In the United States of America, health care is provided by diverse organizations, with private sector businesses managing a huge chunk of the health care facilities. The government provides health insurance for the employees in the private sector, while employers insure their employees along with some of their family members. However, a huge proportion of the healthcare spending (60-65 %) comes from government initiated programs (such as Medicare and Medicaid). Nevertheless, there is a huge proportion of uninsured Americans, which means that they do not have access to affordable health care. Although the government has tried to initiate programs which reduce the number of uninsured Americans, the number of uninsured Americans is still high, and this calls for a review of the strategies aimed at alleviating the problem.
The Issue of Non-Insurance and its Implications
As the Institute of Medicine observed a few years ago, USA could be classified into the category of countries that do not guarantee their population access to affordable health care. It is only in the recent years that the government has been making efforts to seriously address the issue. According to the U.S Census Bureau, 49.9 million residents were uninsured by 2009 - a huge proportion representing 16.1 % of the population. Recent statistics (2011) indicate that the number of uninsured residents fell to 48.6 million, representing 15.3 % of the American population. While the drop is good news, the proportion of uninsured Americans is still high. The uninsured category includes people who cannot afford private health insurance, those who do not qualify for insurance programs funded by the government, those who are not covered by their employers, and those who do not qualify, or choose not to pay, for private health insurance.
Unfortunately, there are many people below the age of 65 in the cities and towns of USA without insurance cover. The high rates of uninsurance have lots of implications for such communities. For instance, high rates of uninsurance mean that only a few people have access to clinic-based primary care, hospital emergency services and specialty treatment services. High rates of uninsurance also mean that many people forgo preventive care; preventive care is essential for children who need immunization services, and people with high risk diseases which require routine checkups. Consequently, the limited access to a regular doctor and prescription medication means that the uninsured are likely to get hospitalized for conditions that could have been treatable.
Ultimately, some of the uninsured fear the high cost of medical bills, but this a downward spiral which leads to high health care costs for all the Americans. Due to lack of health insurance, the uninsured only seek medical attention when they are facing a health crisis, and for some, this could come at a time when they cannot pay. As a consequence, the burden falls on the shoulders of the insured people, the government and hospitals. The uncompensated care, tallying to billions of dollars, ultimately, drives up the cost of health insurances premiums.
On the other hand, the uninsured are at the greatest risk of dying from preventable conditions. The fact they lack health insurance means that they cannot have regular care at the times when they need it, and cannot access the best treatment after falling sick. Moreover, the uninsured are also at a higher financial risk when faced with a serious medical problem, and can even lose their life savings when confronted with a serious health problem. This is an issue that policy makers should aim to address, considering the fact that the leading causes of preventable deaths (such as tobacco smoking, obesity and overweight) in USA could be contributed by uninsurance.
Roadblocks to Increasing Insurance cover
The issue of uninsured Americans has been a source of political controversy and bickering over the years. Nonetheless, the roadblocks to achieving universal health care in USA are as diverse as the American politics. The main challenges, in no particular order, are: affordability, accessibility, and affordability.
In the last decade, the cost of health insurance has increased at a faster pace than wages. For instance, from 2000-2006, wages increased by 3.8%, while the cost of health care premiums increased by 87%. As a result, it is little wonder that most of uninsured Americans are working families which cannot afford health insurance; it is too expensive for them. Employer-sponsored health insurance has enabled many American families to afford coverage, but the self-employed, and those with jobs that do not offer employment health benefits find it expensive to purchase individual plans. Approximately, of the 84 % of Americans with coverage, 60 % are sponsored by their employer(s), with only mere 9 % opting to purchase individual plans.
Apart from affordability, portability is another challenge facing the uninsured. Since the majority of health insurance is pegged to employment, those who change jobs, or those who lose their jobs end up uninsured; approximately, 24 % of the uninsured lack coverage because they either lost their jobs, or changed jobs recently. In the current system, when people retire, take time off, get injured, or engage in activities that affects their employment, they also lose their coverage. This is a worrying trend because Americans should be assured of health insurance, with or without a job. In the current state of affairs, portability of health insurance is a roadblock to universal health care.
Lastly, the primary reason why many Americans lack health insurance is because of the prohibitive costs, and pre-existing medical conditions. Therefore, accessibility is a major issue. Private insurance companies are profit-driven, and this explains why high risk clients are not covered, and why some health insurance premiums are canceled if the client has a pre-existing illness or injury. Due to lack of access to health insurance, the uninsured cannot access, regular checkups, preventive healthcare, prescriptions and immunizations. As a result, the uninsured live without proper medical care, a situation which allows minor health challenges to develop to emergency cases. The implication is that treatable health conditions are not attended, and some people may even pass away due to preventable health cases. The good thing is that the government is currently doing something about the issue, especially with the “Obama Care”. The Obama care refers to Patient Protection and Affordable Care Act (PPACA) signed into law by President Barack Obama in 2010. The act represents one of the most ambitious government programs intended to overhaul the US healthcare system since the Medicaid and Medicare passage in 1965.
Potential Solutions to the Uninsured Problem
Future policies should aim to strengthen the universal coverage plan, and this will guarantee that every American is enrolled to a health plan of their choice. The uninsured could be given an income payment to act as an incentive for enrolling in basic health plans, and to enable them to cover for the maiden enrollment costs. Although guaranteeing basic health care is expensive, there are possible ways of funding health insurance for the uninsured. For instance, employers (with more than 10 employees) who do not currently provide health insurance to their employees could be included into the program, and this would inject approximately $ 43.9 billion.
Another potential source of funds for universal coverage includes automation, and other innovations that raise the efficiency of billing. For instance, if the efficiency of billing is raised by more than 10 %, insurers would save $ 27.2 billion, physicians would save $ 6.9 billion and hospitals would save a further $ 17 billion. Also, federal and state government funds already dedicated to the uninsured could also be directed to the universal coverage. Lastly, redirecting funds spent on charity care, and reducing bad debts would save $ 17.2 billion, which could be spent on universal health coverage.
Universal health coverage has many potential benefits for patients, physicians and business. For example, patients would have access to preventive care, organizations would concentrate on their core business, and physicians would concentrate on treating patients instead of spending time on administrative duties. Again, employers would benefit from increased productivity delivered by healthy employees. Universal coverage would also help to make health insurance affordable and accessible to the uninsured, which is not a small feat by all means.
Despite the fact that USA spends 15.2 % of its GDP on healthcare, the high number of uninsured residents remains a big challenge to policy makers. However, this would be a dilemma to any government, because the health costs brought about by the high rates of uninsured spiral down to the insured, the government, and the hospitals. A simple remedy to the problem would be to include the uninsured in health insurance programs, with the main focus being increasing ease of access to affordable health insurance. Without addressing this core problem, the health care system in USA will still lag behind other countries which provide universal healthcare.
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