Also worth considering: the job losses resulting from loss of access to care- particularly along disabled and chronically ill persons. Many workers in the US are not covered by employer plans, so their access to health insurance is contingent upon the enforcement and enactment of the Affordable Care Act, which also includes Medicaid expansion at the state level.
In the context of ideologies that eschew government policies that benefit vulnerable populations, Medicaid poses a challenge to state governments. For one, its costs (partially funded by state governments) are higher when unemployment is highest and tax revenues are lowest. For this reason, among others, many states have not expended Medicaid under the PPACA. These states are also states with the highest proportions of disabled people, which is related to the 1996 Personal Responsibility and Work Opportunity Reconciliation Act, signed by Clinton, which placed limits on the benefits that eligible persons could receive. For many, it was more feasible to wait 2 years to become eligible for SSI and become dual eligible for Medicaid and Medicare.
Nationally, the number is 2.6 million jobs lost over the next 3 years
One area of forecasted job losses is auxiliary healthcare positions- social workers, community health workers whose services are not covered under health insurance, but are nontheless necessary for hospitals’ and medical centers’ compliance with provisions in the PPACA- particularly pertaining to Medicare readmissions.
“In a survey of 222 white medical students and residents, about half endorsed false beliefs about biological differences between blacks and whites. And those who did also perceived blacks as feeling less pain than whites, and were more likely to suggest inappropriate medical treatment for black patients, according to the paper published in the Proceedings of the National Academy of Sciences.”
“In a recent article in the Journal of the American Medical Association, Williams, along with colleague Ronald Wyatt, cited a 2003 Institute of Medicine report that labeled widespread “implicit bias” for differences in the care that African-Americans and other minorities receive. They said that substandard care leads to an estimated 260 premature African-American deaths each day.”
Black children brought to the ER for stomach pain and cramps were less likely to be prescribed pain medications than white children with the same complaints- speaks to the ways that racism structures healthcare disparities, and the way that the medicalization of Black (and brown) bodies has served to further deny our lived experiences and capabilities to feel pain.
This is an oldie but a goodie that highlights a reality that has been affirmed by recent studies in social science and medical practice.
Alumna of the University of California, Berkeley & the University of Chicago, University of Illinois at Urbana Champaign.
Assistant Professor at the Department of Health Policy and Management in the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill.
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