“The Determinants of Unequal Access to Health Care in the United States, and the Consequences for Health Inequality”
Though average life expectancy has increased from 68 years of age in 1950 to 79 years of age in 2015, inequality in life expectancy remains high in the United States, especially compared to other developed countries (Eggleston & Fuchs, 2018). Across age groups, inequality in life expectancy among infants and children has decreased, but inequality in life expectancy among older adults has increased (Currie & Schwandt, 2016). Moreover, most of the recent gains in life expectancy come from medical advancements that treat conditions that occur in middle age and at the end of life, rather than in early life (Eggleston & Fuchs, 2012). This presentation will explore how changes in the U.S. health care system in recent years have affected access to care for different populations, and how differential access to care has contributed to inequality in life expectancy and other health outcomes. I will discuss the access-to-care problems that occurred prior to the Patient Protection and Affordable Care Act (ACA), how the ACA addressed those problems, and the ongoing challenges associated with getting people access to high-quality care in the US. The presentation will focus on the importance of health care provider quality – what it means, how it’s measured, and whether unequal access to high-quality care, rather than any care, is likely to drive health inequality in the future. In the presentation, I will draw upon other scholars’ research as well as my own. I will conclude with a set of policy recommendations aimed at reducing unequal access to high-quality care.
Jessica Van Parys is an Assistant Professor of Economics at Hunter College, CUNY. She received her PhD in Economics from Columbia University in 2015 and completed a post-doctoral fellowship at the Dartmouth Institute for Health Policy and Clinical Practice in 2016. Her research focuses on inefficiencies in the American health care system. One strand of her research shows how competition in health care markets affects patients, while another strand of her research shows how differences in provider practice styles explain variation in health care utilization and outcomes across patients. This year, as a participant in the Advanced Research Collaborative, she is researching how physician career trajectories contribute to inequality in access to high-quality health care.