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I chose this topic because healthcare remains a widely debated issue in the United States. I want to explore the social issues associated with the U.S. healthcare system.

It can be a controversial subject, especially for those with excellent health insurance or the financial means to cover medical expenses without incurring debt.

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Historical context and key people in the healthcare system

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Historical context and key people in the healthcare system

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Teddy Roosevelt and the Progressive Party first introduced social insurance and also included health insurance, as a result the health policy and reform began in 1912. In the same year the National Convention of Insurance Commissioners developed the first state law to regulate health insurance.

After hundreds of years of bills passing for insurances, medicaid and medicare. Obama introduced in 2010 that all individuals of the United States have health insurance by 2014. This was a big step towards a more equal health care system. The poorest individuals would be covered under medicaid and people with low income would be able to purchase health insurance with the help of federal subsidies.

Unfortunately in 2016, President Trump eliminated the mandate section of the Affordable Care Act.

From 2020 till now The Biden Administration took steps to reduce healthcare costs and boost enrollment through the healthcare marketplace.

But the problem is still visible: the healthcare system is not equal. Not everyone can afford it or needs help with getting enrolled.

“August 2023: Approximately 7.7% of the US population is uninsured”(A (Brief) History of Health Policy in the United States, Katherine Smith)

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810293/

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How are social factors affecting access to healthcare in the US?

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How are social factors affecting access to healthcare in the US?

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Class and income: The ability to obtain or afford health insurance can vary on an individual's income and employment status. Poor and low-income individuals put off the needed medical care because they can’t afford the copay or deductible and they don’t want to be in debt.

Region: The region the individual lives in can determine whether you have access to health insurance or not. In urban areas and big cities the healthcare providers might be limited or hard to find, which makes it hard on individuals to find a provider they are comfortable with.

Legal status: For noncitizens it's almost impossible to seek medical help if they need to. They might face waiting periods and might not even be eligible for public health insurance. Some immigrants are also not seeking medical help because of fear of deportation.

Race and Ethnicity: Nonwhite Americans are underrepresented in medical fields, this makes it hard for Black, Latino and Native Americans to find a provider who shares their race. These patients face racial and ethnic background discrimination and are most likely to be not taken seriously or their symptoms/ pain is dismissed or minimized.

Gender Identity and Sexual Orientation: Abortion, practices to preventHIV and gender confirmation surgery are often controversial in politics. This has a big impact on cisgender and LGBTQ individuals. Transgender as well as LGBTQ individuals often feel ashamed or are scared of judgment and therefore are having a hard time finding a provider they feel comfortable with.

Disability: Some government administrations try to limit the range of federally funded healthcare coverage, which can affect disability benefits. For example, the Trump administration attempted to narrow Medicaid coverage by allowing states to require work as a condition for receiving benefits.

Source: https://online.maryville.edu/blog/social-issues-in-healthcare/

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Health and healthcare disparities in the US

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Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment.

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More than 30% of direct medical costs faced by U.S. Blacks, Hispanics and Asian-Americans can be tied to health inequities.

Because of inequitable access to care and other health-promoting resources, these populations are often sicker when they do find a source of care and incur higher medical costs. (...) In addition, studies have shown that clinicians tend to have more negative attitudes toward people of color, and unconscious racial bias among clinicians has been shown to lead to poorer communication and lower quality of care.

Source:

https://www.apha.org/what-is-public-health/generation-public-health/our-work/social-justice#:~:text=Health%20care%20—%20More%20than%2030,and%20incur%20higher%20medical%20costs.

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"Women often go undiagnosed or receive delayed diagnosis"

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Gender Disparities in Healthcare | Cedars-Sinai

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How do social issues affect the health of these individuals?

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How do social issues affect the health of these individuals?

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Many individuals are underinsured or don’t have health insurance at all

Uninsured individuals are more likely to be hospitalized for avoidable health problems

They also receive fewer diagnostics and have a higher mortality rate

Individuals are ashamed or scared to seek medical help

Diseases are more likely to spread without medical help

Obesity and diabetes are more likely to form without the needed medical assistance

Individuals are feeling like a minority and don’t feel equal to the ones with adequate medical help

Higher stress levels due to the social issues can negatively impact mental and physical health

Source:

https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/#:~:text=When%20they%20are%20hospitalized%2C%20uninsured,rates%20than%20those%20with%20insurance.&text=Research%20demonstrates%20that%20gaining%20health,effects%20of%20having%20been%20uninsured.

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A personal story about health inequality

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A personal story about health inequality

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Minority Health Disparities | Michelle's Story

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Laws and regulations within the healthcare system:

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Laws and regulations within the healthcare system:

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Healthcare regulations are crucial for many reasons, especially for ensuring that healthcare services are safe, high-quality, and run smoothly. One of the main goals of these regulations is to protect patients' rights and health. For example, the Health Insurance Portability and Accountability Act (HIPAA) in the U.S. requires healthcare providers to keep patients' health information private and secure. Other regulations ensure that patients give informed consent before receiving any treatment.

These regulations also help improve the overall quality of care. They set guidelines for the certification and operation of healthcare providers and facilities, making sure that healthcare professionals meet certain training and qualification standards. This helps guarantee that patients receive high-quality care. Additionally, regulations promote the use of best practices and evidence-based medicine, ensuring that patients get the most effective treatments available.

Despite the numerous regulations and laws in the U.S. healthcare system, disparities in treatment still exist. Issues like racism, sexism, and bias continue to affect how medical staff treat patients. This has been a persistent problem, and it's crucial that it changes. We need to ensure that everyone has access to equal healthcare, regardless of their background.

Source:

https://www.ambula.io/5-regulations-that-impact-healthcare-practices/

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What needs to be done to achieve equal healthcare for everyone?

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What needs to be done to achieve equal healthcare for everyone?

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Addressing bias and discrimination: Healthcare providers and staff need training to recognize and combat biases.

Improving access to care: Ensuring that everyone has access to affordable and high-quality healthcare is essential.

Promoting diversity in healthcare workforce: A diverse healthcare workforce can help bridge cultural and language gaps, improve patient-provider communication, and reduce biases.

Enhancing patient education and health literacy: Educating patients about their health, their rights, and how to navigate the healthcare system empowers them to make informed decisions.

Community engagement: Engaging with communities to understand their specific needs and challenges is vital.

Sources:

https://www.ama-assn.org/delivering-care/health-equity/ama-guidelines-offer-path-prevent-discrimination-medicine

https://harvardpublichealth.org/policy-practice/taking-steps-toward-anti-racist-healthcare/

https://health.gov/healthypeople/priority-areas/health-equity-healthy-people-2030

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Coming from Germany, I always had the security of health insurance, which I knew was a privilege and deeply appreciated.

However, when I first arrived in the U.S. on a K1 Visa, I found myself without insurance, and the possibility of being uninsured was frightening. I needed temporary health coverage until I could join my husband's plan after our marriage, but finding affordable options was challenging, especially since many required citizenship. There were a few available, but they had specific conditions that I couldn't meet, leaving me with limited choices.

This experience alone was unsettling. It made me empathize with those who can't afford healthcare or are afraid or ashamed to seek medical help. I strongly believe that society, along with politicians and those in power, should work together to ensure healthcare is accessible, affordable and equal for everyone, regardless of race, gender, or background.