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Medicaid and access to health care--a proposal for continued inaction?

机译:医疗补助和获得医疗服务-关于继续不作为的建议?

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Since Medicaid was enacted in 1965, its coverage guarantee for millions of the poorest Americans has faced a substantial vacuum in actual access to health care. Multiple factors contribute to this problem: severe shortages of physicians and hospitals in many low-income inner-city and rural communities; low rates of participation in Medicaid among available providers, owing to low payment rates; state administrative practices that drive providers away; and the economic, clinical, educational, and cultural characteristics of Medicaid beneficiaries. Where they are operating, federal programs such as community health centers, federally funded family planning agencies, the National Health Service Corps, local public health agencies, and public and children's hospitals help to mitigate the situation. But thousands of U.S. communities lack such programs, and even where they do exist, they don't address the specialized long-term care needs of beneficiaries with severe disabilities.
机译:自1965年制定医疗补助计划以来,数百万最贫困美国人的医疗保障范围在实际获得医疗保健方面面临着巨大的真空。造成这一问题的因素多种多样:许多低收入城市和农村社区的医生和医院严重短缺;由于付款率低,现有提供者参与医疗补助的比率低;陈述将提供者拒之门外的行政惯例;以及医疗补助受益人的经济,临床,教育和文化特征。在他们开展业务的地方,诸如社区卫生中心,联邦政府资助的计划生育机构,国家卫生服务队,地方公共卫生机构以及公共医院和儿童医院等联邦计划有助于缓解这种情况。但是成千上万的美国社区缺乏这样的计划,即使存在,他们也无法满足严重残疾受益者的长期专业护理需求。

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