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Health Care and Urban Poverty

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In her analysis of the provision of health care services to a black family living on the edge of poverty in urban Chicago, Laurie Kaye Abraham notes that at least thirty-five million Americans do not have any form of health insurance (34). The reason for the lack is the United States' failure to provide a basic level of health care to all its citizens. It is the only industrialized nation, with the exception of South Africa, to fail to do so (Abraham 34). Instead, the American health care system for people who cannot afford commercial insurance or who do not receive insurance from their employers is a patched together system of state and federal programs that are attended by the inevitable service gaps and inconsistencies (Abraham 53). The case of the Banes family, and Mrs. Jackson, the matriarch, in particular is instructive of the system's problems.

The current patchwork system does not sufficiently stress the need for good preventive care. Every effort must be made to detect and treat health problems at the earliest possible stage of illness. Currently, age-old communicable diseases such as tubercolosis, sexually transmitted diseases, and childhood measles still plague Chicago's poor in disproportionate numbers (Abraham 18). In many cases these diseases may not be life-threatening, but they can lead to more expensive treatments if not caught early enough. The cycle must be broken at some point if the system is ever to be run in an

. . .
ndation grant for that purpose in 1984 but was rejected. Thus, though Medicare covers both rich and poor, poor people such as Mrs. Jackson are much more vulnerable to its shortcomings (Abraham 49). For example, Medicare reimbursement pays a set fee for each patient according to diagnosis, regardless of the length of the hospital stay (Abraham 79). Officials at the Health Care Financing Administration (HCFA), which administers Medicare, charge that many centers compromise patients' care by reducing staff and shortening treatment times to increase their profit (Abraham 35). In addition, more affluent elderly people often retire with supplementary health insurance from their employers or buy "Medigap" policies that cover the care Medicare does not. Mrs. Jackson could not afford Medigap insurance and she would be barred from coverage by her "pre-existing" medical conditions anyway (Abraham 49). Abraham notes that Medicaid also suffers from a host of problems. Generally, Medicaid's pay rates to health care providers are so low few doctors practice in poor neighborhoods (Abraham 172). Consequently, mothers often cannot find doctors for their children. In addition, the lack of doctors usually means Medicaid patients are concen
. . .

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Approximate Word count = 1314
Approximate Pages = 5 (250 words per page)

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