Millions of Americans across the United States think of healthcare as simply being a part of life. When they start to feel ill or experience pain, they call a doctor and schedule an appointment. Then, they simply show up, flash their health insurance card, and receive healthcare services. When the bill for a small portion of their fees, they simply pay it, and proceed with their lives as normal; they think nothing of it. The reality, however, is that this narrated interaction of activities is highly idealistic, and is becoming rarer for a good number of average, everyday Americans. Access to healthcare is not a universal right in the United States because many people cannot access healthcare, even though it is a governed expectation of citizens. The following pages will discuss the social groups most negatively affected by this disparity of accessibility to healthcare.
The stark financial reality is that one must hold health insurance in order to gain access to healthcare. Healthcare is not free. Health insurance gains people access to primary care, follow-up care, in-depth treatment, and helps to minimize the risk of financial ruin for both patients and healthcare providers (Olivero 2). Thus, prospective patients who are unable to pay for services, whether that payment comes out of pocket or from a health insurance plan, are not simply welcomed with open arms by healthcare facilities. And, health insurance is becoming exponentially more expensive than it once had been. As a result, not only have large amounts of employers across the nation discontinued the offering of health insurance to their employees, but private citizens have found themselves simply unable to afford the employee portions of the insurance premiums, private insurance, and the out-of-pocket costs of medical bills in addition to the insurance fees.
The majority of uninsured Americans would certainly love to hold insurance; they would love to be able to carry insurance to be able to feel the same sense of security as everyone else. Instead, millions of Americans must live with a daily sense of fear. They hold fears about the unknown, knowing that should their child develop emergency appendicitis, or break a leg or an arm, that it would bankrupt their family and entire livelihoods. Or, worse, the just simply wouldn’t be able to seek treatment. Many people believe that Americans living with this fear is absolutely wrong, but don’t know what an actual solution would, or could, be. This is because a lack of health insurance is fiscally driven. As the Henry Kaiser Family Foundation wrote, “In 2016, 45% of uninsured adults said that they remained uninsured because the cost of coverage was too high. Many people do not have access to coverage through a job, and some people, particularly poor adults in states that did not expand Medicaid, remain ineligible for financial assistance for coverage” (“Key Facts about the Uninsured Population” 2).
In other words, citizens are either not financially eligible for subsidies to help them pay for health insurance, or their residing states are not able to help them to begin with. Impoverished and low-middle class citizens are most affected by this inability, and are the most often uninsured social groups. Non-white citizens, or racial minorities, are also at a statistically higher risk of being uninsured, and thus, experiencing an inaccessibility to healthcare (“Key Facts about the Uninsured Population” 2). Then, there is also the issue of an overall failing economy, and citizens losing health insurance as they lose their jobs.
Take the story of Marcia’s husband as a key example of an uninsured American. Via the Soujourner website, Marcia wrote the following:
For 25 years, we had great insurance through my husband’s employer. In 2015 we heard devastating news the mill was moving out of state. We weren’t too scared; we planned on finding work. He had good references and experience. Then October 14, 2016, he had a massive heart attack, collapsed, and was rushed to the hospital. Our insurance was still good, thank goodness. But while recuperating he received the letter. The mill closed; our insurance was gone. (“Your Health Care Stories” 3)
And, just like that, Marcia and her husband’s insurance was gone, just as was the insurance of her children.
Again, impoverished Americans as well as lower-middle class workers, with an emphasis on racial minorities, are the social groups most affected by inaccessibility to healthcare (4). Most specifically, Hispanics experienced the highest rate of non-insurance in 2016, which was the most recently reported year according to the United States Census Bureau (Barnett and Edward 4). Beyond that, impoverished non-Hispanic whites experienced the second-highest rate of a lack of health insurance (Barnett and Edward 4). Then, according to the New York Post, middle class Americans is the group growing at the fastest rate in regard to experiencing a lack of health insurance, and that rate is expected to continue (McCaughey 2). It is projected that several million middle class Americans will end up dropping their health insurance plans during the course of 2018, due to unaffordability and an inability to pay for the accessibility to healthcare (McCaughey 2).
As access to healthcare is becoming rarer for the average citizen, a shift within the healthcare industry is occurring: rather than seeking to treat the ill, the healthcare community as a whole is seeking to help more people stay healthy. This initiative is new, is community-based, earns the industry less financial return than they once enjoyed, and it is also where community psychologists and community psychology comes in. Essentially, society needs to shift its teachings and behaviors towards an environment that prevents illness and disease, as opposed to the current environment that largely relies on the treatment of illness and disease (“Featured Articles from Around the Globe” 3). Community psychology can assist with this shift as it seeks to educate, train, and guide key societal members, especially the middle class and Hispanic minorities (“Featured Articles from Around the Globe” 3). The community psychology sector can help people adopt attitudes of health management, garnering less of a need for healthcare accessibility to begin with, and pushing for a reliability on independence and self-preservation (“Featured Articles from Around the Globe” 3).
Sadly, I came across a seemingly large amount of unfortunate accounts of inaccessibility to healthcare in my community group conversations. It almost seemed as if one story was sadder than the next. The stories ranged from a woman crying about her father’s inability to afford his Alzheimer’s medication, to a man who had to take on a third job (a third!) to afford the medication for his young son’s diabetes. While some people I spoke to were insured, they all reported to be living financially comfortably. And, this stated, financially well-off people weren’t predominant in my conversation groups. It seemed that, everywhere I turned, middle class people were being affected by a lack of available healthcare. And this was happening in one of the most successful nations in the world, with a supposed insurmountable amount of power.
This exercise has been nothing short of eye-opening. It seems that healthcare in America absolutely is not a right, but a privilege. And, unbelievably, this is happening in one of the most successful nations in the world, one with a supposed insurmountable amount of power. Thus, it seems, at this point, that a community psychology approach to moving towards health management is the only likely and realistic answer for America’s citizens.
Barnett, Jessica C. and Edward R. Berchick. “Library.” Health Insurance Coverage in the United States: 2016, 12 Sept. 2017, www.census.gov/library/publications/2017/demo/p60-260.html. Accessed 3 Jan. 2019.
“Featured Articles from Around the Globe.” Community Psychology and the Future of Healthcare by Chris Michael Kirk and William D. Neigher in GJCPP Volume 4 Issue 4 2013, www.gjcpp.org/en/article.php?issue=16&article=82. Accessed 3 Jan. 2019.
McCaughey, Betsy. “ObamaCare Is Making the Middle Class the New Uninsured.” New York Post, New York Post, 7 Sept. 2017, nypost.com/2017/09/06/obamacare-is-making-the-middle-class-the-new-uninsured/. Accessed 3 Jan. 2019.
Olivero, Magaly. “Why Do You Need Health Insurance?” U.S. News & World Report, U.S. News & World Report, health.usnews.com/health-care/health-insurance/articles/2016-11-01/why-do-you-need-health-insurance. Accessed 3 Jan. 2019.
“Key Facts about the Uninsured Population.” The Henry J. Kaiser Family Foundation, 7 Dec. 2017, www.kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/.
“Your Health Care Stories.” Sojourners, 12 Oct. 2017, sojo.net/your-health-care-stories. Accessed 3 Jan. 2019.