Extending Access to Health Care
Many lawmakers and citizens aim for health care reform to ensure equal, reliable access to health care and insurance for all Americans. This concern is valid, as millions lack insurance or face challenges in obtaining care. Unexpected events, like illness or job changes, can leave individuals without coverage, affecting not just low-income individuals but also middle-income families.
Rising health care costs complicate reform efforts, with some arguing
that controlling costs is necessary before expanding coverage. However,
the committee believes this approach ignores the inefficiencies caused
by the lack of universal coverage, which can lead to delayed care, "job
lock," and cost-shifting, where providers raise prices for private
payers to offset losses from charity care and underpayments.
The committee is of the opinion that enhancing health coverage is likely
to result in increased overall health care expenses—stemming from public
and private sectors—in the short term. While a gradual approach to
comprehensive reform, which includes improved access, is sensible, it is
essential to take immediate actions that guarantee broader.
Many reform proposals emphasize financial challenges as the primary
barriers to access, particularly regarding inadequate, insufficient, or
unreliable health insurance. However, it is important to acknowledge
that achieving access to effective health services involves more than
just financial considerations; other obstacles must also be addressed.
Barriers to access
Many obstacles can prevent people from getting timely and effective healthcare services. These obstacles include:
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lack of money, as mentioned earlier
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the distance from primary, secondary, and tertiary healthcare facilities, which is worsened by transportation problems
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insufficient education, language difficulties, unsafe neighborhoods, and other non-medical issues
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issues within the healthcare system itself, like uncoordinated service delivery and low payment rates for certain providers (such as those under Medicaid), which can limit access to care for those who need it
There are still gaps in understanding how factors like medical treatment, community and work environments, and personal social, cultural, and biological elements interact to influence health outcomes and healthcare usage
Healthcare reform can be crucial in eliminating barriers that stop people from receiving the medical attention they need, which could ultimately lead to better health and well-being for many individuals. However, it’s important to understand that these reforms won’t fix every health problem or tackle every underlying issue in the same way. For instance, there aren’t effective medical treatments for problems like cocaine addiction in pregnant women. Conversely, challenges like injuries or deaths from domestic or neighborhood violence may be better addressed through non-medical approaches, such as job creation, improving education, and crime prevention, instead of relying solely on medical solutions. One reason for linking healthcare spending increases with the economy is to free up resources for these types of programs. Ultimately, a long-term approach to healthcare reform must consider what is realistically achievable and recognize the limitations in improving health outcomes.
Financial Access
Principal
The committee argues, based on both philosophical and practical reasons, that addressing financial obstacles to healthcare needs to be rooted in the fundamental, interconnected principles mentioned below. Transforming these principles into laws that effectively enhance access to health services will be a tough task due to various political and technical factors. Surveys and personal experience reveal a disconnect between the admirable values our nation claims to uphold and the narrower interests we tend to protect. Nevertheless, the committee insists that these principles form a strong foundation for healthcare reform.
Every individual—whether they are working or not, whether they are sick or healthy, young or old—should be part of a health benefits plan. This plan might be a single national program or a variety of public and private options. However, no one should have to depend on charity healthcare or go without insurance simply because they feel healthy now. “All or virtually all persons—whether employed or not, whether ill or well, whether old or young—must participate in a health benefits plan.”