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New Report Notes Wide Disparities in U.S. Health Care

WebMD Health News

Feb. 15, 2000 (Washington) -- When it comes to health care, all Americans are not created equal, at least according to a disturbing new report from the American Association of Retired Persons (AARP). The 273-page document, called "Reforming the Health Care System: State Profiles 1999," is a snapshot of public and private health insurance programs. Comparing 100 key indicators, it points out some glaring discrepancies, particularly along financial lines.

In fact, some of the differences could make a life or death difference. "I think it's an awesome thought to conclude that where you live might so powerfully affect not only your lifestyle, your health, but also how many years you have left," says John Rother, AARP's director of legislation and public policy.

Among the findings: The death rate from heart disease is more than twice as high in Mississippi as it is in Minnesota. While the average employee health insurance contribution was just $757 in Michigan, a person in Florida might have to kick in $2,165 to get coverage. Where you live also determines how likely you are to go to the doctor, says the report. In Wisconsin, just 6% deferred a doctor visit because of cost, but in Arizona a whopping 25% postponed medical care because they couldn't afford it.

"Low income among older persons is often associated with unmet medical needs because of the burden of out-of-pocket expenses," says Jo Ann Lamphere, DrPH, who is lead author of the AARP report. Even though Medicaid is designed to helpthe poor, the analysis says that low-income people are often short-changed by the Medicaid program. In Nevada, for instance, just 26% of the poor have Medicaid coverage, while the number rises to 61% in the District of Columbia, the highest in the nation.

Because each state creates its own Medicaid program in partnership with the federal government, there are bound to be differences -- but some of them are glaring. Only in 11 states do disabled and very poor elderly get full Medicaid benefits.

There are also some striking state-by-state differences in Medicare payments. While the U.S. average is $5,416, in North Dakota the amount is only $3,650. In Los Angeles, the typical Medicare payment is nearly $7,000.

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