Access to Health Services

The US doesn’t provide equal access to health services.

That’s not up for debate. The Centers for Medicare and Medicaid Services has created a set of interactive charts showing who has access and who doesn’t.

The example below is for home health services. Basically, nursing homes/rehab facilities are expensive. The average cost of nursing home care is $9,200 per month. That’s  more than many families can afford. That’s especially true for seniors, as Medicare only covers the first 100 days of nursing home care. The rest is the responsibility of the patient.

The viable alternative to nursing home care is home care, but families sometimes require assistance from trained professionals in providing this care. At $3,600 per month, that’s a lot less than a nursing home, although still not cheap.

Unfortunately, a skilled facility isn’t always available.

The map shows the average number of home health care providers per county.

  • Certain states are well provisioned: Arizona, California, Connecticut, Florida, Illinois, Massachusetts, Michigan, Nevada,, Ohio, Oklahoma, Texas and Utah.
  • Certain states aren’t: Arkansas, Iowa, Kentucky, Mississippi Montana, North Dakota, South Dakota, West Virginia and Wyoming.


When we look in detail at the better served states, we see that services are primarily in urban areas. Smaller towns and rural areas are poorly served. The examples of Illinois and Texas are shown below. In Illinois, services are concentrated around Chicago and the St. Louis suburbs. In Texas, the concentrations are around Dallas, Austin and Houston. West Texas is relatively poorly served.



(Sorry about the chart titles: that’s a problem with the jpeg download from the CMS site. The titles are supposed to read “Home Health — Average number of providers per county”)

Why don’t voters hold their politicians accountable for the lack of services?

For that matter, since Mississippi and West Virginia are at the rock bottom on almost every measure of quality of life, why does anyone live there?



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