scholarly journals Health insurance rights and access to health care for trans people: The social construction of medical necessity

2021 ◽  
Vol 55 (4) ◽  
pp. 539-562
Author(s):  
Anna Kirkland ◽  
Shauhin Talesh ◽  
Angela K. Perone
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Construction ◽  
Access To Health Care ◽  
Medical Necessity ◽  
Trans People ◽  
Access To Health ◽  
The Social

Participation as Inclusion and Exclusion: Policing the Boundaries of “Citizenship” in Roma Health Mediation

2019 ◽  
Vol 24 (3) ◽  
pp. 430-443
Author(s):  
Charlotte Kühlbrandt
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Social Inclusion ◽  
Participant Observation ◽  
Community Members ◽  
Access To Health ◽  
The Social ◽  
Roma Health ◽  
Governing Institutions ◽  
Improve Access

Participatory health interventions have long been advocated as an approach to help marginalised community members exercise their rights as citizens, including access to health care. More than two decades ago, the Roma health mediation programme was established in Romania as a participatory community health intervention. Mediators are employed specifically to act as intermediaries between ‘Roma patients’ and local authorities or health professionals, with the overall aim to increase trust and improve access to health care. Based on data gathered during a year of ethnographic fieldwork with Roma health mediators in Romania, including participant observation and interviews, this article analyses the social processes by which participatory approaches produce both social inclusion and exclusion. It illustrates how mediators exceeded their remit of health and attempted to discipline communities into forms of neoliberal citizenship. Mediators reframed access to health care not as a right that community members already have, but as a benefit that must be individually ‘earned’ through the fulfilment of neoliberal citizenship. The article argues that far from being an ‘empowering tool’, community participation can extend the power of governing institutions and thereby may in fact contribute to the maintenance of a political status quo that perpetuates the precarisation of marginalised communities.

Access to health care for people with multiple sclerosis

2007 ◽  
Vol 13 (4) ◽  
pp. 547-558 ◽  
Author(s):  
S.L. Minden ◽  
D. Frankel ◽  
L. Hadden ◽  
D.C. Hoaglin
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Access To Health Care ◽  
Prescription Medication ◽  
Population Based ◽  
Care Providers ◽  
Usual Source ◽  
Access To Health

The Sonya Slifka Longitudinal Multiple Sclerosis (MS) Study follows a population-based cohort of approximately 2000 people with MS to study demographic and clinical characteristics, use and cost of health services, provider and treatment characteristics, neurological, economic, and psychosocial outcomes. We examined key indicators of access to health care and found that the majority of participants had health insurance, a usual source of care, and access to specialty care. Nevertheless, 3.8% did not have health insurance which, with application of sampling weights, corresponds to approximately 7000 people with MS in the US population. Even with insurance, population-based estimates indicated that substantial numbers of people with MS have plans that pay nothing toward prescription medication, limit their access to specialists, and restrict their choice of hospitals and providers. Some 9% of the sample, corresponding to 15 800 people with MS, did not have a usual source of MS care; 11.8% or 17 300 people did not have a usual source of general health care; and 31% or 57 400 people did not see the specialists that they or their physicians wanted them to see. Further, 10.5% or 19 400 people reported difficulty obtaining prescription medication, 4.1% or 7600 people encountered obstacles accessing medical care, and 2.4% or 4500 people could not obtain the mental health services they needed. Finally, out-of-pocket health care expenditures were twice those found for the general population. Two-thirds of study participants (representing almost 70 000 people) chose their MS care providers because they were neurologists or MS specialists, creating a demand that almost certainly exceeds current supply. Multiple Sclerosis 2007; 13: 547-558. http://msj.sagepub.com

Inequality in access to health care, health insurance and the role of supply factors

2018 ◽  
Vol 213 ◽  
pp. 134-145 ◽  
Author(s):  
Meliyanni Johar ◽  
Prastuti Soewondo ◽  
Retno Pujisubekti ◽  
Harsa Kunthara Satrio ◽  
Ardi Adji
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Access To Health Care ◽  
Access To Health ◽  
Care Health

scholarly journals Health Care Access Among Essential Critical Infrastructure Workers, 31 States, 2017-2018

2021 ◽  
pp. 003335492199668
Author(s):  
Winifred L. Boal ◽  
Jia Li ◽  
Sharon R. Silver
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Personal Health ◽  
The Past ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Objectives Essential workers in the United States need access to health care services for preventive care and for diagnosis and treatment of illnesses (coronavirus disease 2019 [COVID-19] or other infectious or chronic diseases) to remain healthy and continue working during a pandemic. This study evaluated access to health care services among selected essential workers. Methods We used the most recent data from the Behavioral Risk Factor Surveillance System, 2017-2018, to estimate the prevalence of 4 measures of health care access (having health insurance, being able to afford to see a doctor when needed, having a personal health care provider, and having a routine checkup in the past year) by broad and detailed occupation group among 189 208 adults aged 18-64. Results Of all occupations studied, workers in farming, fishing, and forestry occupations were most likely to have no health insurance (46.4%). Personal care aides were most likely to have been unable to see a doctor when needed because of cost (29.3%). Construction laborers were most likely to lack a personal health care provider (51.1%) and to have not had a routine physical checkup in the past year (50.6%). Compared with workers in general, workers in 3 broad occupation groups—food preparation and serving; building and grounds cleaning and maintenance; and construction trades—had significantly lower levels of health care access for all 4 measures. Conclusion Lack of health insurance and underinsurance were common among subsets of essential workers. Limited access to health care might decrease essential workers’ access to medical testing and needed care and hinder their ability to address underlying conditions, thereby increasing their risk of severe outcomes from some infectious diseases, such as COVID-19. Improving access to health care for all workers, including essential workers, is critical to ensure workers’ health and workforce stability.

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