Premium Essay

Access to Insurance Versus Access to Care

In:

Submitted By tyanna01
Words 1091
Pages 5
Access to Insurance Versus Access to Care
Access to Insurance Versus Access to Care and the Impact of the Affordable Care Act
Tyanna Qualls
Walden University

Access to insurance differs from access to care because of cost. One example of my personal experience of insurance and access to care was when I had to assist my brother with his sickness battling sickle-cell anemia. My brother resided with me the last six months before he transitioned over so I witnessed firsthand the lack of quality care he received due to being underinsured. Medicaid was my brother’s only source of health insurance. His sickness prevented him from maintaining a full-time job. The full-time jobs he did hold did not offer him an affordable insurance plan due to his condition. One employer denied him coverage completely because it cost too much to insure a person who needs extensive long-term care. Pre-existing clauses prevented him from receiving necessary preventatives services. The pharmaceutical companies charged high copays for name brand medications that he needed. Medicaid drug formularies limited his access to many beneficial drugs. Lack of insurance coverage prevented him from having a primary care physician to see consistently so he frequented the ER departments at the community hospitals. Whenever he was admitted into the hospital, he had a certain amount of days they would keep him, a lot of medical services were not provided to him because of his level of benefits with Medicaid, and he was often discharged from the hospital still in pain. His access to care was breached due to lack of insurance. Insurance plays a very important role with people who have terminal and genetic illnesses. Access and quality care are necessary and important key components in healthcare. Having health insurance increases access to care and positively affects health outcomes (Teitelbaum & Wilensky,

Similar Documents

Premium Essay

Access to Insurance vs. Access to Care

...Access to Insurance Versus Access to Care October 23, 2011 Access to Insurance Versus Access to Care Access to insurance means that a person has a contract where a company will reimburse either the person or health care professional for treatment of a certain disease process or medical problem. However, one may have insurance for a condition but not be able to access care for that condition. This can arise for several reasons including physical proximity to the care being rendered, available care opportunities already being occupied by people requesting the care earlier than the next-comer, and businesses closing their doors due to costs not being reimbursed adequately for care being provided. Access to Insurance The Patient Protection and Affordable Care Act of 2010 (PPACA) as explained by Davis (2010) gives more access to insurance for United States citizens. Improved access to insurance comes from multiple rules that range from prohibiting restriction of insurance coverage to covering children of already those already covered by insurance up through age 26. Since the PPACA is based on the Massachusetts’ 2006 health care reform plan (Gruber, 2011), it is reasonable to evaluate the effects that have been experienced in Massachusetts. One thing to note is that 124,000 fewer people in Massachusetts have employer-sponsored insurance, creating an even bigger public burden, since this is a way to reduce non-salary personnel expenses (Byron, 2011). The same scenario is being...

Words: 1009 - Pages: 5

Premium Essay

U.S Health System vs. Canada Health System

...it comes to the Health System. One similar being is both of their cultures and their health status. They have unlimited access to health care and are able to provide good quality care to their citizens no matter the cost. There are far more differences than similarities though. The most significant differences between the two countries are the role of private health care insurance and spending levels. Canada’s health system seems to do more for less, they provide access of health care to many of its citizens. Canada’s health system allows unlimited access to the public for many medical health services. These different services include the different physician and hospital services for their patients. Their health care system is through a government-sponsored system. They have many advantages and their unlimited coverage is universal and portable. In Canada health system, any and all citizens are covered through medical insurance no matter what their age or job may be. Many health systems won’t give you medical coverage because of your age and that shouldn’t be the case. Just because you may be too young or too old, everyone should have unlimited access or health care coverage. Also just because you may not have a job or have a career job that gives you everything you need for the rest of your life. You should still get coverage and Canada allows this access. One positive being about Canadas health system is that your preexisting medical conditions cannot deny you from any health...

Words: 834 - Pages: 4

Premium Essay

Rising Cost of Health Care

...The Rising Cost of Health Care: Effects on Access to Care The rising cost of health care is a trend that is negatively influencing access to health care. According to our course textbook, Policy and Politics in Nursing and Health Care, over 46 million Americans did not have health coverage in 2008, and 25 million American adults were underinsured (p. 124-125). For most people, this can be attributed to the high cost of premiums, co-pays, and deductibles. The purpose of this paper is to discuss the history of the trend of rising health care costs, the influence rising costs have on the delivery of health care, how rising costs create disparities in health care, and two ways that nurses can address inadequate access to health care. Access Trend In the U.S., there are more people today than ever before, unable to access quality health care. “Access is the ability to obtain needed, affordable, convenient, acceptable, and effective health care in a timely fashion” (Mason, Leavitt, & Chaffee, 2012, p. 124). This lack of access is attributable to the high cost of health care, which makes it unaffordable for the working poor, and those working for small businesses, to pay for adequate health care. There is an inverse relationship between the cost of health care and good patient outcomes. It is estimated that $7,000 per person, including children, is spent on health care in the U.S., yet the country does not rank in the top 15 of industrialized countries in terms of good health...

Words: 1289 - Pages: 6

Premium Essay

Primary Care Barriers

...Barriers to Access In an ideal world, after the enactment of the ACA, millions of Americans would gain coverage under the Medicaid expansion or young adults expansion, and all of these newly covered people would then have the opportunity to set up a primary care provider and receive care and treatment through their own primary care physician. Unfortunately, that is not the case and millions of Americans are left with coverage, but no access to primary care. Thus resulting in higher numbers of ED visits by newly insured individuals due to lack of access to primary care. Identifying the barriers to accessing primary care will help to formulate solutions for this health care crisis. One of the most popular barriers to access to primary care is an inadequate supply and availability of primary care options (Cheung et al., 2012). Most primary care offices run a normal 8am to 5pm Monday through Friday schedule, which proves to be difficult for many Americans who are working. Specifically looking at Medicaid versus private insurance, there is a large gap between access to primary care, 16.3% of Medicaid beneficiaries had greater than or equal to one barrier to timely primary care compared to the 8.9% of private insurance beneficiaries (Cheung et al., 2012). In a recent survey, researchers took five common...

Words: 633 - Pages: 3

Premium Essay

Different and Equal or Different and Better

...Better The Economics of Health and Health Care June 10, 2013 Strayer University Assignment #4 Select a country that has universal health care system provided by that country and provide some background information on this country. The Obama administration passed a health care bill that takes the U.S. part of the way towards a government-controlled system. However, it’s no secret that health care costs are increasing out of control in this country. Research says, as individuals we spend more per person on health care than both food and housing. Insurance premiums are multiplying much faster than inflation, which prevents economic growth and leaves businesses with less money to provide raises or hire more workers. While the quality and availability of medical care in the United States remains among the best in the world, many wonder whether we'd be better off adopting a universal government-controlled health care system like the one used in Canada. America doesn’t have universal health coverage; over 37 million people are without health insurance and approximately 53 million are underinsured, which means that they are inadequately insured in the event of a serious illness. Universal health care is a term that refers to a government system meant to ensure that every citizen or resident of a region that has assess to the required medical services. Thirty years ago there wasn’t a significant difference in the provision of health care between the U.S and Canada. However, Canada...

Words: 1171 - Pages: 5

Free Essay

Abc Insurance

...The first step that ABC Insurance Company should do is the conduction of some research in regards what Verde Greene Hospital wants them to do in order to get with their contract. ABC has always taken in consideration what employers wants and how to provide services for their costumers. They should analyze how much they will win or loose if they get the contract with the stipulations that Verde Greene Hospital has requested. If they agree they should consider an antitrust behavior and consider the two laws that controls those type of action: 1. The Sherman Act (1890) “Section 1: Every contract, combination in the form of trust or otherwise, or conspiracy, in restraint of trade or commerce among the several states, or with foreign nations, is hereby declared to be illegal. (Stone, 2011)” 2. The Clayton Act (1914) “Section 2: It shall be unlawful for any person engaged in commerce . . . to discriminate in price between different purchasers of commodities of like grade and quality . . . where the effect of such discrimination may be substantially to lessen competition or tend to create a monopoly in any line of commerce, or to injure, destroy, or prevent competition (Stone, 2011).” Is evident that Verde Greene Hospital as a condition to sign the contract imposed ABC to get exclusivity and be the only provider in cardiac and maternity services for the 14 counties that they served. Verde Greene Hospital is getting into the antitrust practice and monopolistic behavior and...

Words: 686 - Pages: 3

Premium Essay

Health Care Industry Analysis Paper

...then, that the combined interaction of these environmental forces influences the course of health care delivery in the United states. The main characteristics of the U.S health care systems : No central governing agency and little integration and co-ordination Technology driven delivery system focusing an acute care High on cost, unequal in access, average in outcome. Delivery of health care under imperfect market condition Legal risks...

Words: 1502 - Pages: 7

Premium Essay

How Structural Racism Affects Healthcare

...cost of medical care seems to be standard across the nation, this is not the case. As stated in the article “Racial Discrimination in Healthcare: How Structural Racism Affects Healthcare” by St. Catherine University, “around 20% of Black adults and 35% of Latinx adults can not access health insurance compared with 10% of white and Asian adults, according to a study cited in Medical News Today.” Without insurance, health care can be extremely pricey, which leads to people not receiving the care they need. Minority groups are less likely to be insured, which means they more often than not will be unable to receive the proper treatments because they can not afford them. Insurance is one of the major parts of medical care. While there are companies across the nation that will offer health insurance to their staff, this is not always the case, and it is much more prevalent in racial minorities; they will often not be insured by their place of work, and because of this would not be able to afford the cost of other healthcare...

Words: 1569 - Pages: 7

Premium Essay

Health Care Systems: the U.S. vs. Canada

...United States health care system is quite unique when compared to Canada’s health care system and those of other countries. Canada provides universal coverage, is privately run and is publicly funded through taxes. The U.S. is the only industrialized country that does not offer universal health coverage. The U.S. is said to be part of the developed world in terms of technology, well trained health professionals and job opportunities although when it comes to health outcomes it doesn’t do so well. Available studies suggest that the health outcomes in Canada were superior to those compared the U.S. The U.S. faces multiple barriers that have made their health care system inconsistent and so costly. In the past the system focused on revenue maximization instead of quality care at an affordable cost. The U.S. spends twice as much more per capita on health expenditures when compared to Canada (O'Neill & O'Neill, 2007). Canada spends much less on health care and yet performs better than the U.S. in health outcomes, infant mortality and life expectancy. A comparison of the U.S. health care system and Canada’s system performance will be evaluated along with the health outcomes that have resulted from each system. The U.S. has a multi-payer private health care system where Canada has a single payer and is mostly a publicly funded system. “In Canada in order to receive full funding for health insurance the provincial government must meet the following criteria: care available to all eligible...

Words: 1238 - Pages: 5

Premium Essay

Standards of Evaluation

...Standards of Evaluation: A Comparison of Health Care Standards Between the US and Canada The Canadian health care system is often compared to the US system. In 2007 a systematic review concluded that outcomes may be superior in Canada versus the United States. The US system spends the most in the world per capita, and was ranked 37th in the world by the World Health Organization in 2000, while Canada's health system was ranked 30th (Guyatt, 2007). In terms of access, more Canadians seem to be covered with a decent health care insurance than Americans. Canada employs the single-payer system, which is a type of healthcare that is financed by a single public body (the Canadian government) from a single fund. In some ways, it appears to be a monopoly of care, because Canadians do not enjoy a wide range of choices in terms of services. This can lead to long wait-times and delays in delivering quality healthcare (Nieves, 2009). According to Dr. Albert Schumaker, former president of the Canadian Medical Association, and estimated 75% of health care services in Canada are delivered privately, but funded publicly. The US, on the other hand, has a mixed private and publicly funded healthcare, with about 16% of the population being uninsured (Guyatt, 2007). This is why there is a lot of pressure on the government to implement universal healthcare, because of the stupendous amount of money being wasted and spent on paying expensive healthcare for the uninsured. There is a push...

Words: 1084 - Pages: 5

Premium Essay

Could Healthcare Reform Improve Its Current Overburdened Healthcare System?

...widespread and affordable health care to its citizens. Will health care reform be able to deliver quality services at affordable cost with its existing workforce crisis in the healthcare system? Number of uninsured Americans has significantly increased, mainly due to aging population and income change. The prevalent issue of America’s healthcare system is insurance coverage, access to healthcare. Americans believe this issue should be prioritized, and it is the direct responsibility of federal government to ensure medical care for those citizens that lack insurance. This essay include history of United States healthcare system, its evolution and how healthcare providers can contain costs of healthcare and provide quality and access to healthcare for everyone. From the beginning of 2014 Affordable Care Act by Obama government is trying to solve the enduring issue of American healthcare system. It is a step in the right direction but this reform is facing lots of resistance from Republican Party, that this reform will put country in debt stress. Many Americans are concerned with quality and access to healthcare with the influx in number of insured entering the healthcare system which is already facing the workforce crisis. United States Health care History Healthcare in United States is enduring issue and it is very sensitive subjects for Americans. United states from the beginning choose a market approach to medical care. Medical care is as a market commodity, that...

Words: 2652 - Pages: 11

Premium Essay

The Paradox of the Affordable Care Act

...the Affordable Care Act Submitted By: Vodney Wynn vewynn@aol.com October 12, 2014 PA582_CourseProject Table of Contents Introduction…………………………………………………………………………………………………………………3 The History of Healthcare Reform……………………………………………………………………………..…4 The Problem with the ACA……………………………………………………………………………………………6 The Current Policy………………………………………………………………………………………………………..8 Policy Alternatives………………………………………………………………………………………………………10 Evaluation Criteria………………………………………………………………………………………………………10 Policy Recommendation……………………………………………………………………………………………..12 Conclusion…………………………………………………………………………………………………………………..13 References………………………………………………………………………………………………………………….14 Introduction Recent health care reform legislation, The Patient Protection and Affordable Care Act and Education Reconciliation Act, which is now being referred to simply as the Affordable Care Act (ACA), was signed into law by President Obama on March 23, 2010. Since the 20th century, several United States presidents have faced challenges in passing national health reform into law. Before the ACA was enacted, national health reform proposals under different governments in the United States faced strong opposition from various stakeholders and multiple interest groups. Therefore, the enactment of the ACA is revolutionary healthcare reform in the history of the United States. Healthcare insurance is a program that assists in paying medical expenses through privately purchased insurance or social welfare...

Words: 4260 - Pages: 18

Premium Essay

Racial Disparities In Health Care

...grave impacts on an individual’s access to health care. These disparities have been around for several centuries and continue to be problematic despite the little progression being made with the revisions of preexisting health care laws. Laws and regulations are continually being revised to allow further health insurance expansions in hopes to reduce the ethnic and racial disparities for access to adequate care. Even with the increase in awareness, policymakers and clinicians have...

Words: 1320 - Pages: 6

Premium Essay

Canadian Healthy Policy vs. United States Health Policy

... United States Health Policy AHS 330 Health Care Systems: 7Q April 2, 2014 Healthcare in the United States is extremely different from the rest of the world. Over the years government and political analysts have compared and contrasted the health care systems of the United States to that of Canada’s. Despite being located on the same continent both countries have different ways of delivering health care to its citizens. Canada has a single-payer system that is publicly funded, while the United States has a multi-payer system that relies heavily on privately owned healthcare. This could be due to the differences in how many patients are cared for compared to those in America or it could be just a matter of who developed the better healthcare. However, due to the close proximity of the countries it is possible that the United States can adopt the Canadian healthcare system. According to Health Canada, Canada's publicly funded health care system is best described as an interlocking set of ten provincial and three territorial health insurance plans. Known to Canadians as "Medicare", the system provides access to universal, coverage for hospital and physician services. With this being said it is safe to assume that health care services are provided on the basis of need, rather than the ability to pay. “The Canadian Health Act contains a single national plan that is composed of thirteen provincial and territorial health insurance plans that all share common features and basic...

Words: 1987 - Pages: 8

Premium Essay

Latinx Community Analysis

...community, in particular, occupies a position filled with disparities and barriers that highlight the intersection of socioeconomic factors and immigration status. These barriers dig deep into medical care but also tie into systemic obstacles such as unequal employment levels, linguistic difficulties, and problems regarding legal status. Derose et al. (2007) discuss...

Words: 2241 - Pages: 9