Eco – Access to healthcare in the US
Introduction
Access to quality healthcare is a significant need for every individual. Ideally, everyone should be able to expediently and confidently access and use all the health services. Provision of quality healthcare and access have been significant issues in the American political and economic scene. Sound policies on healthcare coverage in the US have greatly influenced the election of American presidential candidates into the oval office. Healthcare is a crucial component in ensuring that the citizens of a country have stable physical, social, and mental status. Furthermore, disease prevention, detection, and treatment are also provided. Excellent healthcare improves health and life expectancy. This paper will examine the factors that prevent access to quality healthcare in the US and make recommendations on how these barriers can be overcome.
Discussion
Numerous economical and social factors hinder access to quality healthcare in the United States. One of the factors is the high fee of medical services. High costs make good medical services unaffordable by many people. The policymakers in the U.S. are struggling to find ways of restraining the ever-rising healthcare costs while providing opportunities for every individual to live better and healthier lives (Berwick, 2012). However, the rate of increase in the U.S. spending on health care continues to exceed the rate of economic growth at unsustainable rates. Pressures to minimize costs in the U.S. are intensifying because of current financial and economic restraints, among other factors. Other factors are high costs resulting in higher premiums for employers and employees, increased spending for public health initiatives, and greater costs for the citizens. The high cost of healthcare services is mainly alarming considering the fact that it is not linked to better health outcomes (ACP, 2009). Other factors include inadequate medical insurance coverage and low incomes.
- High costs
The key drivers of increased charges of medical services include inappropriate use of advanced technology. Technology is defined to comprise drugs, devices, and medical as well as surgical procedures. In accordance to an analysis conducted by the Kaiser Family Foundation, about half of the increase in medical expenditure in recent times is attributable to technological change. This has been found to account for approximately 75% of the increase in healthcare spending (Callahan, 2008; Andersen, 2011). It should be noted that even though the high utilization of new technology is a factor, it also means high prices, which make healthcare services unaffordable for many individuals. The general agreement among health economists is that the great rise in healthcare expenditure over the past several years was mainly due to the emergence of new healthcare service technologies and their adoption and the widespread dispersal by the healthcare system of the United States (ACP, 2009). Advances in healthcare and technology have lengthened the lives of many; however, they do not come without a cost. New procedures are very costly.
High costs of healthcare services also results from high financing costs for setting up the relevant infrastructure and training the required medical personnel. The need for setting up additional healthcare infrastructure and training the necessary medical personnel is because of the growing population. Shortage of healthcare professionals can hinder access to services through limiting the supply of available services. This is a key factor mostly in rural areas. This shortage of healthcare professionals in rural areas is partly because of national healthcare labor shortage. The healthcare labor shortage in the United States has been mainly documented, as it is expected to last in the near future. Rural areas are mainly affected because the present education system is tending to be urban-centric (Schoen et al, 2010). Access to educational programs is limited in the rural areas for the people who wish to pursue careers in medical fields in their communities. In addition, urban regions sometimes draw people away from the rural regions. Individuals from the rural areas seeking for degree programs that are not offered online or through distance educational programs usually have to travel to urban areas and may not go back to the rurals once successful. Another factor is that there are few medical role models for potential students in the rural areas.
- Healthcare insurance coverage
There is also inadequate medical insurance coverage, which translates to high medical bills that patients at times cannot meet leading to poor healthcare. Increasing healthcare costs increases health cover premiums, which are also increasing at a much faster pace than the overall employees’ income. As a result, this puts pressure on employers to shift costs to their workers, minimize the range of their coverage, or even drop the coverage. Increasing premiums also make harder for individuals without access to employer-sponsored coverage to acquire insurance policies by themselves, which is contributing to the increase in the number of the uninsured individuals (Palmer et al, 2004). Increase in healthcare costs also puts pressure on governments whose publicly funded healthcare initiatives are competing for funds with other significant spending priorities. The increasing healthcare cost can strain a person’s budget making it difficult for the person to access quality healthcare. As insures are shifting a greater share of the medical costs to employees, many people are burdened with greater out of pocket expenditure. Healthcare expenditure has been increasing by 2.5% annually faster than the GDP over the past years (Schoen et al, 2010).
Other factors associated with the decrease in health cover includes, lack of job opportunities in the recent recession as well as other less profound economic downturns. In accordance to an analysis carried out by the Kaiser Family Foundation in the year 2002, indicated that in the previous decade, every percentage point rise in the rate of unemployment is resulted in an increase of 0.5 percentage point in the young population without health cover (ACP, 2009). Recession results almost immediately to loss of health insurance for many people and their families who were covered through agreement with their employers. Whilst newly jobless workers may be capable of retaining insurance temporarily, others may not qualify or may not be able to afford continuation of the insurance. Reduction in coverage is also prompted by employers’ needs of controlling benefit costs when there is an economic depression. According to economists, employee profits are traded off against earnings, so that decreasing profits is not a good way of limiting costs. Joblessness, lower income rates, and loss of healthcare insurance cover in economic recession can lead to reduced access to quality health services. Economic insecurity itself also affects Individual’s behavior, which includes how they are spending money on health care as well as other commodities that can have an impact on their health (Palmer et al, 2004).
- Low income
Accessibility of quality healthcare is also affected by an individual’s income. An individual’s low income and educational attainment is a major obstacle to accessing timely and suitable healthcare. Low-income individuals are incapable of affording the out of pocket costs of healthcare even if they have health covers. Low levels of education may impair individuals’ capability of navigating the complex healthcare delivery system, communicating with the healthcare professionals, and understanding the professionals’ instructions. Additionally, the low income and an individual’s occupational characteristics are linked to the low rates of health insurance cover. Lack of health care cover makes the cost of medical services prohibitive for many individuals. It is considered the most significant obstacle to accessing quality healthcare (Escarse & Kapur, 2006). Children from the low socioeconomic backgrounds normally have poorer health outcomes. This is mainly due to obstacles in accessing quality health care and using primary care services. Even with the services of family health professionals as well as expanded health cover, children from the low-income parents are not assured of accessing quality health care services. The high cost of medical care services places a burden on individuals especially women who have high probability of requiring and using health services but usually struggle to pay for premiums because of lower wages and time out of the workforce to take care of other family care giving responsibilities. The issue has been aggravated because most insurers charge women higher rates due to their gender. This puts premiums unaffordable for many low-income earners. As a result, many low-income individuals end up delaying or forgoing healthcare because of the high costs (Schoen et al, 2010).
Recommendations
- Inappropriate issue of use and advancing technology
To address the issue of inappropriate use and advancing technology, a synchronized and evidence based appraisal process should be established to help in analyzing the cost and clinical advantages of new healthcare technology before it goes into the market, which includes comparing it with the existing technology. This kind of information should be incorporated into approval, coverage, imbursement, as well as plan benefit conclusions. Coverage of tests and medication should not be denied mainly because of cost effectiveness ratios; decisions concerning coverage should reflect evidence of appropriate use and clinical effectiveness. Helpful information concerning the effectiveness and benefits of technology and public education should be broadly distributed to minimize the demands for technology of unproven advantages by patients and physicians (ACP, 2009).
- Shortage of healthcare professionals
To address the issue about shortage of healthcare professionals especially in the rural areas, the rural health facilities can apply numerous strategies to help ease the shortages of healthcare workers and ensure better care. For example, they can employ technology like telehealth for filling gaps in care resulting from the workforce shortages. Additionally, facilities can utilize inter-professional care teams to give more efficient and high quality care. Improving practice and processes to enable each professional to be working at the top of their license and capabilities set can also reduce the effects of shortages (Johnson et al, 2006). Rural regions normally experience hardships in the recruitment and retention of the primary care professionals and other health workers. For this reason, it is very significant for rural healthcare facilities to arrange for their future workforce requirements as much as possible. Engaging in the recruitment of new professionals, nurse practitioners, or physician assistants before the retirement date of the primary care providers can help in avoiding the long-term vacancies. Payment, benefits and flexibility increment, can also improve chances for success with the recruitment and retention efforts (Shi & Singh, 2012).
- Impact of economic shifts
To comprehend the impacts of economic shifts, and its effects on individuals’ health cover, it is important to sort out the probable effects of the economy on health insurance, use and the structure and effectiveness of the health care delivery from the long-term structural transformations. Several changes of the employment base health cover like bankruptcies or decrease in force that also prevents workers’ access to health cover, or cuts in a company’s investment in insurance, may turn back as the economy cycles back up. Other effects of depression and adjustments in the system of employment during recoveries may include changes not likely to be upturned or may have an impact on the trajectory of long-term trends, or maybe move medical care in completely novel directions (Schoen et al, 2010). Changes in health cover or in provider organization may also have an impact on the different segments of the population differently, which contributes to long-term effects on health outcomes. The systematic challenges that arise from this complexity are aggravated by the unavailability of data required to understand how health cover, monetary access to care and the utilization of health services changes with the changes in economic status among different people (Johnson et al, 2006). Insurers should cover a key set of preventive health services without cost sharing necessities like co-pays, co-insurance, or deductibles. For the women, services such as the yearly mammograms as well as cervical cancer screening should be covered without out of pocket costs for the patients. Insures should not be charging very high costs for emergency services that are obtained outside the provider network. This will assist in protecting women from financial hardships when they get sick.
- Low income earners
To help the low-income earners access better health care, changes should be made in insurance coverage in order to improve healthcare accessibility by this population. The availability of family health professionals in the underserved communities should make sure the primary health care services are more widely available. Family health professionals who care for vulnerable populations should understand the differences in access to health care and use of services in their communities. Communities should collaborate effectively with the government and federal funders on health insurance programs (Jansen, 2008). The key issue is that governmental regulations at times deters rather than support community’s suggestions to issues concerning healthcare access. By identifying, what communities require to collaborate well, government leaders will be capable of offering meaningful support. As the government decision makers struggle with how to improve healthcare financing policy, their work can be toughened by successful; community based efforts in making health services more widely accessible to everyone. Resourcefulness and determination are the efforts that can help communities successfully prevail over obstacles to health care access (Jansen, 2008). The models may vary, but all should involve diverse community partners who come together to address this issue. The government should ensure apparent communication of the advantages of a consensus approach. The return on investment in a joint process should be clear to everyone. For instance, improved accessibility to healthcare can imply less absenteeism and increased productivity from the healthcare workers. Individuals paying taxes and health cover premiums may experience minimal cost shifting. In addition, providers will be seeing more patients at the earlier stages of disease, before complications and occurrences of poor prognoses and individuals’ reliance on uncompensated care may go down.
Conclusion
Provision of healthcare should be a top priority of the United States federal government. Quality of medical care plays a crucial role in improving the health of individuals and life expectancy. The key components of healthcare services should be factored in while drawing up healthcare plans. They include coverage, services, timeliness, and workforce. There is still room for further research on how access to medical care can be improved in the United States. Some of the key factors addressed in the paper that prevent access to quality health care in the United States include high costs, which make healthcare services very expensive. The high costs are as a result of inappropriate use of advanced technology, high financing costs for setting up the relevant infrastructure and training the required medical personnel. These factors can be addressed by establishing a synchronized and evidence based appraisal process to help in analyzing the cost and clinical advantages of new healthcare technology before it goes into the market, which includes comparing it with the existing technology.
To address the issue about shortage of healthcare professionals especially in the rural areas, the rural health facilities can apply numerous strategies to help ease the shortages of healthcare workers and ensure better care. For example, they can employ technology like telehealth for filling gaps in care resulting from the workforce shortages. There is also inadequate medical insurance coverage, which translates to high medical bills that patients at times cannot meet leading to poor healthcare. To comprehend the impacts of economic shifts, and its effects on individuals’ health cover, it is important to sort out the probable effects of the economy on health insurance, use and the structure and effectiveness of the health care delivery from the long-term structural transformations. To help the low-income earners access better health care, changes should be made in insurance coverage in order to improve healthcare accessibility by this population.
References
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