0
Invited Critique |

Health Care Reform and Access: Will It Work?:  Comment on “Equal Access to Care Eliminates Racial and Socioeconomic Disparities in the Treatment of Appendicitis in Patients With Equal Health Care Access”

John H. T. Waldhausen, MD
Arch Surg. 2011;146(2):161. doi:10.1001/archsurg.2010.312.
Text Size: A A A
Published online

Extract

The article by Lee and colleagues hypothesizes that universal health insurance coverage for their patient population eliminates racial and socioeconomic disparities in access to care. In the current debate on health care reform, this is an important topic since the findings in this article might be extrapolated to suggest that universal coverage of the US population may have significant, demonstrable health care and cost benefits. One must be careful, however, in taking the conclusions of this article too far; further research, which the authors are conducting, is needed. The annual median household incomes examined may not be separated enough to determine any real differences in the defined groups because people at the income levels chosen may face similar problems with loss of income from time off their jobs, as addressed in the article. In southern California where the cost of living is one of the highest in the United States, the income levels may not adequately reflect differences in a family's access to outside resources when coping with a sick family member. The study is limited in that it deals only with adults and it is not clear whether the same findings will be noted in children. In addition, it is not clear whether the Kaiser Permanente patient population base in southern California can be extrapolated to be used as a surrogate for the entire US population. Recognition of these limitations, however, does not minimize the potential importance of this article. If further study substantiates the findings, this will add evidence that universal coverage and health care reform are not only beneficial for society but may also be associated with health care cost savings by dealing with illness early in its course rather than later when it has become more difficult, complex, and costly to treat.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Acute Appendicitis

The Rational Clinical Examination
Make the Diagnosis: Appendicitis, Adult