If you had an extra health care dollar, would you spend it on improving health care treatment or improving access to health care? Historically, access to health care has lost this fight. It isn’t even close — it has been reported that ten times as much is spent on health care treatment than health care access (Steven Woolf keynote entitled “Consequences of Health Disparities” at the 2007 Social Equity Leadership Conference).
The New York Times reports that the American Cancer Society plans to use their entire $15 million ad budget to promote broad problems associated with access to insurance and care (instead of encouraging people to quit smoking and getting colonoscopies). The uninsured are less likely to receive routing cancer screenings and are more likely to be diagnosed when the cancer has advanced. It is hard to know when to even receive cancer screenings when not seeing a doctor for regular checkups (another problem with the uninsured). “I believe, if we don’t fix the health care system, that lack of access will be a bigger cancer killer than tobacco,” Cancer Society chief John R. Seffrin told the New York Times. Read the Wall Street Journal blog on this topic.
Whether we like it or not, the US health care system has large disparities in access to health care, and these equity discrepancies have not always been addressed with as much rigor as providing new medical treatments. This issue is important since Americans receive only 55% of recommended medical treatments.
This is a reminder that using operations research to make systematic improvements of health care systems may fall short of what we could accomplish if we look at the big picture.