In this book Dr. Cooper argues that U.S. 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 U.S. 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.
Riding the A-train : income inequality and health care consumption along New York's subway lines -- Milwaukee : a microcosm of America's social and health care crisis -- Los Angeles : high health spending amidst wealth, poverty and complexity -- Boston versus New Haven : the big stir -- Health care costs of poverty : hands across the border -- A nation of nations : cultural foundations of health care -- Global perspectives : American exceptionalism in health care and social services -- States : communal resources and federal cross-subsidies -- The 30% solution : what you see depends on where you are standing -- Solution #1 : eliminate poverty! -- Solution #2 : looking within the health care system
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