期刊
MEDICAL ANTHROPOLOGY QUARTERLY
卷 33, 期 2, 页码 191-206出版社
WILEY
DOI: 10.1111/maq.12500
关键词
cancer; moral distress; undocumented immigrants; public insurance; health policy
资金
- National Science Foundation, Doctoral Dissertation Research Improvement Grant
- Barbara Rosenblum Dissertation Scholarship from Sociologists for Women in Society
- Florence Hemley Schneider Prize in Women's Studies from Gender & Women's Studies at the University of Arizona
- University of Arizona College of Social and Behavioral Sciences Research Institute
Public programs such as Medicaid offer highly circumscribed access to health care for low-income patients in the United States. This article describes the work of a variety of health care staff who manage specialized cancer care for publicly insured patients who have difficulty gaining or maintaining program eligibility or for uninsured and undocumented patients who are excluded from state programs. I highlight the moral distress that occurs when clinic employees become individually responsible for reconciling policies that limit patients' access to care. I conclude that responsibility for securing access to cancer care for structurally vulnerable patients frequently falls to safety net clinics and that patients' financial constraints are visible to particular types of staff, such as non-licensed health care staff and non-physician providers, who may experience moral distress disproportionately.
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