Affordable Care Act: Access to Health Care Matters

Introduction Around 12.2% of people in the United States are uninsured. Another 16% are covered by the Affordable Care Act (Blumberg et al.). The total of people that would be uninsured if the ACA was repealed would be a quarter of the U.S. population. Having access to health care matters to everyone. Some may argue that being able to live healthily and know about risks to them should be a basic human right. Living a life of free may have cost, but one of that should not be one’s health. Although having access to health care is important, something equally important is having that health care be effective when used. No matter what one’s social position, income, education or occupation in relation to others, one should have access to health care. Socioeconomic status is one’s social standing or class, usually based on their level of income, education, and occupation. Those of lower socioeconomic status are hindered and discouraged having access to health care due to disparities and social position. Background Health care is an industry that helps people become healthy and stay healthy.

Disparities of Low Socioeconomic Status Those with lower socioeconomic have a higher susceptibility to illnesses and medical conditions. According to an APA article on health and socioeconomic status, those of lower status are more likely to develop: “…hypertension, diabetes, upper extremity musculoskeletal problems, back problems, and cardiovascular disease.” The article also presents the cause of this likeness which lies in the environment lower status brings with it. Stress, fatigue and sleep deprivation from work are all often correlated to these problems as mandatory and voluntary overtime. Other causes that affect the likeness of facing certain diseases is a lower status student’s performance in school (APA). According to the article “Socioeconomic Disparities in Health Behaviors” by the National Center for Biological Information (NBCI), students who perform poorly in school often relieve stress through smoking.

The study also found that smoking along with overeating and inactivity is used by those in a lower social position to control their moods. The predisposed problems that lower SES often face do not end here (Pampel et al.). It is also prevalent that those with a lower SES are set with challenging disparities to face. Due to lower income and lesser lifetime earning, those of lower status often do not make long term investments and focus on the present (Pampel et al.) With less knowledge, people tend to stay complacent and believe they are stuck in the reality they live in. This creates an endless cycle that keeps people at the bottom for generations. These disparities and challenges can start at birth and continue forward when having a lower socioeconomic status. Lower SES children are at a higher risk of death of an “…infectious disease, sudden infant death, accidents, and child abuse” (Fiscella et al.).

These risks do not stop here, as low SES children tend to have higher rates of asthma, learning disabilities, and hospitalizations that could have been avoided. Problems continue onward towards adolescence, which includes higher rates of becoming pregnant, obtaining sexually transmitted diseases, developing depression, becoming obese, and committing suicide. Low-status adolescents are more likely to face sexual abuse, dropping out of high school, and being killed. Moving into adulthood, low SES adults have a higher chance of death to a myriad of causes. Lastly, low SES elders, although have similar problems to higher SES elders, often have a greater disability and have more rapid cognitive deterioration (Fiscella et al.). All of these risks and potential health conditions discourage those in a lower social status to seek primary health as it seems inevitable these problems will come to them. When people similar to them develop or adapt these problems, it creates a complacency that pushes those in lower status to accept these problems High versus Low Socioeconomic Status The disparities and differences between low and high socioeconomic status establish those with a lower SES at a significant disadvantage.

To start, individuals with a lower status tend to have higher mortality rates then those of higher status (Feinstein) This problem may be due to the fact that those with a lower status generally live and work in more worse physical conditions. Poorer neighborhoods are highly likely to be found near highways, toxic sites, and industrial areas. The neighborhood locations are not the only factor as well. The quality of houses in these neighborhoods also tend to be poorer for the people that live there (Adler 66). As a result, those with low SES in comparison with higher SES are six times more likely to have higher blood lead rates while those with middle SES are twice as likely (Adler 66). The level of education also creates a major difference between low and high SES. Those with lower SES tend to be less educated. When one is less educated, they often have fewer resources or knowledge to find resources to help them. This creates a disparity between the status of lower and higher individuals ( Pampel et al.). For example, access to books, computers, simulators, skill builders, and/or tutors are out of reach for people with a lower status.

They are also less likely to have information about the college, which in comparison to their higher status counterparts, creates a risk for them to get student loans that exceed the national average. Students who were put into higher quality classrooms with more experienced teachers were more likely to earn more, go to college, and lived in better neighborhoods. The quality of teachers often a student’s academic achievement. Lower status students are more likely to have lesser and lower quality teachers which then hinders them from achieving causing a chain reaction effect that sets them up to continue their entire lives with a low SES. The limit of being less educated leads to missed opportunities for learning about what is detrimental to one’s health (Pampel et al.). Health Care for Those With a Low Socioeconomic Status Health care for those who are considered low socioeconomic status is currently at risk. With the threats from President Donald Trump, the Affordable Care Act may be removed. (Luhby) If the president goes through with what he says, the number of uninsured Americans would rise from 27 million to around 53 million uninsured Americans. This would affect the so-called large amount of jobs he “created” as people would have less money to spend on other things as their money would go to paying the price of health care. As lower status people already do not use health care as much as they should, they would be driven away from ever using it if they were forced to pay for it again.

Socioeconomic Status gravely affects the access to effective health care. Having low SES positions one to avoid health care altogether because of multiple circumstances. In a SAGE Journal Study, researchers have found that the scare amount of physicians and hospitals treating low SES patients unintentionally created time and distance barriers which discouraged them from seeking care initially. Having limited access to health care is one thing, but even when one has access to health care, having that care be effective is another dilemma. In that same study, they found that physicians were more likely to view low SES patients as ‘less intelligent, independent, responsible, or rational” and less likely to adhere to the prescriptions provided as well as return for follow-ups in comparison to other patients of higher status. Some physicians believed accommodating to a patient’s status would improve the outcome of their care.

These physicians were also likely to delay diagnostics, prescribe general medication, and avert referrals for specialty care for lower status patients (Aprey et al.). Although physicians may have good intent, their implicit bias toward poorer people may result in ineffective treatment, thus leading to worse overall health. The way people of low socioeconomic status use health care when not insured is a testament to why they are more susceptible to health conditions. The Emergency room (ER) and acute hospital services (short-term illnesses, urgent conditions, after surgery) are more likely to be used than primary care by lower status (Kangovi et al.). This is due to patients seeing the emergency room and acute hospital services cheaper, higher quality, and accessible. The ER is also seen as more effective as in some cases, transportation is provided. The ER also provides respite services, which only charged based on the hours or days the services are used which are less costly than an insurance plan (RWJF).

The use of these two short term solutions to one’s health creates a need to only go to the hospital when their health has already deteriorated. This causes lower status people to have worse health over time as they only use health services when it is possibly too late to recover when primary care could have solved or prevented the problem to even happen. Solutions There are many challenges to solving health disparities and effective health care for socioeconomic status. A majority of health-care for those of lower income is through a safety-net of providers, such as community health centers and other non-profit organizations. However, these providers have their own share of problems, from financial crises and struggling to keep physicians. Although universal health care seems to be the fix, many problems come with it. There would be an influx of patients which may be overwhelming to providers. Scheduling appointments could pose as problematic.

Longer wait times in-between appointments would keep people from going to health care all together as well. Having lower levels of education would also present problems as treatments would need more time for explanations. Although reimbursements for physicians would be offered, providers like the federal and state program that helps with medical cost, Medicaid, reimburse physicians as significantly low rates. (Fiscella et al.). However, universal health care can work. Community health centers have proven to provide adequate health care to that of higher status health care. Providing effective care has to consist of patient-centered care and the ability to combine “…biomedical, psychological, and social factors” (Fiscella et al.). Having a reminder system for providers would also help with the large pool of patients awaiting treatment. Outreach to patients can also help with “hard-to-reach” patients and encourage taking medications prescribed by the physicians (Fiscella et al.).

To combat low rates from Medicaid, policies that increase these could potentially help keep physicians with providers of low-income patients. Many of the “barriers” that low-status patients face are often attributed to providers and hospitals who do not accept patients with little or no insurance (Aprey et al.). Complications with physicians and having bias can be fixed by educating them on the bias they may or may not have. This was proven to change physicians’ clinical choices when they become aware of their implicit bias. Conclusion Due to their disparities and social position, those in the low socioeconomic status are hindered and discouraged from accessing effective health care.

Already at a disadvantaged position, those of low-income face factors with odds stacked up against them. With the numerous risks and health conditions, they do not have access to the health care they need. This lack of access to effective care because of cost and physician bias highly discourages people of low status to seek health care all-together and avoid it instead. However, with the help of things like the expansion of the Affordable Care Act, Medicad, and training of physians can help reduce this problem. Having this knowledge will allow those who choose to keep helpers like the ACA through voting and support of local community health centers. By expanding and bettering the health care system, millions of more people will be able to thrive and live with fewer worries in life.