Year: 2005
Type: article
Abstract: What is the health-care safety net in the United States, why is it necessary, how did it arise, and what is its future?In this issue, Jacobson, Dalton, and Berson-Grand (2005) present a picture, within one state, of the current challenges faced by the safety net, which they define as ''those organizations and programs, in both the public and private sectors, with a legal obligation or a commitment to provide direct health care services to uninsured and underinsured populations.''The researchers have used qualitative methods to collect and to analyze data from interviews with representatives from a spectrum of safety net organizations.The article conveys a convincing overview of the chronic crisis that such organizations endure.While the study focuses on selected organizations within one state only, those who work in safety net organizations throughout the United States will recognize that problems in Michigan resemble those of many other organizations that try to serve the underserved, especially in poor and minority communities.On the other hand, readers based outside the United States may become surprised by these troubles of the U.S. safety net.Among economically developed countries, such difficulties arise only in the United States.All other developed countries have enacted national health programs that assure universal entitlement to health-care services.These national health programs do not completely eliminate access barriers.For instance, several countries have not corrected the barriers rooted in geographic isolation of rural communities.Moreover, universal entitlement does not eliminate social class and ethnic/ racial disparities in health-care outcomes, which derive more from socioeconomic hierarchies than from inaccessible services (Waitzkin 2001;Bodenheimer and Grumbach 2002;Isaacs and Schroeder 2004;Navarro 2004).The Michigan study, however, will add to the voluminous literature, over at least three quarters of a century, which demonstrates an urgent need for a national health program in the United States (Himmelstein and Woolhandler 2001; Waitzkin 2001;LeBow 2003).
Source: Health Services Research
Author: Howard Waitzkin
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: bronze
OpenAlex ID: W1942906308