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Healthcare Disparities: Uninsured, Rationing, and Unnecessary Procedures

Being uninsured increases the risk of mortality, while one-third of Americans face rationing of care and unnecessary medical procedures. Explore the impact of market forces and Medicare privatization on healthcare disparities.

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Healthcare Disparities: Uninsured, Rationing, and Unnecessary Procedures

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  1. Dr. Woolhandler has no financial conflicts of interest to report

  2. Being Uninsured Increases The Risk of Dying by Between 3% and 41%

  3. Many Specialists Won’t See Kids With Medicaid Bisgaier J, Rhodes KV. N Engl J Med 2011;364:2324-2333

  4. Rationing • One third of Americans are uninsured or underinsured • They are often denied care • They are sicker and die younger than the affluent and well insured

  5. Unnecessary Procedures

  6. How Market Force Shaped Which Hospitals Opened New Invasive Cardiology Programs Between 1996 and 2014 A competing hospital opening a program was a strong predictor of opening a new program. For-profit ownership was a strong predictor. Being a non-profit in a market dominated by for-profits was also a predictor. Lack of service availability in the community was a weak predictor. Source: NBER Working Paper W23530 - June, 2017 – N = ~315

  7. Rationing a Surplus 100s of 1000s of unnecessary procedures Excess capacity (for well-reimbursed services) Excess high-tech equipment Ubiquitous low-value/no-value care

  8. Medicare Privatization Increases Inequality, Costs and Profiteering

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