Dynamics of Spatial Inequality in the Development of us Healthcare and State Regional Policy

Abstract

One of the key aspects that reveals the essence of the uneven distribution of social benefits in economically developed countries is the dynamics of spatial inequality that has been characteristic of the US healthcare sector for many decades. The results of an empirical study of this inequality as a dynamic process with the properties of historicism, carried out by decomposition of the Theil index according to the intragroup and intergroup characteristics of the corresponding groups of indicators, indicate an increase in the polarization of territories in terms of the provision of the population with medical benefits. Given the organizational and economic inconsistency in the health care of American citizens and the predominance of the spontaneous and commercial nature of free pricing in the relevant markets of American medical goods and services, the center-peripheral spatial structure of inequality in the development of US health care, traditional for capitalist reproduction, is confirmed.The objective nature of the long-term formation of such a structure is complemented by the subjective factor of state regional regulation of health care in the subregional and transregional sections, through the implementation of differently directed typologically relevant policies – from traditional and proactive to selective. It is shown that not only the economic situation, but also the socio-political and ideological expediency are the subjects that determine the tools for activating, polarizing, stimulating or restraining the development of healthcare in specific areas of the United States.