Population the Accessibility and Affordability of Medical Essay

Excerpt from Essay :


The accessibility and affordability of medical care is significantly promoted and influenced by health insurance since it protects against risks of costly and unexpected medical events. However, many underinsured Americans i.e. both the uninsured and those with inadequate health coverage experience difficulties in acquiring and paying for care services. Consequently, the plight of this population has become a major aspect for the national health care reform throughout the country. Despite of the importance of health insurance, the number of the underinsured population has continued to increase because of the in-affordability of health coverage. Actually, this population is described as people with certain forms of health insurance who lack the financial protection that is required to cater for out-of-pocket health care expenditures.

Demographics of the Uninsured Population:

The number of people with some form of medical care coverage that does not adequately prevent them from high expenses in health care services has continued to increase dramatically. As compared to 2003, the number of this population has increased by more than 60% by 2011. The increase in this population has largely originated from the middle-class individuals and families. Even though the low-income people have remained vulnerable, middle-class people have been hugely affected. While the underinsured adults are more likely to experience health problems, approximately seven in ten of these people have annual incomes of below $40,000 or below the 300% of poverty (Schoen et. al., 2008).

One of the most evident characteristics of the underinsured population is that it's made up of people from low socio-economic status regardless of their age or ethnicity. However, the state of health insurance varies greatly by race or ethnicity and an individual's gender. As compared to whites, minorities such as blacks and Hispanics are more likely to be underinsured or even uninsured. Nonetheless, a huge portion of the underinsured population is older people and those with co-morbidities like coronary heart disease and depression. Generally, the population consists of people with lower health related quality of life as they suffer significantly from physical and mental health problems.

According to the findings of a research, it's estimated that 42% of adults between 19 to 64 years old are either underinsured or uninsured. Moreover, men across the different racial groups are less likely to have health coverage as compared to their women counterparts. 30% of Hispanic men, 16% of black men, and 9% of white account for the underinsured population while there are 19% Hispanics, 9% blacks, and 7% women who lack adequate health coverage. Therefore, the Hispanic minority group accounts for the highest population of the underinsured followed by blacks and whites respectively.

Reasons for the Vulnerability of the Underinsured:

The underinsured population is considered as a vulnerable population because of various reasons including & #8230;

Increased Health Problems:

This population is classified as vulnerable because people with inadequate health coverage have numerous difficulties in paying medical bills due to limited insurance plans, which increases their susceptibility to severe medical conditions (Reinberg, 2008). As they are less likely to cater for their care services adequately, their medical conditions worsen as numerous health problems emerge.

Increased Expenditures:

As compared to their adequately insured counterparts, the underinsured population is likely to spend 5% of income on out-of-pocket medical expense. Actually, this population is described as people with health insurance but spend approximately 10% more of their income on out-of-pocket health care expenses.

Increased Risks on Economic Security:

The other reason for the classification of these people as a vulnerable population is its ability to contribute to increased risks on economic security. The underinsured population can have health coverage throughout the year but still get into medical debt due to the increased out-of-pocket medical expenses. Consequently, the population may face bankruptcy, especially during sickness, which increases risks on the country's health and economic security. These risks originate from the erosion of health insurance protection that underinsured patients and families experience.

Wealth-Reform Initiatives:

The vulnerability of the underinsured population can be partly attributed to several wealth-reform initiatives. These initiatives have restricted the ability of many unemployed and low-income patients and families to access Medicaid coverage (Nunley, 2008). The low-income people lack adequate health coverage because their employers do not provide insurance benefits to employees. This contributes to huge financial stress and burden that makes the underinsured a vulnerable population. The increased financial stress and inability to access adequate health insurance has adverse effects on the ability of the patient to obtain timely care, especially for low-income individuals.

Challenges faced by the Underinsured Population:

The exponential growth of the underinsured population in the United States is partly attributed to the failure by the government to track these people. This has contributed to several difficulties in defining and describing the underinsured people and even identifying them. However, the growth of the population can also be attributed to the numerous challenges that they face which enhances their vulnerability. Some of these challenges include & #8230;

Coordination and Communication Problems:

Similar to the uninsured adults, the underinsured people are more likely to experience coordination and communication problems than those with adequate insurance. This challenge is evident when 50% of the population undergoes a medical test that had been performed at a time when medical records or test results were unavailable during an appointment. The coordination and communication challenges have forced the underinsured to have more frequent contacts with multiple sources of care. Moreover, these challenges are critical reflections of lack of care continuity and disrupted care that the underinsured experience.

High Rates of Financial Stress:

The underinsured adult population has continued to report high rates of financial stress associated with the high medical bills. These people have difficulties in paying bills that force them to change their lifestyles in order to cater for these expenses. They are frequently contacted by collection agencies for unpaid bills as many of them take loans, mortgages, and credit card debt to pay for medical bills.

Benefit Restrictions and Higher Deductibles:

As reported by the underinsured adults, this population experiences benefit limits and are more likely to report higher deductibles. Actually, these people usually incur high annual premium costs that are similar to those incurred by more adequately insured population.

Impact of the Underinsured on the Health Care System:

As a result of the vulnerability and challenges that these people experience, the underinsured population has significant impact on the health care system. Some of the major impacts of the underinsured population on the nation's health care system include & #8230;

Inability of Long-term Fiscal Viability of the System:

A surge in the number of underinsured people continues to increase burdens to health care consumers who are shouldering the cost of millions of the uninsured people. The government and employer-based plans will be forced to cater for the expenses of people unable to pay for their whole medical bill (Kavilanz, 2009). Consequently, many Americans can't pay for the gap between what the health insurance providers cover and the demands of their medical bill. This results in increased challenges on the government to put the health care system on the path for long-term fiscal viability. This inability is also fueled by the fact that many underinsured people are forgoing or delaying medical care to an extent that it becomes a complete emergency. According to the law, health care facilities are required to treat every emergency admission despite of insurance status.

Increased Cost-shifting:

When the underinsured people are unable to cater for the medical bills from emergency admissions, health facilities are forced to write it off as bad debt or shift the cost to the existing charity care program. This largely contributes to cost-shifting as many hospitals transfer the bills to those who can pay for their care services. Actually, the medical costs of the underinsured are transferred to the government, private insurers, and the self-insured, which results in huge economic burdens on the health care system. The increased cost-shifting forces the commercial insurance providers to charge higher premiums on their clients in order to cater for their cost increases. Moreover, these insurance providers charge higher deductibles and encourage the increased use of generic drugs by patients.

Minimizing the Increase of this Population:

As evident in this analysis, the growth of the underinsured population has huge consequences and impacts on the health care system. As a result, there is need for all the stakeholders in the health care sectors to adopt effective strategies that could help in minimizing the increasing of this population. The government should be the first stakeholder to implement such strategies starting with tracking down these people. After the identification of the population, policies and initiatives that deal with the factors contributing to the growth should be adopted such as a universal health insurance policy.

On the contrary, employers should take advantage of the fact that workers look to them as the basic source of access to financial protection ("Three Steps," n.d.). Employers who help workers from this population secure the suitable amount of necessary protection that enhances…

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