Lack of access to healthcare leads to poorer quality of life, worse medical outcomes and unnecessary pain and suffering associated with inconsistent or unaffordable care. How did access to healthcare in the US become so difficult and expensive?
Minorities and less fortunate families face several barriers to healthcare access that cross geographic, financial and cultural lines. Understanding how the system is broken is a step toward improving access to care.
Why is Access to Healthcare Important?
Quality healthcare prevents disease, reduces the severity of illnesses, and reduces the risk of mortality by supporting life-long wellness. In 2019, more than 29 million Americans lacked any kind of health insurance, severely limiting access to preventative and emergency care.
Primary Barriers to Healthcare
Households with a full-time, year-round wage earner usually have some access to employee-sponsored healthcare. These families typically make more than 200% than the federally mandated poverty level. This leads to a generally accepted truism that doesn’t reflect the 82% of uninsured Americans who live with at least one full-time worker.
The myth of the unemployed person lacking healthcare isn’t accurate. Eight out of ten Americans without healthcare live with a full-time wage earner and six out of ten uninsured Americans are their households’ primary earners.
Why don’t Americans have healthcare? The answer lies in three main societal factors.
Healthcare is Too Expensive
The average premium family coverage in the US is $22,221 per year. That cost alone is just $190 more than the 2022 Federal Poverty Level for a family of three. The US spent more than $4.1 trillion on healthcare in 2020, three times most other developed countries. Insurance costs are increasing due to an aging population, increasing prices for healthcare services, and reduced coverage by insurance companies.
Despite spending an average of $12,500 per person per year, the US doesn’t have substantially better medical outcomes. The US lags behind other developed countries in infant mortality rate, diabetes cases, obesity and average life expectancy.
Healthcare Staffing Problems
In the next decade, the US is expected to be more than 124,000 doctors short of its population’s needs. That shortage extends to highly qualified technicians, nurses and administrative staff. Staffing problems will lower institutional capacity, lower the quality of care and lead to higher prices for many healthcare services. Many experts believe technology, specifically telehealth, will play a vital role in increasing healthcare provider capacity.
American workers who lack transportation to access healthcare or cannot seek out treatment for fear of employer reprisal are serious concerns for medical experts. While telemedicine may serve to reduce the impact transportation has on medical care, more should be done to increase public transit options and introduce legislation that protects workers from consequences if they need time off for medical care.
Language and Bias
Intentional and unintentional bias impacts healthcare access and reduces the trust patients need to have in their healthcare providers. One 2022 study found that biases and stigma based on race, sex, gender, immigration status and sexual orientation all play a role in accessing care or returning for additional care for patients who feel discrimination.
Additionally, language reduces the ability to demand, receive and follow medical care and recommendations. Roughly 1 in 5 American households speak a language other than English and the number of non-English speakers is expected to increase.
The Price We Pay
A Deloitte report estimates that Americans will pay an additional $1 trillion annually related to healthcare barriers by 2040. These forecasted costs are associated with high-cost diseases ranging from cancer to diabetes to heart disease. We’re already paying the financial – and human – cost of more healthcare disparities resulting from financial, geographic and cultural inequalities.
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