Health and Medicine - U.S. Healthcare (SOCI 1306)

Health and Medicine SOCI 1306 U.S. Healthcare The two primary types of healthcare coverage in the United States are public healthcare, which is supported by the government, and private healthcare, which is funded privately. The two primary publicly supported healthcare programs are Medicaid, which serves individuals with extremely low incomes who satisfy certain qualifying conditions, and Medicare, which offers health services to those over 65 and those who fulfil additional standards for disability. Services for Native Americans (the Indian Health Service), veterans (the Veterans Health Administration), and children (the Children's Health Insurance Program) are among the other government-funded initiatives. Direct-purchase insurance or employment-based insurance are the two main categories into which private insurance falls. Health plan coverage supplied in full or in part by an employer or union is known as employment-based insurance. It can cover an individual alone or the employee and their family. Insurance that a person purchases straight from a private firm is known as direct purchase insurance. Not everyone in the United States has health insurance, despite the availability of several alternatives. Approximately 26 million Americans, or 8% of the population, did not have health insurance in 2019. That figure increased to 31 million in 2020 (Keith 2020). According to Keisler-Starkey 2020, many additional million people received health insurance for a portion of the year. People without insurance run the danger of developing chronic illnesses over time as well as serious illnesses. Less uninsured individuals take preventative medicine or routine checkups; instead, they depend on urgent care centres for a variety of urgent medical needs. Compared to prior decades, there are substantially fewer people without health insurance. The percentage of the population without health insurance was around 18%, or 40 million, in 2013 and many of the years before. More individuals are now able to obtain inexpensive insurance thanks to the inexpensive Care Act, which went into effect in 2014. Before starting to rise once more, the uninsured rate peaked in 2016 (Garfield 2019). Individuals who pay at least 10% of their income for healthcare costs that are not covered by insurance or, for low-income adults, whose medical expenses or deductibles are at least 5% of their income, may appear to have adequate insurance coverage, but in reality, they may be underinsured (Schoen, Doty, Robertson, and Collins 2011). Why do so many individuals have inadequate or no insurance? Part of the problem is the skyrocketing expense of healthcare. Although most individuals obtain insurance via their jobs, not all employers provide it, particularly small and retail enterprises where a large number of employees may work part-time. Last but not least, for a long time, insurance companies had the right to refuse coverage to anyone who had chronic illnesses or prior illnesses. A significant shift in American healthcare was brought about by the Patient Protection and Affordable Care Act, also known as Obamacare or simply ACA. Enacted in 2010 and put into effect in full in 2014, it expanded eligibility for Medicaid and other programs, helped ensure insurance coverage for individuals with pre-existing conditions, and established rules to ensure that premium money collected by insurance companies and healthcare providers is used for medical care. It also had an individual mandate, according to which everyone must have insurance by 2014 or face a fine. The aim of a number of measures, which include sizeable subsidies, is to rectify the economic disparities that are now fuelling high rates of underinsurance and uninsurance. The individual mandate of the Affordable Care Act was deemed constitutional by the U.S. Supreme Court in 2012. The Affordable Care Act has increased health insurance coverage for 29 million Americans (Economic Policy Institute, 2021). The ACA is still divisive. In the 2012 case of National Federation of Independent Businesses v. Sebelius, the Supreme Court decided that states may not be coerced into taking part in the Medicaid expansion provided under the PPACA. This decision made it possible for more challenges to the ACA to be brought before Congress, federal courts, state governments, conservative organisations, and private companies. Public sentiment and elections have been influenced by the Affordable Care Act. Republican wins in Congressional seats in 2010 and 2014 were largely attributed to intense disapproval of Obamacare. Elections and public opinion, however, turned against the bill as millions of people were covered by it and the economy improved. Voters' top concern was healthcare, and many of the Democratic wins in the election were attributed to their desire to uphold the legislation. These gains continued into 2020.