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Equalities And Inequalities In The Us Health System

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By Author: Sherry Roberts
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Equalities and Inequalities in the US Health System
The United States has one of the poorest health care systems despite the nation being one of the most developed nations in the world. The inequalities in the healthcare system persist irrespective of efforts to eliminate the gap. An area that stands out is racial inequality in accessing quality health care services. Minority communities continue to experience inequality in accessing healthcare services, especially in the public health sector. In fact, it is argued that incarcerated minority communities have a better chance of accessing quality services compared to their counterparts in the free world. Sectors such as the incarceration facilities are mandated by law to provide quality healthcare services to inmates.
Paradoxically, an inmate is thus likely to have decreased mortality and morbidity compared to his counterpart in the free society. The United States also continues to express significant levels of income inequality that impacts access to quality, healthy health care services. Well-paid citizens can afford even the most expensive treatments as they can afford insurance. In contrast, low-income citizens have no choice but to utilize the public healthcare system that is strained and underperforming. Moreover, without insurance, the low-income earner cannot access the same level of quality healthcare services as the high-income earner (Bezruchka, 2010). The problem of income disparity is also tied to the level of education as well as level of access to information on different health issues. A low-income earner is likely to have minimal or no education which means that he is also unable to access healthcare information.
The introduction of laws such as the patient protection and affordable care act (Obamacare) was meant to reduce the inequality of accessing healthcare services. The act was introduced with the intent to increase the number of people that have insurance coverage and thus can access quality health care services. The introduction of the act led to a significant reduction in the number of uninsured persons in America. The enactment of the law also saw a significant reduction in overall healthcare spending. Obamacare thus provided the uninsured public with the promise of reducing disparities in health and medicine by enhancing access to equitable and efficient health care (Adepoju, Gonzales, 2015).
Unfortunately, Obamacare remains adequate in eliminating health disparities in its entirety. The act enhanced equity by increasing the number of people covered by insurance. The increase in insurance coverage meant that a larger percentage of the American public could now enjoy access to quality healthcare than before. However, Obamacare did not eliminate inequalities as there were differential accesses to health insurance across different states. By 2015, only 27 states had decided to expand Medicaid programs in line with the provisions of Obamacare. Moreover, there has been evidence that children from minority communities are unable to access a patient-centered medical home. The Accountable Care Organization (ACO) has become fledgling ACO type of arrangement with Medicaid and private health insurers. The arrangements have had no advantage in reducing disparities in the delivery of healthcare services. Moreover, despite the introduction of Obamacare, there is a continuous underutilization of effective preventive health care services and early detection interventions (Blumenthal, & Collins, 2014). The burden of chronic disease remains irrespective of the introduction of Obamacare. The healthcare community needs to increase awareness of the areas that are covered by Obamacare so that the public engages in aggressive preventive health care initiatives. Early detection increases the chance of recovery even for chronic disease.

Reference
Adepoju, O. E., & Gonzales, G. (2015). Health Care Disparities in the Post–Affordable Care Act Era. American Journal of Public Health, 105(Supplement 5), S665–S667.lumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act—a progress report.


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