Posting date: December 6, 2005

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Health Affairs, 10.1377/hlthaff.w5.566
Copyright © 2005 by Project HOPE

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A Widening Rift In Access And Quality: Growing Evidence Of Economic Disparities

¹ Bob Hurley is an associate professor in the Department of Health Administration, Virginia Commonwealth University, in Richmond.
² Hoangmai Pham is a senior health researcher at the Center for Studying Health System Change (HSC) in Washington, D.C.
³ Gary Claxton is a vice president at the Henry J. Kaiser Family Foundation in Washington, D.C. Hurley and Claxton are senior consulting researchers at HSC.

^*Corresponding author.

Abstract

Data from the Community Tracking Study provide a valuable perspective from which to observe how economic disparities--largely a function of different sources of coverage--influence access to medical care in the United States. Many recent investments and initiatives are focused on affluent communities and are accessible mainly to people with employer-based or Medicare coverage. For people with Medicaid or no coverage at all, access to basic care is worsening, as a result of stalled coverage expansions and service cutbacks. An improving economy could forestall further cuts and permit reversal of earlier ones, but progress in closing this rift does not appear imminent.

Key Words: Access To Care, Business Of Health, Consumer Issues, Health Reform, Insurance Coverage, Quality Of Care, Health Spending

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