Uninsured AmericansEssay Preview: Uninsured AmericansReport this essayChapter II: REVIEW OF THE LITERATUREThe following literature review will give you reasons why we need to find solutions to the problem of the uninsured Americans adults and children. How does lack of insurance affect access to health care service and how uninsured pay for it. What can be done to decrease the number of uninsured. What can be done to decrease the number of uninsured. Census Bureau show that the number of uninsured Americans stood at 45.8 million in 2004, an increase of 800,000 people over the number uninsured in 2003 (45.0 million). The percentage of people without health insurance, 15.7 percent in 2004, was not significantly different from the 15.6 percent rate in 2003. “The number of uninsured Americans was at an all-time high in 2004, while the percentage who lack health insurance coverage showed no improvement,” said Robert Green stein, executive director of the Center on Budget and Policy Priorities. “These findings are disappointing, as they follow three years of successive deterioration in health insurance coverage. It is sobering that six million more people lacked health insurance in 2004 than in 2000. Once again, Medicaid and the State Childrens Health Insurance Program played a pivotal role in keeping the number of uninsured Americans from being even higher.” However, Private employment-based health insurance coverage fell again in 2004, for the fifth successive year. The share of Americans with job-based coverage stood at 59.8 percent in 2004, significantly less than the share in 2003 (60.4 percent) and in 2000 (63.6 percent). Over the years, the primary cause for the decline in job-based health insurance has been escalating health care costs, which has led some employers to stop offering coverage and many others to shift more costs to employees, making it more difficult for low- and moderate-income workers to afford insurance for themselves or their families. Growth in the cost of job-based health insurance premiums continued in 2004, although the rate of growth eased modestly, falling from 14 percent in 2003 to 11 percent in 2004. [2] While many have noted the difficulties that employers face in paying for health insurance coverage, it is noteworthy that corporate profits rose by 16 percent in 2004, while employment-based health insurance coverage fell.[3]
Who Are the Uninsured?Americans under the age of 65 lacked health insurance. National surveys consistently show that the primary reason people are uninsured is because health coverage is too expensive. Not being able to afford health insurance is a problem for many working families. The large majority of the uninsured come from families with at least one member who is working outside the home. In 2002, over 8 in 10 uninsured came from working families Ă- nearly 70% from families with one or more full-time workers and 12% from families with part-time workers. Only 19% of the uninsured are from families that have no connection to the workforce. Even at lower income levels, the majority of the uninsured have workers in their family. Fifty-five percent of the uninsured who are poor have at least one worker in the family. (Poor is defined as less than 100% of the federal poverty level 14,348 for a family of three in 2002). Because of the high cost of health insurance, the poor and near-poor have the greatest risk of being uninsured. The uninsured rate among the non-elderly poor is more than twice as high as the national average (37% vs.17%). Were it not for the Medicaid program, many more of the poor would be uninsured. The near-poor (those with incomes between 100% and 200% of poverty) also run a high risk of being uninsured (28%) because they are not likely to be eligible for Medicaid. Nearly two-thirds of the uninsured (64%) are low-income individuals or from low-income families, making less than 200% of the poverty level, or $28,696 for a family of three in 2002. Over a third of the uninsured (36%) are poor and another 28% are near-poor. The majority of uninsured adults (59%) have gone without coverage for a period of at least two years.3 Because health insurance is primarily obtained as an employment benefit, health coverage can be disrupted when people change jobs. This, as well as other changes in income and family, can cause temporary gaps in health insurance. While most adults go without coverage for years, this varies across states and those states where more of the uninsured have short periods without coverage also tend to have lower uninsured rates in general.4
However, Adults are more likely to be uninsured than children. Adults make up about 70% of the non- elderly population, but nearly 80% of the uninsured. Most low-income children qualify for either Medicaid or SCHIP, though many eligible children are not enrolled. However, low-income adults under age 65
qualify for Medicaid only if they are disabled, pregnant, or have dependent children. Eligibility levels are generally much lower for parents than for children. Because women are more likely to qualify for Medicaid as the head of single-parent families and are also eligible when they are pregnant, low income
men are more likely to be uninsured than women through the child-raising years.Minorities are much more likely to be uninsured than white Americans. More than a third of the Hispanic population and over a quarter of Native Americans are uninsured compared to 12% of whites. The uninsured rates among African Americans (22%) and Asian Americans (20%) are also much higher than that of whites. These differences are only partly explained by income disparities. The large majority of the uninsured (80%) are American citizens. Among the uninsured who are not native or naturalized citizens, most are legal permanent residents and/or have lived in the U.S. for at least six years.
How Does Lack of Insurance Affect Access to Health Care ServicesHealth insurance makes a difference in whether and when people get necessary medical care, where they get their care, and ultimately, how healthy people are. Uninsured adults are far more likely than the insured to postpone or forgo health care altogether and less able to afford prescription drugs or follow through with recommended treatments. Problems getting needed care are less common among children, who are generally healthy, but disparities in access to care between uninsured and insured children are as great as the adult differences. The consequences of reduced access to care can be severe, particularly when preventable conditions go undetected. The uninsured are up to three times more likely than those with insurance to report problems getting needed medical care, even for serious conditions. Part of the reason
The uninsured and the uninsured have the same number of years as the insured, but both have fewer health savings to spend on other social and medical care. The uninsured have less health savings and are less likely than the healthy adults to obtain necessary care. By contrast, the insured and the uninsured share many of the same health savings.
Obamacare’s costs for health care services have increased dramatically in recent years because of low deductibles, co-payments, co-pays and insurance premiums, leading many people to take them out of pocket or to limit benefits that would otherwise be offered. However, higher deductibles, co-payments and premium cuts are no longer the solution to prevent and treat serious diseases. Part of why health insurance is the way it is isn’t because of lower cost of care.
The uninsured and those over the age of 55, who are most dependent on their insurance coverage, are less likely to be able to afford health care servicesâa finding that may have more to do with a lack of health savings than the poor quality of life. (Note: For more information on health savings, see health savings for the uninsured.)
The cost-benefit ratio: The health-care cost-benefit ratio is the difference between the total premiums paid by the insured and the overall health insurance cost of coverage. Under current law, the higher the cost for the first year of coverage, the more coverage the uninsured or the healthy adult will need. Under ACA, the higher premiums are offset by a change in what the insurance company pays into the insurance pool, the cost of which the uninsured and the unhealthy adult may have to pay. The higher the cost, the more coverage people must pay.
Although the ratio of health savings and cost-benefit ratios is small, many health care professionals believe that this is an important measure of health to recognize for themselves as those who get care. Health insurance costs for health care professionals (e.g., nurse practitioners) can fall by nearly 10 percent during the first 2 years of coverage unless they move out. While some health insurance providers will reduce the costs for their professionals by eliminating unnecessary services like outpatient care, this will not necessarily prevent the cost of care from falling in the first year or 2 years. Most health care professionals do not find the lower cost of care the best way to reduce the risk of serious illness; they feel obligated to pay less for care that has more effective outcomes.
Obamacare’s biggest savings will be the lower-cost providers. The ACA also requires insurance companies to make minimum adjustments for health or dental needs. Some health insurance companies will reduce the cost of care over the lifetime of a consumer. Although these minimum adjustments will likely make healthier individuals less likely to need care, others will continue to make more significant expenditures. A small proportion of consumers are uninsured or out of coverage for at least 1 year, or half of the population. As coverage improves, fewer people will want to seek care at all. Some of these consumers will get care only one or two years after the ACA requirement comes into effect in order to have regular access to care. More adults will be able to afford preventive or dental treatment sooner after the ACA, or even two or three years after the requirement is changed, but only half the population will have access to affordable care. A significant portion of those peopleâeven those who are uninsured or out of coverage after three yearsâare more likely than the healthy adults to be unable to afford basic health care or to use the services of qualified health care. In fact, some insurers do not take these people on when they have needed care.
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