Immigrants do not push up US healthcare costs, study shows
http://www.100md.com
《英国医生杂志》
Immigrants in the United States receive about half as much medical care as their native born counterparts, a study reports. Immigrants spend an average of $1139 ($640) a year in health care, whereas US born residents spend $2564.
The study found that Asian immigrants had healthcare expenses similar to those of US born people and that the biggest gap in spending was among Latino and black people (American Journal of Public Health 2005;95:1431-8).
The authors, who presented the study as the first nationwide analysis of immigrants?healthcare expenditure, based their research on data for 1998 from official health and income statistics kept by the Agency for Healthcare Research and Quality, a federal agency that generates health statistics and data for the US government. The data covered 21 241 people.
In total, immigrants accounted for $39.5bn in healthcare expenditure. After multivariate adjustment, the total healthcare expenditure of immigrants was shown to be 55% lower than that of US born people. Similarly, expenditure among uninsured and publicly insured immigrants was about half that of their US born counterparts.
Of the $39.5 billion, about $25bn was reimbursed by private health insurers, $12bn was reimbursed by government programmes, and the remaining just under $3bn was paid out of their pockets.
Latino immigrants on average spent $962 each on health care in 1998, compared with $1870 for native-born Latino Americans. The corresponding figures for black people were $1030 and $2524 and for white people $1747 and $3117.
In all, 25% of immigrants lacked health insurance in 1998, compared with 10% of native born residents.
Average healthcare expenditure was 74% lower on immigrant children than on US born children. However, spending on visits of immigrant children to emergency departments was more than three times higher than that on US born children. Immigrant children were also much more likely than US born children to be uninsured (29% versus 9% (P<0.0001)) or publicly insured (31% versus 20% (P<0.0001)).
The authors of the study theorised that immigrants receive a smaller proportion of health care than they pay for. The study also challenged the belief that immigrants are to blame for the rising cost of health care in the US, said Dr Sarita Mohanty of the University of Southern California, the lead author of the report.
"Our study lays to rest the myth that expensive care for immigrants is responsible for our nation抯 high health costs," she said. "The truth is, immigrants get far less care than other Americans. Our data indicate that many immigrants are actually helping to subsidise care for the rest of us."
However, some health officials postulated that the lower spending on health care among immigrants may be a sign that they were having trouble accessing medical services. "You can explain this disparity as a lack of access due to language, financial, and insurance barriers," said Dr Ron Anderson, president and chief executive officer of Parkland Memorial Hospital, which serves a large immigrant population. "There抯 nothing to celebrate in this study," he said.(Scott Gottlieb)
The study found that Asian immigrants had healthcare expenses similar to those of US born people and that the biggest gap in spending was among Latino and black people (American Journal of Public Health 2005;95:1431-8).
The authors, who presented the study as the first nationwide analysis of immigrants?healthcare expenditure, based their research on data for 1998 from official health and income statistics kept by the Agency for Healthcare Research and Quality, a federal agency that generates health statistics and data for the US government. The data covered 21 241 people.
In total, immigrants accounted for $39.5bn in healthcare expenditure. After multivariate adjustment, the total healthcare expenditure of immigrants was shown to be 55% lower than that of US born people. Similarly, expenditure among uninsured and publicly insured immigrants was about half that of their US born counterparts.
Of the $39.5 billion, about $25bn was reimbursed by private health insurers, $12bn was reimbursed by government programmes, and the remaining just under $3bn was paid out of their pockets.
Latino immigrants on average spent $962 each on health care in 1998, compared with $1870 for native-born Latino Americans. The corresponding figures for black people were $1030 and $2524 and for white people $1747 and $3117.
In all, 25% of immigrants lacked health insurance in 1998, compared with 10% of native born residents.
Average healthcare expenditure was 74% lower on immigrant children than on US born children. However, spending on visits of immigrant children to emergency departments was more than three times higher than that on US born children. Immigrant children were also much more likely than US born children to be uninsured (29% versus 9% (P<0.0001)) or publicly insured (31% versus 20% (P<0.0001)).
The authors of the study theorised that immigrants receive a smaller proportion of health care than they pay for. The study also challenged the belief that immigrants are to blame for the rising cost of health care in the US, said Dr Sarita Mohanty of the University of Southern California, the lead author of the report.
"Our study lays to rest the myth that expensive care for immigrants is responsible for our nation抯 high health costs," she said. "The truth is, immigrants get far less care than other Americans. Our data indicate that many immigrants are actually helping to subsidise care for the rest of us."
However, some health officials postulated that the lower spending on health care among immigrants may be a sign that they were having trouble accessing medical services. "You can explain this disparity as a lack of access due to language, financial, and insurance barriers," said Dr Ron Anderson, president and chief executive officer of Parkland Memorial Hospital, which serves a large immigrant population. "There抯 nothing to celebrate in this study," he said.(Scott Gottlieb)