Inpatient Admissions If poor people were as healthy as the rest of America, we actually would not see any decline in inpatient admission because the rest of America is really not very healthy. As several studies have recently noted, an alarming trend is occurring in American health care: wealthier Americans are now receiving more care than poorer Americans. As Almberg (2016) notes, “in 2012, the wealthiest fifth of Americans got 43 percent more health care ($1,743 more per person) than the poorest fifth of Americans, and 23 percent more care ($1,082 per person) than middle-income people.” With the rising cost of health care and the rise in premiums and deductibles—along with the long waits just to receive care in many health care facilities (Nicks, 2012), poor people are foregoing inpatient care while wealthier individuals are filling up the spot.

The big surprise is that wealthier people are also becoming less healthy in recent years. They are consuming more fast food (Grabmeier, 2017), their diet is poor, their reliance upon pharmaceuticals for treatment is increasing, and they are not exercising or receiving the type of preventive care needed to keep them from being in a position where they need more and more treatments to address health issues (Goldhill, 2009).

The assumption that poor people are less healthy than middle and upper...

The newer and more recent trends in health show that middle and upper class people are actually going to receive care more than in past decades. Equating poverty with poor health or poverty with inpatient visits is also misleading because two of the big issues that impact inpatient rates are 1) access to primary care (the expansion of which is a Healthy People 2020 objective) and 2) a lack of preventive care. ER admission is going as a result of both of these issues, and while many people who rely on Medicare and Medicaid will use the ER to obtain inpatient services (Nicks, 2012), the reality is that inpatient services are not primarily being sought by poor people. The rest of America is splurging for health care services as well, which indicates that health issues are problematic for all people regardless of class or income level.
Therefore, if poor people were as healthy as the rest of America, it is more likely that inpatient admission rates would actually increase, as the rest of Americans are not so healthy that they are abstaining from inpatient services. What’s more is that hospitals are less willing to take on poor people as inpatients as it is, since the funding for this type of patient is not guaranteed. Cutler and Morton (2013) show that “the Affordable Care Act (ACA) reduced the growth…