For nearly half a century, the gap between health care services available to the rich and the poor in the United States narrowed, largely because of enormous investment by taxpayers in public health programs such as Medicare and Medicaid.

But a new study shows that that trend reversed in 2004 because of the rising cost of health care and cuts to public health programs.

The analysis was published in The Hill by Drs. Steffie Woolhandler and David U. Himmelstein, professors of health policy at the City University of New York and co-founders of the Chicago-based Physicians for a National Health Program, a group that advocates for a single-payer health care system.

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