Published 11/6/16 in the Bangor Daily News
By Barbara Leonard, President & CEO
Being young or poor shouldn’t equate to being sick or being forced to skip needed medical care, but too often it does. And many Maine adults, of all income groups, have trouble paying their medical bills.
A new report from the University of Southern Maine and the Maine Health Access Foundation shows that income, age and education are all closely tied to a person’s ability to see a doctor when she’s sick or hurt, to take medicine as prescribed and to access preventative check-ups and screenings.
The results are predictable and supported by many other studies. Without proper care, the young and poor are sicker, and they have worse long-term health outcomes than they should. And the cost of health care has risen to the point that all income groups struggle to cover health care costs.
At the Maine Health Access Foundation, our mission is to promote access to quality health care, particularly for people who are uninsured, and improve health for all Mainers.
We work in communities and statewide with nonprofit partners and public and private sector leaders to advance policies that help to break down the barriers that keep people from accessing the health care that they need. Each year, we provide about $4 million in grant and program funding to accomplish those goals.
We wanted to better understand the issues that keep people from getting the care they need, which is why we undertook this important analysis with the University of Southern Maine.
Using data from 2012-2014, we examined the disparities in health care among Maine adults ages 18-64. We found that there is significant inequality in access to health care associated with income.
Adults with household incomes of $25,000 or less are more than twice as likely not to have a family doctor than families with incomes of $50,000 or more. They are three times more likely to delay seeking needed health care because of cost. And they are five times more likely to be unable to afford prescription medicine. Unsurprisingly, adults with household incomes of $25,000 or less also are five times more likely to be uninsured as than their better-off neighbors.
But the problems of accessing health care and its cost aren’t limited just to families with low incomes. Our research found that young adults also have trouble getting the care they need and affording health insurance, and that all families — even those making $50,000 or more — have difficulty paying medical bills.
Young adults, particularly those between the ages of 25 and 34, are more likely to lack routine health care or to have put off needed care due to cost. And nearly 1 in 4 below age 34 don’t have a regular doctor. The rate of being uninsured for these same young adults is almost double that of adults aged 35-64.
Regardless of age and income, the cost of health care is putting financial strain on most Mainers. Nearly 30 percent of families with household incomes of less than $50,000 reported having to pay their medical bills over time. The same is true for 1 in 5 families with incomes of more than $50,000.
Our analysis shows the devastating inequality access to health care for people in Maine. If you’re young, have a low-income, lack formal education, or are a racial or ethnic minority, then health care has become a luxury that you struggle to afford. To make improvements that help people to live better, healthy and happier lives, we have to change the way we approach health care delivery.
That requires increasing access to affordable health insurance coverage and health care, with a strong and consistent focus on preventive care. We also have to strengthen social supports in communities to break down barriers to care and to help fill the gaps in health care access, especially for people who lack insurance.
We can get there, but it will require commitment from policymakers and community leaders and a rethinking of how we provide health care that focuses more on strategies that promote a comprehensive approach to good health. Maine’s innovations in patient-centered medical homes, integration of behavioral health with primary care and linkages between health and social services are positive steps.
We need to make sure these improvements benefit all families, no matter if they have the most education or the best-paying jobs.
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