Vulnerable Populations: The Uninsured in the US

Financial burdens greatly limit the system’s accessibility; however, many in the U.S. are unable to fully utilize either option. Census estimates from 1999 indicate that 43 million Americans live without health insurance even though 75 percent of them have a full-time job or live in a household with at least one member working full-time (Mueller, , 5) In addition to the totally uninsured, census estimates also reveal that approximately 42 million other people in the U.S. are underinsured. This means that they have some insurance, but are still unable to afford all of their needed prescriptions, tests, visits to physicians, or hospital

It is not just the poverty-stricken population that can’t afford insurance. The cost of U.S. health care and insurance is out of reach even for those who do not live in what we technically classify as “poverty”. By the 2003 Federal Poverty Guidelines, released by the U.S. Department of Health and Human services, poverty

As of 2008, there are approximately 73.9 million children living in the United States. Of these children more that 5.5 million have some form of mental or physical disability. In addition, 77 percent of uninsured children come from low-income families (CoverTheUninsured.org, 2008). However, Missouri’s population of uninsured children fares much better at almost half the national average or 7.2 percent (Missouri Foundation for Health, 2004). More than 8 million children in America are uninsured. That means 1 out of every 10 does not have any form of health coverage. Racial and ethnic disparities among those uninsured children are dramatic. Most recent data has found that one in 13 White children is uninsured compared to: one in five American Indian children, one in six Latino children, one in nine African American children, one in nine Asian/Pacific Islander children. (Children’s Defense Fund, 2010)

Health Care reform is a major topic of discussion in today’s society, especially with the relatively novel release of the Patient Protection and Affordable Care Act (ACA) by the Obama administration. Historically, the health care system has disproportionally favored those of higher class and income, resulting in diminished health care for those that could not afford it. The Institute of Medicine’s (IOM) 2002 report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, states that a lack of insurance substantially contributes to the proliferation of healthcare disparities. Furthermore, racial and ethnic minorities are most subject to these healthcare disparities because they are significantly more likely to be uninsured. (1) The history of health care reform in the United States, as it pertains to under-insured urban populations, will be discussed, with a specific emphasis on its impact on African-Americans; in addition, the modern resolutions to healthcare disparities will be assessed.

Financial barriers to access health care are common in a low-income family when they are uninsured or underinsured. Many uninsured and undocumented immigrant received federal and state health care coverage. Latinos and African American are the ethnicities that are disproportionally get affected. Limited access to a doctor when they are sick, taking non-prescribed medication and holding off recommended treatment is only some of the problems they encountered (Carrillo et al., 2011).

Medic-aid: This covers the destitute, pregnant women, individuals with severe physical disabilities, mental illnesses or addictions, seniors that require long-term care and people that need government support because of their financial status. But People in this category are not given much attention by the doctors as it is clearly written ‘poor’ all over their faces as soon as they present the type of insurance they possess. This means doctors lose money each time such patient consults them. A reluctant behavior is noticed by this group of people to seek healthcare even when it is needed, as many of them feel they will not be attended to or given proper care, due to the fact that they are unable to pay. Unfortunately, this is one of the causes of depression, morbidity and mortality.

Today uninsured Americans make up approximately 4.2 million people. Because these families cannot afford the high cost of insurance, they do not get the health care needed to maintain good health. They must live with the pain and worry of the problem and when they do get medical care, they assume huge debts and another worry of how to pay for it.

In America, we not only have the problem of the non-insured but the under insured which causes just about as much problem as the underinsured. Each group has contributed to the vast growing cost of healthcare. Over the last decade or two, the amount of uninsured has risen due to the job market in the economy and the fact that most insurances are tied to employment, which is also a problem as the unemployment rate rises. The purpose of this paper is to explore this issue.

According to World Health Organization, “Universal Health Coverage means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship”. (WHO.int) By doing so, we give the people the opportunity to be equal to the rest of the society. Since the cost of a healthcare plan is beyond most people’s budget in the United States, the average person spends more money on healthcare insurance than groceries and housing together. This condition leads many to have no coverage at all. In fact, there are over 45 million uninsured residents in the U.S. in it

It is estimated the uninsured population will reach as high as twenty-three million people even after the implementation of the ACA. Undocumented migrants and exempted individuals fall under the uninsured population. The exempted individuals are those who will pay higher than “8% of their household incomes on health insurance”; therefore they are not required to adhere to the individual mandate of purchasing health insurance. As a result, other policy interventions are needed if the US seeks to promote universal health insurance coverage. Perhaps the US should consider other countries’ practices as they have tried to deal with undocumented migrants’ health coverage. For instance, in Spain, undocumented migrants can only seek medical treatment for emergency, maternity, and pediatric care. Proving limited care may be a good choice for the remaining uninsured. Also, since the US does have non-profit hospitals, perhaps the undocumented migrants should seek care at those designated hospitals only. In addition, those same options can cross over to the exempted uninsured individuals. However, I feel the exempted individuals would be best served in another way. Perhaps the income qualification guideline for Medicaid should be increased to

Difficulties arise when attempting to implement an evidence-based practice (EBP) when caring for patients who are uninsured or underinsured. Although the Affordable Care Act has been implemented into law, many continue to be uninsured or underinsured due to the inability to pay for insurance. These individuals continue to have difficulty in obtaining a regular source of health care and are less likely to seek health care until their condition is serious. Medical debt is responsible for 60% of bankruptcies in the United States (Cherry & Jacob, 2014, p. 418). The uninsured and underinsured populations generate uncompensated or indigent care costs for health care providers (Cherry & Jacob, 2014, p. 418). With the growing number of uninsured

The launch of the Affordable Care Act (ACA) website was a disaster but not surprising at all. Ethics is certainly involved with the development and launch of this new system. ACA aimed to fill gap and provide insurance to the uninsured population. The number of uninsured expected to enroll in health care coverage was understood. The technology was certainly not designed or tested to support the volume and complexities. As a result, the uninsured was bewildered by the faulty website and perhaps lost the confidence of many that the commitment to help the uninsured was simply not well done. The big website technology failure significant hampered the enrollment process and highlighted the need for a thorough analysis prior to implementation

It’s believed that these individuals were uninsured due to the negativity that is surrounded by being a holder of state insurance. Basically, saying that the type of health insurance you utilize proclaims your worth to society, your value is depicted on a system that only offers one choice for those that are poverty stricken, needless to say there are no alternatives for numerous individuals. Unfortunately, the problem doesn’t conclude there, in a recent study published in The Milbank Quarterly, the authors explore the stigma on Medicaid patients that filters all the way to the way these patients are being treated by the Doctor, granted it is unclear if the patient was sensitive to the experience due to their socio-economic status or if there truly was a clear bias due to the insurance that they were utilizing (Allen, Wright, & Harding, 2014).

Changes in access to health care across different populations are the chief reason for current disparities in health care provision. These changes occur for several reasons, and some of the main factors that contribute to the problem in the United States are: Lack of health insurance – Several racial, ethnic, socioeconomic and other minority groups lack adequate health insurance coverage in comparison with people who can afford healthcare insurance. The majority of these individuals are likely to put off health care or go without the necessary healthcare and medication that is needed. Lack of financial resources – Lack of accessibility to funding is a barrier to health care for a lot of people living in the United States

When medical insurance is provided to the poor people, they not only find regular checkups from doctors, but also feel better, are less depressed and are better to maintain financial stability, according to new, large-scale study that provides the first rigorously controlled assessment of the impact of Medicaid. A research was conducted and it says that “Being uninsured is incredibly stressful from a financial perspective, a psychological perspective, a physical perspective,” Dr. Baicker said. “It is a huge relief to people not to have to worry about it day in and day out.” Health insurance provides the opportunity to maintain health by providing a low cost way to attend the doctor visits and to buy affordable prescription drug if needed.