The Poverty Syndrome

Hospitals know them as the sizable and growing self-pay population. Many well heeled Americans refer to them as deadbeats, hangers-on, or freeloaders. Some collection agencies see them as a potential source of revenue. “They” might be identified as uninsured Americans, but that is largely a symptom of an underlying affliction.

They are America’s poor.

According to Dr. Otis Brawly, Chief Medical Officer for the American Cancer Society, in today’s Atlanta Journal-Constitution, “Insurance versus non-insurance is a great marker for people who are socially deprived or poor.”

The findings of a major ACS study released today show that cancer patients with private insurance are much less likely to be diagnosed with late-stage cancers than those who lack insurance. The broad study of 3.5 million patients with 12 common types of cancer also found that many of those advanced-stage diseases could have been discovered by appropriate early screening methods.

The notion that insured patients statistically seek care earlier, have access to more care, and ultimately live longer than uninsured patients is perhaps not earth shattering. But it highlights a false dichotomy in the rhetoric that surrounds the U.S. healthcare crisis.

Uninsured Americans, many of whom are poor—or the American poor, many of whom are uninsured—not only lack insurance. In most instances they lack basic heath information, reliable and convenient modes of transportation, and jobs that afford them the benefit of leave time to visit a doctor’s office. Circumstances like these that impede adequate medical care are conditions of poverty often ignored in an “insured v. uninsured” assessment of healthcare in America. Thus, Dr. Brawly notes, “While giving people insurance would improve things, it will not improve everything.”

If that weren’t enough, findings recently presented at the American Association for the Advancement of Science found that “many children growing up in very poor families with low social status experience unhealthy levels of stress hormones, which impair their neural development.” In short: poverty affects biology. The result is that the poor stay poor.

Now reinsert the corollary absence of health insurance for this population and the grim cycles repeat themselves.

In this election year, Americans are talking about things that matter to them. The economy and healthcare are high on voters’ lists of priorities, and politicians have been quick to fall in step with their supporters’ concerns.

But eloquent proposals for universal health coverage and quick tax rebates aren’t going to solve poverty in America. The question is—can will we ever solve “the economy” and “healthcare” without first addressing poverty