher incomes and more years of schooling have significantly greater access to specialized health services."
France, which features a combination of private and public care, seems to sail above most of the problems faced by Americans, Canadians and Brits.

According to Enlightened Belle, a blogger on Open Salon, France's health care system is mainly government-funded, but requires employers to offer employees a choice of "heavily regulated private healthcare insurers." Additionally, the unemployed, pregnant women, children, retirees and anyone with cancer or a hearth condition "are covered 100% by the government."

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