Inequitable Access to Quality Healthcare Services in the USA
Explanation of Issue
Access to healthcare services is one of the social determinants of healthcare services. Many nations have implemented universal health coverage (UHC) to ensure all citizens access healthcare services. This is, however, not the case in the United States. The United States does not have UHC. It is also one of the most expensive healthcare systems globally, and many individuals from low socioeconomic status and racial minorities cannot access healthcare services in the United States.
Even though the US has the highest healthcare spending, it performs worse on healthcare coverage. Many Americans do not have health insurance, while those with health coverage cannot access healthcare services due to the high costs of seeking healthcare services (Crowley et al., 2020). Major changes are needed in the expensive system, which leaves too many people while delivering little. The American College of Physicians (ACP) states that the government should transition to a system that ensures universal health coverage with reduced administration costs while offering essential benefits (Crowley et al., 2020). This plan should also ensure patients can access hospitals, healthcare professionals, and additional care sources (Crowley et al., 2020). ACP recommends that UHC be mandatory for all (Crowley et al., 2020). UHC will thus ensure access to healthcare services.
The United States healthcare system requires some reforms. Many Americans lack health insurance coverage. Despite having Medicare and Medicaid plans, the US is the only developed nation with no implemented UHC (Doherty et al., 2020). The high healthcare costs in the country are one of the reasons why many Americans do not have insurance, which negatively impacts healthcare coverage (Doherty et al., 2020). Healthcare in the country must thus be transitioned to a system in which all Americans are covered and can access the care they need at affordable costs (Doherty et al., 2020). This system should ameliorate social factors that result in inequitable health and overcome barriers to accessing care for underserved and vulnerable populations (Doherty et al., 2020).
Universal Healthcare in the US offers several options for financing healthcare with substantial advantages compared to the current system in the country, which promotes inequitable access to healthcare services. UHC can address the growing burden of chronic diseases, mitigate the healthcare costs associated with chronic conditions, reduce healthcare disparities in the population due to socioeconomic status, and enhance opportunities for implementing preventive strategies (Venechuk, 2021). The most significant effect of UHC is the potential to address the rising burden of chronic diseases such as obesity and type 2 diabetes mellitus.
Influence of Context and Assumption
Policymakers oppose UHC implementation in the United States due to the associated healthcare implications. The financial implications are massive. The costs of attaining UHC are based on vaccination coverage, diet, pollution, physical activity, and sanitation infrastructure (Bloom et al., 2018). It is estimated that lower and middle-income countries will be required to raise the per capita healthcare spending by U.S.$26 and U.S.$31 to achieve UHC (Bloom et al., 2018). Even though UHC will increase access to healthcare services and solve healthcare inequalities, it will be far more costly to the United States government and taxpayers.
The realization of UHC in the United States to help solve inequalities will require higher fiscal spending. The cost implications would include technological and infrastructural modifications to the healthcare system at all levels of government and provider levels, such as hospitals and outpatient clinics (Barber et al., 2019). In addition, it will involve insuring and treating many unhealthy and uninsured individuals (Barber et al., 2019). Finally, it will require expanding healthcare services such as dental and optical (Barber et al., 2019).
The cost of implementing UHC will depend on the extent of coverage, benefit levels, and structure. Most proposals involve increasing taxes for high earners. One recently published proposal included a 7.5% payroll tax and a 4% income tax for all citizens, with individuals with higher incomes being taxed more (Zieff et al., 2020). Outside projects, however, indicate that these proposals may not be enough to fund UHC. Regarding the national economic toll, financial implications for implementing UHC will range around 44 trillion USD across a decade, while deficit projections are around 2 trillion USD annually (Zieff et al., 2020).
Healthcare inequalities are serious issues affecting the United States healthcare delivery industry. This is mainly due to the expensive healthcare services which do not offer quality healthcare services. UHC is a healthcare plan that can help solve healthcare disparities. It will increase access to healthcare services and reduce out-of-pocket spending. One of the major challenges to implementing it is the high financing costs.
Healthcare inequalities are present in the healthcare system in the United States. Racial and socioeconomic disparities have limited access to healthcare services. The high costs of healthcare services worsen this situation. The ACP has recommended implementing a universal health coverage system to help reduce healthcare costs and improve access to care. There is opposition to this system due to its high financial implications. UHC may be expensive to implement, but it has better benefits in the long run.
Barber, S. L., O’Dougherty, S., Vinyals Torres, L., Tsilaajav, T., & Ong, P. (2019). Other considerations: How much will universal health coverage cost? Bulletin of the World Health Organization, 98(2), 95-99. https://doi.org/10.2471/blt.19.238915
Bloom, D. E., Khoury, A., & Subbaraman, R. (2018). The promise and peril of universal health care. Science, 361(6404). https://doi.org/10.1126/science.aat9644
Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a better US health care system for all: Coverage and cost of care. Annals of Internal Medicine, 172(2_Supplement), S7. https://doi.org/10.7326/m19-2415
Doherty, R., Cooney, T. G., Mire, R. D., Engel, L. S., & Goldman, J. M. (2020). Envisioning a better US health care system for all: A call to action by the American College of Physicians. Annals of Internal Medicine, 172(2_Supplement), S3. https://doi.org/10.7326/m19-2411
Venechuk, G. (2021). Universal health coverage: Evidence from aging cohorts. Health Affairs, 40(4), 680-680. https://doi.org/10.1377/hlthaff.2020.02368
Zieff, G., Kerr, Z. Y., Moore, J. B., & Stoner, L. (2020). Universal healthcare in the United States of America: A healthy debate. Medicina, 56(11), 580. https://doi.org/10.3390/medicina56110580
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