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HEALTHCARE OVERVIEW

How America’s healthcare system is problematic:

 

The way the American healthcare system works creates a lack of accessibility for the underprivileged; it even creates high prices for those who have insurance. These prices are proven unnecessary by other nations that have implemented much cheaper and more effective healthcare systems. The primary problem with the American healthcare system is that it is driven by profit, as insurance companies make profits off of premiums they charge to pay for expensive medical procedures, as well as prescription drugs. Unlike most other developed nations, the American healthcare system is largely run by the private sector rather than being heavily subsidized by the government. This creates an issue for those of low socioeconomic status who cannot afford health insurance. As our healthcare system is capitalistic, the wealthiest fifth of Americans receive 43% more healthcare than the poorest fifth. 

Not being able to afford health insurance poses problems as well. For instance, preventative care, the most important type of healthcare, is made prohibitively expensive, meaning that those who are of a lower socioeconomic status are more likely to develop serious conditions in the future. Moreover, the US spends more money per capita on healthcare than any other nation, meaning that our healthcare system is not cost effective. This increases the odds of a person needing an emergency room visit, which they may not be able to afford. Because the United States law prohibits hospitals from denying care due to a lack of money, the patient’s healthcare bill must be covered by other people. There are no winners in this situation—a patient is suffering in the emergency room and American citizens’ taxes are used to pay for the bill.  

However, the ones who are most negatively affected by today’s healthcare system are the impoverished. Those in poverty are more susceptible to the effects of stress, such as heart disease, diabetes, or obesity. This causes them to be easily hospitalized, leading them to having to pay extremely high medical bills. Making matters worse, if the breadwinner is hospitalized, his/her family will no longer be able to have any financial support. This causes more financial difficulties for the family, being unable to pay for basic needs including food and rent. These struggles will only feed into a cycle of poverty and bad health. 

 

Statistics: 

  •  You’ll pay 10 times as much for the anti-cancer drug Avastin in the US than in the UK.

  • Healthcare as a percentage of GDP in the United States has increased from 5% in 1960 to 18.2% in 2018.

  • Receiving care in the hospital for a heart attack will cost you an average of $20,246.

Information taken from: https://medalerthelp.org/healthcare-statistics/

 

Ways for Americans to afford/get access to healthcare: 

 

There are two systems in place: Medicaid and Medicare

Medicaid - In its essence, Medicaid is a government-funded health insurance program, which allows low-income individuals not to pay direct costs to insurance companies or the government for their healthcare. Medicaid covers costs for a select group of low income patients, but is often insufficient, especially in states that have not expanded it. To qualify for Medicaid, one’s family income must be at or below 133% of the federal poverty level, live in the state from which they are receiving Medicaid, and be a US citizen or qualified non-citizen.

 

 

Medicare - In its essence, Medicare is also a government-funded healthcare program for those who are age 65 and older, have a disability, or have End Stage Renal Disease, which helps them afford a substantial portion of healthcare procedures. Since Medicare mostly functions like a single payer healthcare system, “Medicare for all” is the commonly used phrase by those who support single payer healthcare. There are, however, certain procedures not covered by Medicare, including long-term care, dental care, eye exams, dentures, cosmetic surgery, acupuncture, hearing aids, hearing exams, and foot care.

 

  • For more information, visit https://www.medicare.gov/ 

  • Resource shared with us by RetireGuide - a free web resource dedicated to providing useful information to help older adults fulfill their retirement goals.

On the Laptop

Healthcare is one of the many struggles for people of low socioeconomic status.

Play the Spent game to enter the perspective of someone with financial struggles. 

Reading Map on Mobile

Use this map showing parts of the U.S. where it is the easiest and hardest to escape poverty.

 

MEDICAID EXPANSION

The Affordable Care Act

 

Passed in 2010, the Affordable Care Act (ACA) was made for the purpose of bringing the United States one step closer to the goal of universal healthcare. There have been non-controversial components of the ACA, such as making it illegal for insurance companies to charge more or deny coverage for a pre-existing condition. Other parts of it were more controversial, including the individual mandate to have health insurance (repealed in 2018), the Medicaid expansion (that must be adopted by the states to take effect), and the increased government subsidies for healthcare. The ACA became highly political after it was branded as “ObamaCare” by Republicans in the 2012 election cycle to attract opposition to the ACA. While most aspects of the ACA survived attempts to “repeal and replace” ObamaCare, the Trump administration repealed the individual mandate to have health insurance, which created a tax penalty for those who left themselves and others at risk by not having health insurance in 2018. Meanwhile, more states continue to adopt the Medicaid expansion by legislature and referendums. 

 

The ACA has 3 primary goals: 

  1. Make health insurance available to more people by giving customers subsidies to lower insurance costs for households with an income between 100% and 400% of the federal poverty level.

  2. Expand Medicaid to the states to raise the maximum qualification income from 133% of the federal poverty level to 138% of the federal poverty level, meaning more people can qualify for Medicaid (this requires the states to pass Medicaid expansion). 

  3. Support innovative care delivery methods to lower the cost of healthcare.  

 

Benefits of Medicaid expansion:

Medicaid expansion has shown a variety of benefits. Many states were able to reduce their uninsured rates, have more affordable healthcare, and increase financial security for the underprivileged. Medicaid expansion is also associated with reductions in rates of overall mortality, food insecurity, home evictions, and poverty. Furthermore, there has been further analyses indicating expansion has improved self-reported health and healthy behaviors among Americans. 

 

One of the biggest worries about Medicaid expansion is its financial aspect in that taxes will increase for American taxpayers for it to occur. However, research shows that expansion actually has economic benefits: revenue gains, state budget savings, and economic growth. Specifically for Missouri, Medicaid expansion helps the state’s hospitals and economy by saving/creating jobs, bringing more federal investment to the state, and stopping the closure of rural hospitals.

 

States that have passed and implemented Medicaid expansion: 

 

Alaska                       

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

Hawaii

Idaho 

Illinois

Indiana

Iowa

Kentucky

Louisiana 

Maine 

Maryland

Massachusetts

Michigan

Minnesota

Montana 

Nebraska

Nevada

New Hampshire

New Jersey

New Mexico

New York

North Dakota

Ohio

Oregon

Pennsylvania

Rhode Island

Utah 

Vermont

Virginia 

Washington

West Virginia

Washington, D.C. (not technically a state) 

States that have adopted but have not yet implemented Medicaid expansion: 

Missouri

Oklahoma 

 

States that have not adopted Medicaid expansion: 

Alabama

Florida: A referendum to expand Medicaid will be on the ballot in 2022.  

Georgia 

Kansas 

Mississippi 

North Carolina 

South Carolina

South Dakota 

Tennessee

Texas

Wisconsin 

Wyoming

COVID-19

What we can learn from the pandemic:

 

The COVID-19 pandemic has certainly caused great chaos and sorrow to families throughout America, especially as the United States was hit the hardest by the virus. It is important for community members to also realize that COVID-19 has further exacerbated the gaps in health coverage for underprivileged groups and shown the effects of a profit-based healthcare system. To learn more about structural racism, how it has impacted healthcare for racial and ethinc minorities, and what you can do about it. https://missourihealthcareforall.org/structural-racism/.

 

Racial and ethnic minorities have been infected by and died from COVID-19 at a higher rate than white Americans. This can be attributed to a variety of causes (as stated by the CDC website): 

  • Members of racial and ethnic minorities may be more likely to live in densely populated areas because of institutional racism, making social distancing harder. 

  • Members of racial and ethnic minorities are more likely to have health conditions that make COVID-19 more dangerous to them due to socioeconomic barriers and often living in areas with lower air quality. 

  • Racial and ethnic minority groups are overrepresented in jails, prisons, and detention centers, which further increases COVID-19 risk.

  • Many do not have health insurance. Compared to whites, Hispanics are almost three times as likely to be uninsured, and African Americans are almost twice as likely to be uninsured, making preventative care and COVID-19 infections more financially devastating.

  • Inadequate access is also driven by language barriers and financial implications associated with missing work to receive care.

  • Black and Hispanic workers are more likely to be in jobs that are essential and require them to work outside of home.

 

As you can see, structural racism is a very big issue, and you can help by getting involved with these organizations that are working to end structural racism: 

 

Lasting imprints of COVID-19:

 

Our healthcare system will be forever changed by COVID-19. Therefore, it is important to continue advancing healthcare and expanding accessibility and affordability of healthcare for all patients. The COVID-19 pandemic has highlighted racial and socioeconomic disparities within our healthcare system, making it more important than ever to reform it in the event that such a pandemic ever happens again. Moreover, we will need to take additional steps to be prepared if such a pandemic happens again, which includes expanding access to preventative care that keeps people from developing conditions that make them more likely to die from the virus. Finally, it will be more important than ever before to have a healthcare system that’s not based on making a profit. 

To keep up with how your area has been affected and is being affected by COVID-19, follow the Johns Hopkins University national map, which shows the cumulative number of cases per capita for every county and county equivalent in the United States and the Pandemics Explained national map, which shows the daily average number of new cases per capita for every county and county equivalent over the last week. 

 

Johns Hopkins Map: https://coronavirus.jhu.edu/us-map

Pandemics Explained Map: https://globalepidemics.org/key-metrics-for-covid-suppression/

 

Resource for Joplin, Missouri residents: 

 

This is a Joplin COVID-19 resource guide made by founder Jihyun (Jane) Min, which is based off of a resource guide made by Grace Kyung’s resource guide for St. Louis. Jane collaborated with Missouri Health Care For All in making this as she wanted to provide a comprehensive tool for Joplin residents to give them accessible information on the resources available in their community. Comments/suggestions are welcomed! Please go here.

 

For Grace Kyung’s resource guide, click here