When health care is not enough

Kaiser Health News reported on a trend where policymakers are again opening up to the idea that simply increasing access to health care might not be enough to improve poor health for some patients. Other factors, such as not having stable housing or access to healthy foods, can hamper efforts to improve patients' health. To be fair, the article points out that some previous attempts to address these other factors have not produced the desired outcomes.

Understandably, Medicaid appears to have been designed with certain restrictions in mind: funding for the health of the indigent was not to be spent on other things. However, working only within the silo of what is normally considered health services may severely restrict the usefulness of that work for certain patients. What appears to be shifting is that with the passage of the Affordable Care Act and many states expanding Medicaid coverage, researchers have years of additional data that "simply increasing access to health care is not nearly enough to improve patients' health." With that realization, some state governments have requested waivers from the original Medicaid restrictions, allowing them more flexibility to address these other factors.