No big surprises here, but a Rocky Mountain News article today reports that Colorado residents who live in poverty are more likely to get cancer and more likely to die from it than Coloradans who live above the poverty level.
There are lots of factors involved: less education, higher rates of tobacco use and obesity, and less access to transportation (which makes it harder to get to screenings and medical appointments). Then of course there’s the health insurance issue. People with Medicaid are more likely to be diagnosed with cancer when it’s in an advanced stage, and people without health insurance are also more likely to die from cancer than their insured neighbors. And those living in poverty or near it (in Colorado and just about everywhere else) have a pretty good chance of either being covered by Medicaid or uninsured. For a Medicaid recipient who doesn’t have a car and lives 40 miles from the nearest doctor who accepts Medicaid, realistic access to health care is pretty limited. The same is true for someone who doesn’t have health insurance at all. There may be plenty of doctors nearby who screen for cancer, but if money is tight, putting food on the table is likely to come before a colonoscopy in the family’s priorities.
It’s true that there are aspects of choice in all of this, but there’s a lot that is beyond the control of the individuals affected. Medicaid was enacted to try to provide health care for Americans who live in poverty, but it’s not a perfect system. And when people don’t have any money at all, just getting to the doctor can be a challenge – even if Medicaid will pick up the tab. Perhaps our focus should be on eradicating poverty instead of trying to provide state-funded health insurance to those who struggle to pay for basics like food and heat. When people have to worry about coming up with money to pay for the basic necessities, it’s easy to see how cancer screenings could get pushed to the back burner.
There are lots of ways to improve on the cancer statistics for impoverished Colorado residents. Expanded low-income health insurance coverage, more free screenings, state-provided transportation to hospitals, child care for parents battling cancer, etc. But some overall changes in our tax and employment systems to “spread the wealth” might be a better place to start. This idea was roundly mocked by Joe the Plumber and his buddies during the election, but reducing the number of Americans living in poverty benefits all of us. We all pay for Medicaid in our taxes, and when hospitals treat impoverished patients who don’t have health insurance, we all pay in the form of increased health care prices (the hospitals have to cover the costs somehow). Eradicating poverty doesn’t just benefit those who currently live in its grips.