Rowland D, Salganicoff A, Keenan P S
Henry J. Kaiser Family Foundation, Washington DC 20005, USA.
Annu Rev Public Health. 1999;20:403-26. doi: 10.1146/annurev.publhealth.20.1.403.
Medicaid is the nation's major public financing program for providing health insurance coverage and long-term care services to the poor. This article assesses Medicaid's contributions over the last three decades to improving the coverage, access to care, and health of low-income children and women. The article reviews Medicaid's impact on the low-income population covered by this program, demonstrating both the role insurance plays and its limitations as a strategy for improving the health of vulnerable populations. Medicaid has shown over the last three decades that it is an important lever to help open the door to better health care, and ultimately to improved health for America's poor women and children, by substantially expanding coverage of the low-income population and helping to reduce differentials in access to care between the poor and the privately insured. Gaps in coverage and limitations in access persist, but overall the program has resulted in better coverage, access, and health care for millions of poor children and their parents.
医疗补助计划是美国主要的公共融资项目,旨在为贫困人口提供医疗保险和长期护理服务。本文评估了医疗补助计划在过去三十年中对改善低收入儿童和妇女的医保覆盖、医疗服务可及性及健康状况所做的贡献。文章回顾了医疗补助计划对该项目覆盖的低收入人群的影响,展示了保险所起的作用及其作为改善弱势群体健康的策略的局限性。在过去三十年里,医疗补助计划已表明它是一个重要杠杆,通过大幅扩大低收入人群的医保覆盖范围,并帮助减少穷人与私人保险参保者在医疗服务可及性上的差异,从而有助于为美国贫困妇女和儿童打开获得更好医疗保健的大门,并最终改善他们的健康状况。医保覆盖方面的差距和医疗服务可及性方面的限制依然存在,但总体而言,该计划已为数百万贫困儿童及其父母带来了更好的医保覆盖、医疗服务可及性和医疗保健。