Is There Hope for Healthcare in America?
When Susan Finley was fired from Walmart after more than 10 years of service, she lost more than a steady job. She also lost her health insurance, her ability to pay for necessary medical care and, ultimately, her life.
At the time she was terminated, Finely was recovering from pneumonia. Unfortunately for her, her recovery took her one day past Walmart’s maximum approved leave period and she was terminated for violating the company’s attendance policy. Three months after losing her job and the health insurance benefits that came with it, Susan Finley was found dead in her apartment. She was 53 years old.
According to her son, Colin Finley, “[Susan Finley] was barely scraping by and trying to not get evicted. She gets what appears to her as a basic cold or flu, didn’t go to the doctor, and risk spending money she didn’t have, and as a consequence, she passed away.”
Sadly, Susan Finley’s story is not unique. Millions of Americans forego (or seriously delay) necessary medical treatment because of costs. A 2009 study conducted at Harvard Medical School concluded that about 45,000 Americans die every year as a direct result of not having any health insurance coverage.
Even with the affordable care act (“ACA”), healthcare is still out of reach for many Americans. While the ACA was designed to ensure broad access to quality care, political compromises limited its scope and reach. Unlike its peer nations, the United States’ health insurance system remains primarily employment-based. And, as employers shift to high-deductible health plans (HDHPs) and/or limit benefits to full-time employees only, more and more employees are finding healthcare difficult to access and priced out of their reach. Those lucky enough to be employed full-time and qualify for their employers’ HDHP, still must pay the cost of their care out of pocket until they reach that high-deductible threshold, typically between $2–6,000 dollars per person on an annual basis.
As a result, all but basic preventive care is a luxury item for many individuals. Like Susan Finely, Americans are caught in the cross-hairs, having to choose between their rent/mortgage, food, utilities, and healthcare. In that critical order of priorities, healthcare often gets pushed off for more immediate needs. In truth, the impact we’re looking at is that we have a less healthy population with less access to less complex care leading to more costly healthcare and worse healthcare outcomes.
In 2017, the United States ranked 24th in achieving health goals set by the United Nations (UN), despite spending disproportionately more on healthcare compared to most global south countries. And Americans are still not getting necessary care. While spending $3.65 trillion on healthcare in 2018, almost 28 million Americans went uninsured for the entire year due to cost concerns. These trends will likely continue as costs are expected to grow at an annual rate of 5.5% over the next decade.
Yet, many of our elected officials don’t believe that access to healthcare is an issue and their positions on healthcare policy defy basic documented evidence. In 2017, with little debate or transparency, US House Republicans passed the American Health Care Act, which would have cut almost $900 million from Medicaid over the following decade. During a town hall, Idaho Rep. Raul Labrador rejected his constituents’ concerns about the bill’s impact on Medicaid recipients. In response to one woman’s concern that “You are mandating people on Medicaid to accept dying”, Rep. Labrador retorted “that line is so indefensible, nobody dies because they don’t have access to health care.”
But as Nancy Fullman, a scientific adviser at the Institute of Health Metrics and Evaluation at the University of Washington in Seattle, put it, “despite having good performance overall in 2016, the US has made ‘minimal progress’ since 2000 on the measure for universal health coverage. The US spends more than any other nation on health care, but often has similar, or even worse, health outcomes than many high-income countries.”
Though studies have shown the importance of fact-based public and healthcare policy, Americans still hesitate to embrace big changes in healthcare — even when in mutual agreement towards the need for it. Fortunately, reform does not require total abandonment of the current system.
There are many programs and elements of the current system we can build on and make consistent. With genuine outreach to leading lawmakers on Capitol Hill, the Biden Administration could achieve bipartisan progress on health reform. Structural change does not have to come in the form of one giant bill; it can be achieved through a series of bills and administrative actions.
With a clear, shared vision of the objectives, leadership, and a willingness to build on or revamp existing parts of the current system, there is a bipartisan path to an equitable, inclusive, and comprehensive American health system.
Works Cited:
“Affordable Care Act (ACA) — Glossary.” Glossary | HealthCare.gov, https://www.healthcare.gov/glossary/affordable-care-act/#:~:text=Make%20affordable%20health%20insurance%20available,and%20Human%20Services%20(HHS).
“The Americans Dying Because They Can’t Afford Medical Care.” The Guardian, Guardian News and Media, 7 Jan. 2020, https://www.theguardian.com/us-news/2020/jan/07/americans-healthcare-medical-costs.
Cecere, David. “New Study Finds 45,000 Deaths Annually Linked to Lack of Health Coverage.” Harvard Gazette, Harvard Gazette, 7 Jan. 2019, https://news.harvard.edu/gazette/story/2009/09/new-study-finds-45000-deaths-annually-linked-to-lack-of-health-coverage/.
Kirby, James B. “Poor People, Poor Places and Access to Health Care in the United States.” Social Forces, vol. 87, no. 1, 2008, pp. 325–55. JSTOR, http://www.jstor.org/stable/20430859. Accessed 17 Apr. 2023.
“People Are Dying for Lack of Healthcare Information — Join HIFA.” YouTube, YouTube, 27 Mar. 2017, https://www.youtube.com/watch?v=2Pvdu0mSwQ4.
Phillips, Kristine. “‘Nobody Dies Because They Don’t Have Access to Health Care,’ GOP Lawmaker Says. He Got Booed.” The Washington Post, WP Company, 28 Oct. 2021, https://www.washingtonpost.com/news/powerpost/wp/2017/05/06/nobody-dies-because-they-dont-have-access-to-health-care-gop-lawmaker-says-he-got-booed/.
Scutti, Susan. “Singapore, Nordic Countries Outrank US in Achieving UN Health Goals.” CNN, Cable News Network, 12 Sept. 2017, https://www.cnn.com/2017/09/12/health/un-health-goals-country-ranking-study/index.html.
ValuePenguin. “Rate of Workers Enrolled in High-Deductible Health Plans … — Valuepenguin.” Rate of Workers Enrolled in High-Deductible Health Plans Jumps for 8th Year in Row to Record 55.7%, 30 Jan. 2023, https://www.valuepenguin.com/high-deductible-health-plan-study.
