Nur 420

The lack of access to healthcare by all Americans.

XOXOXOOX

University of Maryland Global Campus

NURS 420: Advocacy and Politics in Nursing

XXOXOXOO

March 23, 2023

Introduction

Healthcare access refers to having the capacity to get healthcare services such as disease prevention, diagnosis, and treatment, as well as diseases and other health-related conditions. Healthcare must be both affordable and convenient to be accessible (American College of Physicians 2019). Health Equity is the attainment of the maximum level of health for all. Access to healthcare services is essential to the health and well-being of individuals and communities. All Americans must be able to access health care services to benefit from them (American College of Physicians 2019).

In the United States, affordability and a lack of insurance can significantly hinder receiving needed care. The introduction of the Affordable Care Act in the United States addressed issues such as lack of healthcare access and affordability. Therefore, the paper is focused on the lack of access to healthcare, describing the population that is mainly affected, healthcare disparities linked to the lack of access to healthcare, providing a summary of the ACA, analysis of the effects on the consumer challenge, and making proposals for the future action. 

Access to healthcare: Problem

The lack of access to healthcare for all is a significant problem in the United States. Most citizens in the country do not have health insurance and face more significant barriers to accessing healthcare (Tolbert et al., 2022). Many Americans will choose housing and food over healthcare coverage. Without access, people live with health problems that increase their suffering and mortality. Many people do not have access to coverage through a job, and indigent adults in states lacking the expanded Medicaid, remain ineligible for financial help for coverage.

Many people face barriers due to high costs, financial constraints, physician shortages, and the limited availability of healthcare providers. Lack of access to healthcare prevents people from obtaining needed prescription drugs, behavioral health services, reproductive health services, and prevention services. Individuals from vulnerable populations like low-income families, middle class, racial and ethnic minorities, and rural residents suffer disproportionately from the problem. 

Affected Population

           Those from low-income families are most affected by the lack of access to healthcare services. The lack of access to healthcare also affects race and ethnic minorities and individuals living in rural regions. Most of these people are insured but underinsured, making it hard to access life-sustaining services (Cyr et al., 2019). Due to this vulnerability, the barriers to healthcare access are linked to the lack of transportation, cultural beliefs and practices, and language barriers. The population also experiences more significant health disparities associated with high incidences of chronic diabetes, preventable hospitalization, and a high mortality rate. 

Health Disparities Associated with the Problem and Population

           The lack of access to healthcare services results in health disparities. It denies this group primary preventive care like immunization to help prevent some health issues. It exposes them to tertiary prevention only when the disease progresses, and the health outcomes are often adverse. It may lead to exposure to other chronic conditions like hypertension, diabetes, chronic kidney disease, and asthma. These individuals are also at high risk of exposure to preventable hospitalization and high mortality (Braveman, 2022). Hospitalizing individuals, especially those with diabetic complications, may lead to amputation of extremities and diabetic Ketoacidosis. It exposes patients to other nosocomial conditions that result in long-term hospital stays, increased medical costs, and disabilities. Racial and ethnic minorities face more significant disparities in access to healthcare services and quality hence poor health outcomes. The rural population faces a challenge in accessing services due to the reduced availability of providers and hospitals. 

Legislation and the Political Activities

           The Patient Protection and Affordable Care Act (ACA) is the principal legislation addressing the country's lack of access to healthcare services. The focus of the ACA policy is to ensure an increase in the number of individuals accessing affordable healthcare services in the country (Baumgartner et al., 2020). The ACA legislation ensures that such objectives are met by supporting the expansion of Medicaid coverage, creating health insurance marketplaces, and implementing the laws. Furthermore, ACA protects consumers from the abuses caused by insurance firms. Additionally, the provisions of the ACA legislation are used to enhance the quality of services and reduce the medical costs for the general population, especially those considered to be vulnerable to lack of access to healthcare services in the country. 

           American College of Physicians continues to advocate for improvements to ACA and comprehensive reforms to achieve universal coverage, including consideration of a single-payer or public option to ensure that no one goes without affordable coverage. In addition, they advocate control of the rising cost of prescription drugs and healthcare services, expanding access to behavioral health and reproductive and preserving access to care for immigrants to the United States (American College of Physicians 2019).

Effect on the Consumer

           There has been a significant effect of the ACA on healthcare access and affordability for individuals falling under the vulnerable population. The expansion of the ACA Medicaid has led to a rise in access to healthcare services, especially for individuals in the category of low-income groups (Baumgartner et al., 2020). Consequently, there has been an improvement in the overall healthcare outcomes for the population. 

           The ACA policy has also resulted in the creation of the insurance marketplace. As a result, individuals have found it easier to purchase affordable health insurance coverage. Also, the introduction of the ACA consumer protection provisions has improved the quality of the services and a drop in the medical costs for consumers. 

Conclusion

           The lack of access is a significant problem in the United States, and it affects equity, access, affordability, and social justice within the healthcare sector. In the United States, individuals are most vulnerable to the impacts of the lack of access to healthcare services. These population groups are those from low-income families, the racial and ethnic minorities in the country, and individuals from rural regions. These groups are greatly affected compared to other population groups in the country. They experience health disparities in preventable diseases ad unfavorable outcomes. The affected population is exposed to preventable hospitalization and high incidences of mortality. 

References

Baumgartner, J., Collins, S., Radley, D., & Hayes, S. (2020). How the Affordable Care Act (ACA) Has Narrowed Racial and Ethnic Disparities in Insurance Coverage and Access to Health Care, 2013‐18.  Health Services Research,  55, 56-57. https://doi.org/10.1111/1475-6773.13406

Braveman, P. (2022). Defining health equity.  Journal of the National Medical Association,  114(6), 593-600. https://doi.org/10.1111/1475-6773.13406

Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to specialty healthcare in urban versus rural US populations: a systematic literature review.  BMC health services research,  19(1), 1-17. https://doi.org/10.1186/s12913-019-4815-5

Tolbert, J., & Drake, P. (2022). Key Facts about the Uninsured Population. Retrieved from KFF: https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/

American College of Physicians (2019). Access to care. https://www.acponline.org/advocacy/where-we-stand/access-to-care

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