The United States Department of Health and Human Services created the initiative Healthy People, which uses “science-based benchmarks” (“Healthy People 2020”, 2017) every decade, to set targeted goals. Healthy People’s goals focus on the promotion of society’s health, as well as the prevention of diseases through preventative care and immunizations. By becoming healthier as a society, the cost of healthcare decreases for the nation. Goals are reassessed and analyzed every few years to decipher the nation’s progress towards the set targets, access to healthcare, extending the life expectancy, and decreasing the disparities to zero. Access to care components are health insurance coverage, available services, timeliness, and the effect on …show more content…
the workforce (“Healthy People 2020”, 2017). One of the topics that Healthy People 2020 places emphasize on is access to care. An individual’s whole being, their “overall physical, social, and mental health status (“Healthy People 2020”, 2017)”, is affected by their ability to receive healthcare. When people have health insurance coverage they are more likely, than those who are not ensured, to seek out care. Individual’s that lack insurance coverage, tend to have a higher number of chronic conditions, and when accessing care without coverage are faced with the possibility of expensive medical bills (“Healthy People 2020”, 2017). Preventative services not only aid in the promotion of one’s health, but can reduce the cost of healthcare by lowering risk, diagnosing illnesses early, and increasing the life expectancy (“Healthy People 2020”, 2017). By providing “improved health care services” people can obtain exams, follow-ups, and build a physician-patient relationship (“Healthy People 2020”, 2017). Having a primary provider also assists with consistent care instead of the inconsistency of care from walk-in clinics or emergency room visits. Health care coverage and services work hand in hand for preventive services in disease detection, immunizations, and to gather information to improve the quality of healthcare experiences. In 2010, the Affordable Care Act (ACA) was enacted by President Obama to increase the insurance coverage of people with minimal amount or no healthcare coverage. Per the article “Health Reform and Healthy People Initiative”, the Affordable Care Act expanded upon the goals set forth by the Healthy People, coupled with their promotion and prevention measures, to work towards a healthy society (Fielding, Teutsh, & Koh, 2012). Preventative services, that are reflective of the National Prevention Strategy, became mandatory with the enactment of the act. Doctors Fielding, Teutsh and Koh used the “ecological model of health”, a model that displays the impact of factors that can influence a person’s health, to look at how the ACA will aid in healthy outcomes (2012). The ecological model of health is centered around the person themselves and their behaviors, next their surrounding relationships of friends and family, third encompasses their living environment, and the outer circle expands to include the person’s “economic, cultural, health, and environmental conditions…national, state, and local (policies)” (Fielding, Teutsch, & Koh, 2012, Figure 1). The authors agreed that the ACA and Healthy People 2020 use an ecological model, and working to achieve the same goals, they will stimulate the improvement of health outcomes by decreasing preventable health conditions and promoting the accessibility of healthcare through the expansion of insurance (Fielding, Teutsh, & Koh, 2012). Other movements of the ACA include: better coordination of care, immunizations, mental health and substance abuse services (Koh, Blakely, & Roper, 2014). Two other component of the Healthy People goals are timeliness and workforce.
Often an emergency room visit has wait times that are past what is expected. An influx of patients into an emergency room that are “less acutely ill”, increases the wait time for others that are extremely sick or injured (“Healthy People 2020, 2017). When care is not rendered in a timely manner the perceived satisfaction and quality of care is lowered, as well as individuals that have a need of immediate care may leave before receiving it (“Healthy People 2020, 2017). An associated factor in the access to care results from the lack of healthcare workers. Incentives have been made available for physicians to improve the quality and timeliness of their appointments, physicians to join primary care instead of specialties, and for some to provide healthcare in rural areas. Yet, with the limited healthcare workforce patients are left waiting long periods of time for …show more content…
appointments. To supplement the goals of Healthy People 2020, Rural Healthy People 2020 broaden those components to encompass the rural populations and healthcare. A web based national survey, funded by the Texas A&M School of Public Health, collected information on the Healthy People 2020 priorities and what “rural health stakeholders” (Bolin et al., 2015) were most concerned about. The result was a number one concern of access to care, followed by preventative care, chronic disease care, and the less concerning priority was the use of tobacco (Bolin et al., 2015). Rural communities lack sufficient availability of physicians, nurses, clinics, and acute care facilities. Per the article “Rural Healthy People 2020: New decade, same challenges”, notes that in the rural areas minorities groups, the elderly, and disabled persons may be more affected by the decrease in access (Bolin et al., 2015). Rural minority groups tend to have a higher rate of poverty, less education, which brings few physicians and healthcare workers to the area, where they would have less income compared to the larger cities. According to research conducted by the Association of American Medical Colleges’ Center for Workforce studies, estimates that in the next few years the healthcare workforce “will be 45,000 to few primary care physicians” (Mareck, 2011). Much of this shortage will affect the rural communities, their access to healthcare services, and the timeliness of their care. A solution to this dilemma comes from a collection of federal programs, “Area Health Education Centers, Federally Qualified Health Centers, and the National Health Service Corps” (Mareck, 2011), that work with colleges to afford training opportunities, scholarships, and loan-repayments for physicians that are either primary care or specialties to conduct care in rural areas. States offer school loan-repayments as well, but the physicians must sign a contract to work in rural or nonprofit arenas (Mareck, 2011). Women also face barriers to accessing healthcare, even with the expansion of services provided by the ACA. Preventative services such as mammographs and cancer screenings, mandatory prenatal and maternity services, some reproductive services, and equal purchase for insurance coverage are a portion of the expansion (Salganicoff, Ranji, Beamesderfer, & Kurani, 2014). Near the end of 2013, the largest number of insured women were either covered by their employer, spouse, individually, or Medicaid, leaving near 20 percent uninsured, most of those were low income (Salganicoff, Ranji, Beamesderfer, & Kurani, 2014). The largest portion of uninsured women are minorities, where either they are illegal or do not qualify through their state for assistance (Salganicoff, Ranji, Beamesderfer, & Kurani, 2014). Another access to care issue for women is the cost of healthcare, approximately “26% (of) women have had to delay or forgo care…due to cost” (Salganicoff, Ranji, Beamesderfer, & Kurani, 2014).
Although women of low economical standing were some of the most reported as forgoing healthcare due to cost, women that were insured also disclosed the same reasoning for not seeking out care. Healthy People’s components of access-coverage, or the lack of coverage, states that “when they (uninsured) do get care” that is needed, they become “burden(ed) with large medical bills” (“Healthy People 2020”, 2017). Uninsured women faced large amounts of medical debt that hindered their ability to purchase essentials (Salganicoff, Ranji, Beamesderfer, & Kurani,
2014). Women, who do not have adequate gender related care, are less likely to seek out reproductive care and do not have a primary care provider for consistent care. Consequences of healthcare access for women of the reproductive ages include: low health literacy of their own reproductive health and topics that are limited between patient and physician. Topics of concern are: sexually transmitted diseases, sexual history, violence, contraception, female exams, and pregnancy (Salganicoff, Ranji, Beamesderfer, & Kurani, 2014). The prevention of knowledge of their own reproductive health and the understanding of their exams and medications, poses its own barrier. Doctors Fielding, Teustch, and Koh propose “evidence based sex education programs” (2012) as preventative services to increase the awareness of women’s reproductive health and decrease the barrier to access to care for women. Access to care is a process that is continuously revised to decrease the disparities that set certain groups-women, disabled, elderly, and minorities, apart from being able to receive the appropriate care. Two of the greatest disparities in healthcare access are healthcare coverage and healthcare services. Without insurance, many people will either forgo needed care, attend emergency room visits, or will going into medical debt. The lack of insurance coverage also makes a financial barrier to those that are low-income, and do not qualify for state assistance. Healthcare workforce decrease affects the access and quality of care, by limiting the available physicians in comparison to patients, increase the wait times for appointments. Healthy People 2020 includes the components of coverage, services, timeliness, and workforce in their monitoring. Continuous monitoring, revising, and analyzing of the Healthy People 2020 goals is the greatest driving force towards equal healthcare and eliminating disparities.
Access to healthcare provides financial stability by assuring people that they will not be financially destroyed by injury or illness. Additionally, when people can afford regular medical care they tend to avoid chronic problems and financial stress. In a study provided by the American Medical Students Association, researchers reviewed the costs and benefits of universal health care. They came to the conclusion, after reviewing other articles and statistics from multiple sources, that, “The annual cost of diminished health and shorter life spans of Americans without insurance is $65-$130 billion.” (Chua 5) This comes from people not having adequate health care and then losing their jobs because they...
The United States spends vast amounts on its healthcare, while falling short of achieving superiority over other developed nations. One cannot overlook that the deepening recession has left many without jobs and therefore lacking health insurance. According to Fairhall and Steadman, (2009), even though the recession is hard on all, it is worse on the uninsured due to health care and insurance cost rising faster than incomes. Nevertheless, even those with jobs are lacking in health insurance due to employers, who provide insurance, are increasingly dropping their sponsored insurance. Many find that purchasing a health policy or paying for medical care out-of-pocket is cost prohibitive. “Since the recession began in December 2007, the number of unemployed Americans has increased by 3.6 million,” (Fairhall & Steadman, 2009). In 2009 it was stated that approximately 46 million Americans were uninsured, however not all of that number is due to the inability to afford coverage. According to a 2009 story written by Christopher Weaver of Kaiser Health News, 43% of that number should be classified as “voluntarily” uninsured. This subset of uninsured Americans consist of nearly half being young and healthy; therefo...
For example, income often determines one’s access to health-care. Researchers have found that low-income families are less likely to fill prescriptions, have dental coverage, and have preventative care visits (Ives et al., 2015, p. 170). Further, Williamson et al. (2006) declared, “professional treatment services…not covered by provincial health care plans, social services, or Indian and Northern Affairs were most frequently cited by respondents…as services that they choose not to use because of their low-income status” (p. 113). In addition to being unable to afford services, low-income individuals are often unable to afford transportation to appointments (Williamson et al., 2006, p. 116). Clearly, although individuals have the right to health, low-income individuals and families face many barriers in accessing and affording health-care services in
Health insurance, too many American citizens, is not an option. However, some citizens find it unnecessary. Working in the health care field, I witness the effects of uninsured patients on medical offices. Too often, I see a “self-pay” patient receive care from their doctor and then fail to pay for it. Altogether, their refusal to pay leaves the office at a loss of money and calls for patients to pay extra in covering for the cost of the care the uninsured patient received. One office visit does not seem like too big of an expense, but multiple patients failing to pay for the care they receive adds up. Imagine the hospital bills that patients fail to pay; health services in a hospital are double, sometimes triple, in price at a hospital. It is unfair that paying patients are responsible for covering these unpaid services. Luckily, the Affordable Care Act was passed on March 23, 2010, otherwise known as Obamacare. Obamacare is necessary in America because it calls for all citizens to be health insured, no worrying about pre-existing conditions, and free benefits for men and women’s health.
The health of the American people lags behind those from other developed countries. Federal public health agencies have a wide range of responsibilities and functions which includes public health research, funding, and oversight of direct healthcare providers. It has been a long time since changes have been made to the way the federal government structures its health care roles and programs outside of Medicare and Medicaid (Trust, 2013). With healthcare reform on the horizon now is the time to invest time and money in prevention, not medicine, making it a top priority to improve health and prevent disease. Funding efforts at all levels of the public health continuum need to focus on developing programs aimed at such leading initiatives as tobacco cessation, improving nutrition, supplying safe workplaces, and increasing physical activity in all ages of the population. People should have equal access to quality preventative medicine and education.
The growing number of uninsured and underinsured is on the rise. In 1979, 11 million African americans were uninsured (Jaffe 10). Today, the number is 15 million and it is increasing every year (Jaffe 11). According to the Department of Health and Human Services, thirteen million blacks in America have health care and fourteen million do not (Fitzgerald 31). Also, those who are insured today may be at risk tomorrow if their employer drops coverage, or the head of the household changes or loses their job. Most blacks in the United States who are uninsured simply cannot receive health care at an affordable price because their employer does not offer it and self-insurance cost much more. The lack of adequate insurance can be devastating to families both in financial terms and in terms of timely access to needed health care (Jaffe 12). Altogether, collection agencies report every year that most blacks are in debt due to unpaid medical bills, because they are not insured or they are underinsured.
Healthy People 2020 is a program for the promotion of health and the prevention of diseases, launched by the Department of Health and Human Services in December 2010. According to healthypeople.gov, this program has four overarching goals which are first to achieve healthy, longer lives free of preventable diseases, injuries, and premature deaths; to achieve health fairness, eliminate differences, and improve all groups’ health; also to produce social and physical environments that encourage good health; and last but not least to promote life’s quality, healthy development, and healthy behaviors through all life stages. This program has a vision of a community where people live long, healthy lives. Healthy People 2020 offers a comprehensive set of 10 years of nationwide goals and objectives that is meant to improve the health of the American population. Healthy People 2020 covers 42 topic areas with approximately 600 objectives, which include 1,200 measures. A smaller set of Healthy People 2020 objectives, has been designated to communicate high-priority health issues and actions that can be taken to address them, this objectives are called Leading Health Indicators. The program goes above and beyond these health indicators in order to provide the best care for the people of this country. These indictors cover from the access of health service, nutrition, physical activity, and obesity to substance abuse, environmental quality, injury and violence.
The main shortcomings of health care in the U.S. include limited access and difficulty in coordination of care. In an 11-country survey conducted by the Commonwealth Fund, Americans were found to have a greater wait period than adults from other countries. In fact, 20% of adults reported a delay of six or more days to see a doctor or nurse (Schoen, Osborn, Squires, Doty, Pierson & Applebaum, 2010). Access to care is further complicated as only 29% of U.S. primary care practices make arrangements for patients to receive care on evenings, weekends, and holidays (Abrams, Nuzum, Mika & Lawlor, 2011). Physicians also face frustrations in the coordination of care. U.S. physicians are more likely to report that patients cannot afford treatment and are less likely to have electronic patient records that facilitate patient-centered care (Osborn, Schoen, Doty, ...
There are huge impacts of the rising costs. Many people can not afford health insurance. Of the families that do have health coverage, 50 percent are concerned about having to pay more for that coverage in the future, while 42 percent fear they will not be able to afford coverage at all. (National Coalition on Healthcare, 2005, Facts on heal...
Although health insurance can be beneficial because providers get paid for the services they provide to the patient the insurance premiums and deductibles are in many instances way more than many families across the United States can afford. With these extremely high costs for insurance statics show that over 40 million families’ can’t afford or have access to needed health care systems. “It shows that one-fifth of Americans couldn 't afford one or more of these services: medical care, prescription medicines, mental health care, dental care, or eyeglasses (R...
Healthcare is one of the major issues that America faces today. The health insurance companies are destroying America’s health care system by raising their premiums and deductibles. One great concern, access to health care is definitely on the decline. As of 2007, more than 75 million adults-42 percent of all adults ages 19 to 64- were either uninsured or underinsured (Commonwealth Fund Commission 9). The health care system in America needs a complete overhaul, reform.
According to the data given, by CTISP Community Survey 2010 by a Central Texas Region, Health care has a direct correlation to a person’s income or lack thereof. Table 1 displays a graph of respondents to a community survey about Health Care Coverage. The graph contains income amounts from $15,000 to $85,000 and percentages of people who do not receive coverage based on their income. The graph shows the lower the income the less likely to afford coverage. Table 2 displays, of those who took the survey their reasons for having no Coverage. The reason with the highest percentage was “could not afford prem...
Improving population health necessitates a variety of the contributions from health entities. These health entities can be state, local governments, hospitals, health centers, and community organizations. Unfortunately, these contributions and services are not equally distributed throughout the population. Lack of a supermarket in a neighborhood limits residents’ access to healthy food and other resources. Furthermore, ethnic minority and/or low-income communities are burdened with several health disparities such as greater risk for diseases, or limited access to healthcare services (Jackson, 2014). The National Cancer Institute reported that individuals from medically underserved population are more likely to be diagnosed with late-stage diseases because they have inadequate resources to education, or health insurance. When an individual does not have adequate access to healthcare services, healthy disparity grows larger in the overall health of a
Health insurance facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health. Many Americans are foregoing medical care because they cannot afford it, or are struggling to pay their medical bills. “Adults in the US are more likely to go without health care due to cost” (Schoen, Osborn, Squires, Doty, & Pierson, 2010) Many of the currently uninsured or underinsured are forced accept inferior plans with large out-of-pocket costs, or are not be able to afford coverage offered by private health insurers. This lack of adequate coverage makes it difficult for people to get the health care they need and can have a particularly serious impact on a person's health and stability.
Even though women in the U.S. have better access to health care, they still face some inequalities when attempting to afford the care they need. Women are often faced with unfair insurance practices, such as being deprived of coverage or are expected to pay more for health insurance than men. Regardless of that fact, many individual market health plans frequently omit coverage for services that ...