Poverty and the Myths of Health Care Reform

Poverty and the Myths of Health Care Reform

by Richard (Buz) Cooper
Pub. Date:
Johns Hopkins University Press


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Poverty and the Myths of Health Care Reform

In Poverty and the Myths of Health Care Reform, Dr. Richard (Buz) Cooper argues that US poverty and high health care spending are inextricably entwined. Our nation’s health care system bears a financial burden that is greater than in any other developed country in large part because impoverished patients use more health care, driving up costs across the board.

Drawing on decades of research, Dr. Cooper illuminates the geographic patterns of poverty, wealth, and health care utilization that exist across neighborhoods, regions, and states—and between countries. He chronicles the historical threads that have led to such differences, examines the approaches that have been taken to combat poverty throughout US history, and analyzes the impact that structural changes now envisioned for clinical practice are likely to have. His research reveals that ignoring the impact of low income on health care utilization while blaming rising costs on waste, inefficiency, and unnecessary care has led policy makers to reshape clinical practice in ways that impede providers who care for the poor.

The first book to address the fundamental nexus that binds poverty and income inequality to soaring health care utilization and spending, Poverty and the Myths of Health Care Reform is a must-read for medical professionals, public health scholars, politicians, and anyone concerned with the heavy burden of inequality on the health of Americans.

Product Details

ISBN-13: 9781421420226
Publisher: Johns Hopkins University Press
Publication date: 07/08/2016
Pages: 304
Sales rank: 727,328
Product dimensions: 6.20(w) x 9.00(h) x 1.00(d)
Age Range: 18 Years

About the Author

Richard (Buz) Cooper, MD (1936–2016), was a senior fellow at the University of Pennsylvania’s Leonard Davis Institute of Health Economics, the dean and executive vice president of the Medical College of Wisconsin, where he founded the Institute for Health and Society, and the cofounder and director of the University of Pennsylvania Cancer Center.

Table of Contents

Preface ix

Acknowledgments xiii

Introduction 1

1 Riding the A Train: Income Inequality and Health Care Consumption along New York's Subway Lines 15

2 Milwaukee: A Microcosm of America's Social and Health Care Crisis 24

3 Los Angeles: High Health Care Spending amid Wealth, Poverty, and Complexity 41

4 Boston versus New Haven: The Big Stir 58

5 Health Care Costs of Poverty: Hands across the Border 72

6 A Nation of Nations: Cultural Foundations of Health Care 89

7 Global Perspectives: American Exceptionalism in Health Care and Social Services 112

8 States: Communal Resources and Federal Cross-Subsidies 135

9 The 30% Solution: What You See Depends on Where You Are Standing 156

10 Solution #1: Eliminate Poverty! 181

11 Solution #2: Looking within the Health Care System 208

References 239

Index 279

What People are Saying About This

Mary O. Mundinger

Cooper has laid out with strong science and impassioned eloquence the profound influence of poverty and its social consequences on the utilization of health care services. Every clinician will benefit from reading this book in order to provide—and advocate for—the scope of interventions necessary for effective care.

Carol Underwood

Cooper makes the centrally important argument that socioeconomic factors underlie high health care utilizations and costs, leaving people living in poverty vulnerable to poor health, high levels of hospitalization and readmission, and limited life prospects. Approaching the problem from multiple angles, this book is an important contribution to policy, scholarship, and the lives and livelihoods of Americans.

Lillian Thomas

From a ride through New York's crazy quilt of neighborhoods, to a tour of Milwaukee's poverty corridor, to the skillful shredding of academic studies, Buz Cooper makes a compelling case that high health care costs and poverty are inextricably linked. Poverty and the Myths of Health Care Reform is both accessible and authoritative.

Mark V. Pauly

Experts say that there are two main problems with the American health care system: the care is ineffective and expensive, and not everyone has equal access to it. This important book breaks this logical contradiction. This intricate analysis shows that the problem is poverty, not inefficiency.

Michael Whitcomb

A highly sophisticated and powerful analysis of the relationship that exists between poverty and the aggregate cost of health care in this country, this book stands alone in explaining the relationship that exists between the level of poverty and the inexorable rise in health care costs. The book should be required reading.

H. Jack Geiger

The great virtue of this compelling book about the problems of the American healthcare system is its relentless focus on one root cause that is external to that system: poverty and the unequal distribution of income and wealth. Throughout our history we see that the poor are likelier to be sick, the sick are likelier to be poor, and, without intervention, the poor inevitably grow sicker and the sick inevitably grow poorer. These truths distort healthcare access, costs, and quality. While others argue that poverty is not the only cause of our healthcare problems, Cooper argues that no solution that ignores poverty will work.

Michael M.E. Johns

An extremely important, brilliantly told story that, if understood by more people, would bring major changes to our health care system by improving medical care and reducing costs.

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