Health Policies

Posted: July 5th, 2021

Regulatory Vs. Allocative Health Policies

Introduction

Health insurance topic among American citizens has become an important topic among the public, scholars, and lawmakers. Despite the presence of government health insurance policies, insurance agencies, and employer requirements to insure employees, a substantial number of the nonelderly population remains uninsured medically. Below is an extensive and detailed discussion that summarizes the percentage of the uninsured American people, the reasons for not receiving any medical coverage, and the consequences experienced both at the family and at national levels. Finally, a recommendation of changes in the Patient Protection and

ACA policy.

Summary of the Uninsured Population

The number of the uninsured population in America keeps rising, especially among nonelderly people aged below 65 years. According to a report conducted by the Kaiser Foundation, the mainly affected demographic includes the nonelderly population. In two years, the number of uninsured nonelderly population rose to 17.8%, which is equivalent to 46.5 million people (Kaiser, 2018). In most cases, 17.8% involve individuals with financial issues and are mainly middle to low-income populations. Some of them have employers that do not offer any medical coverage, or they are ineligible for the coverage. Despite being employed, 71%, uninsured workers do not enjoy any medical benefits. This shows that the medical coverage costs tend to be very high; hence, it poses a challenge and barrier to coverage.

In another research conducted, the uninsured population comprises people aged 65 years and below. The study showed different statistics between the uninsured males and females, however, indicating that males were more uninsured compared to women. Moreover, the uninsured are likely to earn 2.25 times lesser than those with employer insurance and twice-likely unmarried (Kruger, 2013). For instance, in the report, the uninsured earned a mean annual income of $35,393, while those insured earned a mean yearly salary of $71,269-$79,497. This shows that the insured population makes twice as much as the uninsured population. Therefore, an estimate of 50 million people in America is uninsured due to financial constraints, among other reasons. However, if the premium health coverage costs are minimized, made accessible and affordable, almost 70%, which is equivalent to 35 million of the uninsured are likely to gain Medicare coverage (Kruger, 2013).

Consequences of not Having Healthcare Insurance

When the uninsured population increases to 17.8% of the entire community, there are sounds of alarm. The uninsured population has many reasons for not having health insurance. Most notably, these reasons revolve around financial constraints, ineligibility in the workplace, employers not offering health insurance, and the lack of regular medical facilities.

Primarily, almost 70% of the 50 million uninsured population record the high costs of health insurance premiums as the reason for not having any coverage (Kruger, 2013). They indicate that if the premiums and costs were affordable, then they would automatically acquire health insurance. Health insurance premiums vary depending on the age, state, and package one wishes to receive. However, let us assume that you are 45 years with two children. You will purchase $400 as an individual, and if one picks a family plan, they will pay $833 monthly (Hunt, 2019). Since the highest number of uninsured individuals acquire a mean annual income of $ 35,393, they are likely to use [(833 x 12) = $9,996 plus $ 7,983 as the deductible amount. This totals to $17,979, which is almost 50% of the mean income. Such figures indicate that the premiums are costly as if paid; other basic needs and expenses are not covered.

Other than costly health insurance premiums, uninsured populations are ineligible to take up employer health coverage or have employers that do not offer this benefit. In most cases, only large and reputable organizations can provide both high salaries and competitive compensation packages. However, low-income jobs have employers with lesser or no capabilities to offer both wages and benefits such as health coverage. Nevertheless, most of the people lack the loyalty of visiting a particular medical facility thus cannot access any health insurance plan.

Lack of healthcare insurance has adverse consequences on an individual’s financial status. This means that when faced with unexpected illnesses that require huge costs, they are likely to fall into medical bills. For instance, if an individual has a spouse diagnosed with cancer, they will incur many charges and expenses to cover the chemotherapy, among other treatments. Without coverage, they will use all the life savings that can render them wretched, as they cannot meet different basic needs (Kaiser, 2018). Cancer treatment is quite expensive; it can accumulate one’s savings as well as the acquisition of loans. This results in ‘hand-to-mouth’ kind of living, relative poverty, financial constraints, and eventually absolute poverty.

Socioeconomic Consequences of Large Uninsured Population in the USA

Having a large uninsured population is detrimental in not only the family or individual levels but also at the community and national levels. A large uninsured population may result in undermined shared economic and social foundations. For instance, a higher uninsured population will result in higher health service charges and insurance premiums among businesses. Moreover, local and state taxes levied to maintain healthcare facilities are likely to increase to compensate for the lowered turn up and contribute to the economy. When the sharing economy is undermined in a community, state, or nation, there is the likelihood of economic instability (Hunt, 2019). Economic instability results in a lack of prosperity and a sense of social isolation are conceived. Such negativity makes the public to lose confidence in public institutions and services.

Changes in the Patient Protection and ACA Health Policy

The Patient Protection and ACA play a vital role in the healthy wellbeing of American citizens. It expands access to health coverage, and it has reduced the number of the uninsured population. This expansion is conducted in two approaches, namely access to Medicaid and eligibility for subsidies law. Reducing the number does not mean that the uninsured population is wholly eradicated; in fact, 17.8% is a significant number that should be reduced. A population of 46.5 million within 327.2 million is substantial and should be addressed immediately (Kaiser, 2018). To address the issue of 17.8% uninsured nonelderly population, the PPACA, requires improvements if not changes, especially when addressing the costs of health insurance

The main barrier is the costly health insurance premiums; thus, the first change should be in the eligibility of health subsidies and affordability (Kruger, 2013).

There should be cost-sharing and available premium tax credits to enhance affordability rates. Specifications such as the 400% federal poverty premium tax credits should be eliminated and premium tax credits increased in all income levels. Secondly, there should be a stable and permanent reinsurance plan, especially in the tiered coverage plans. Thirdly, since health insurance varies with the states, the Medicaid services should be expanded and fully accessible to everyone (Hunt, 2019). Finally, in addition to maximizing affordability and eligibility, educating the public on suitable health insurance plans, developing legislation that authorizes mandatory and universal coverage, and providing for a variety of coverage choices are better improvements and changes.

Conclusion 

The uninsured population amounts to 17.8%, an equivalent of 46.5 million people. To better understand why the uninsured remains high, the discussion outlines high costs, changes in employers, employers not offering medical coverage, lack of regular medical facility as some of the reasons for not having healthcare insurance. Some of the financial consequences discussed include strained medical bills, strained life savings, and huge debts. The discussion shows three factors, namely increased medical services charges, destabilized economy, and undermining of the sharing economy as socioeconomic consequences of having a large uninsured population. Finally, the primary changes in the PPACA should be in the eligibility of health subsidies and affordability levels.

References

Hunt, J. (2019, March 14). What is the Average Health Insurance Premium? The Changing Cost of Healthcare in the U.S. Retrieved from https://www.thebalance.com/what-is-the-average-health-insurance-premium-4586358

Kaiser, H. J. (2018). Key Facts about the Uninsured Population. Henry J Kaiser Family Foundation.

Kruger, A. B. (2013). The demand for health insurance among uninsured Americans: Results of a survey experiment and implications for policy. Journal of health economics, Vol 32(5), pp: 780–793.