With the world beginning to return to “normal” after the pandemic, people are more conscious about their health now more than ever. However, not everyone has the same experience when it comes to receiving care. America has a private healthcare system that relies on private companies and providers. This system has its benefits as well as its drawbacks. In this essay, I will be discussing the ways in which the American healthcare system has created large disparities between socioeconomic classes.
Our current healthcare system has two main sections: the public and the private. The public section includes government-funded entities such as Medicare and Medicaid. This section is funded via federal and state taxes. The private section is comprised of insurance companies, pharmaceutical companies, providers, etc. This section is funded via private spending and private investments.
When it comes to someone without private insurance their care options are limited in comparison to someone with private insurance. Without private insurance, many people opt to take medicare or Medicaid because it’s free to them. However, this is not without its drawbacks. Because these options are government-funded and funding is limited, the overall coverage of these plans is often limiting. By using free healthcare options you are funneled into a few crowded networks that accept these plans. These options are also subject to change depending on governmental budgeting. This can mean inconsistent coverage from term to term. In contrast, people with private insurance tend to have more options when it comes to who they get treated by and the extent of their treatment. Not only does having private insurance give you more options, but it also usually means less crowded networks.
These disparities between social classes inside our healthcare system have raised debate over whether a fully public system would be better. In the case of public healthcare, there are multiple advancements I think we could implement. Public healthcare would make sure that everyone has equal access to healthcare regardless of finances. Increasing the population’s overall participation in healthcare can lead to a more productive community. Another benefit to a public system would be the counteraction of adverse selection. Adverse selection is the term for when the most at-risk people tend to buy insurance while healthy people don’t. Thus increasing premiums and making everything for everyone more expensive.
In the case of a private healthcare system, there are some positives that make it appealing. Firstly, a private system is usually more efficient than a public one because of financial incentives. As mentioned earlier, a private system gives people who can pay more options for their care. This includes being able to see specialists and undergoing procedures that wouldn’t be covered under free coverage. Additionally, public systems become overcrowded quickly due to the increased patient volume. This puts a strain on the overall infrastructure of the healthcare system as well as on the staff. A private system allows for better compensation for workers. It also spreads out patients across the private sector. The private sector also allows for research and development using private funds. This bypasses the bureaucracy which can often take too long. Instead, it allows private interests to fund projects without having to rely on taxpayer money.
The next section will be a discussion of two case studies. One is about a series of free clinics in Virginia and the other is about the financial impact of medical bills on people's lives. I felt that it was good to show the two sides of healthcare that many impoverished people face.
Case Study 1: Free Clinics and Services in Virginia (VAFCC)
The Virginia Association of Free and Charitable Clinics (VAFCC) is working to bring free healthcare to their community. Their mission is to provide top-of-the-line healthcare free of charge to their patients. The first patient story is from Christine. Christine recently lost her husband and his employer-based insurance. She then lost her job during the pandemic leaving her without any insurance. She was able to find free healthcare through the VAFCC system. The next patient story is from Deborah. Deborah had been living with little access to medical care due to no insurance. When she suddenly fell ill she didn’t know where to go. Luckily she found the VAFCC system and went to one of their clinics. Once there she was diagnosed with hepatitis C, hypertension, and anemia. These conditions require prolonged treatment and would normally be unattainable for someone without insurance. However, the clinic was able to cover all costs and Deborah can keep on returning for treatments.
This study shows the positive work being done right now in the medical field to aid those without coverage. There are multiple programs like this all around the country. However, because they are all individual entities they lack the infrastructure to have a uniform policy. I also wanted to mention the fact that a hospital will treat any emergent patient regardless of ability to pay. Most hospitals have a fund that covers free treatments. But that fund is only so big, that’s why most of the free treatment is for emergent patients only.
Case Study 2: LA Times Article Interviews
Homes lost. Savings destroyed. How medical debt has upended these people’s lives, By: Noam Levey and Aneri Pattani
In an LA Times article, Levey and Pattani set out to tell the devastating stories of how medical bills have destroyed lives. The first story we’ll look at is from Allyson Ward. Allyson was a nurse practitioner with twins on the way. When the twins were born 10 weeks early with cerebral palsy Allyson's life would change forever. The twins had to spend three months in the NICU. Allyson’s insurance denied claims on certain treatments deeming them “unnecessary.” This racked up over $80,000 in medical bills. Allyson is an example of when people believe that their insurance will cover all their costs and instead are blindsided with hefty payments. The second story is from Ariane. Ariane fell behind on his medical bills and when he went to his primary care office to get treated he was turned away due to his outstanding bills. Instead, he was forced to go to the ER to be treated. Once there he was diagnosed with an intestinal bacterial infection. Since Ariane had to go to the ER he was stuck with thousands of dollars in bills. Years later Ariane is filing for bankruptcy and he says his compounding medical bills are a large reason why. This story showcases the fact that medical providers have the right to refuse you care due to outstanding charges. This often leads people to “ration” their medical care in order to avoid medical bills. This can lead to conditions developing due to a lack of consistent care.
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