Health Insurance Analysis Report: The Uninsured in America 



Health insurance in the United States refers to any program whether social insurance, privately purchased insurance, or social welfare programs that helps in paying for the medical expenses of the insured. The program can also be referred to as health benefits, health care coverage, and health coverage and can either be paid privately, by the employer, or government funded (Schoen, How, Weinbaum, Craig, & Davis, 2006). Despite the importance of this service in improving the access of citizens to primary health care and in the provision of universal quality healthcare to the population, a huge percentage of the American population is not insured (Holmgren, Davis, Guterman, & Scholl, 2007). This problem has greatly been contributed by the convoluted and complex system through which healthcare is delivered and financed in the United States. 

The problem of Uninsured

Health coverage in America is gotten through state programs, privately, the military, the federal government, and through jobs. At the same time, most Americans pay for health coverage out of their pockets, through federal and state taxes, and through employers (Fronstin, 2006). Although this might be viewed as a way of increasing the coverage of health insurance to reach a bigger population in an effort to provide universal health care, it has created more problems. Significantly, it has left out many Americans from health care coverage thus increasing the problem of uninsured. 

The discussion on how to improve health insurance program to cover the large population of the uninsured and to help those having health insurance to keep it has been a centre of interest for long. Government officials, ordinary citizens, community leaders, unions, employers, and political candidates have joined in the discussion to call for reforms and improvement in the national health care system. Similarly, the benefits of health insurance should be made accessible, quality, and widely available (Schoen, How, Weinbaum, Craig, & Davis, 2006). So many citizens fall through the cracks of the health insurance system in America every year and this has continuously increased the number of the uninsured. This problem has been contributed by the soaring costs of health insurance and health care and the way in which health services are financed in America. Due to this problem, even those have health coverage cannot assure keeping it. 

The Interest of the Uninsured

Provision of health care coverage to all Americans is a topic of national interest in the United States as it promotes the achievement of universal quality health care to the people. Unfortunately, the high number of the uninsured population in the country is a cause for worry and concern by employers and individuals since this is contributed by the soaring costs of health insurance and health care (Fronstin, 2006). The justifiable concern by many employees is that increased cost of health care makes it unaffordable for them and this limits their ability to foot the cost of the health coverage offered on their jobs (Buchmueller & Monheit, 2009). On the other hand, making health insurance more expensive discourages employers from offering coverage to their employees. 

Convincingly, raising the cost of health insurance makes it hard for employees to access affordable health care and health coverage in the event that they lose their job. The idea of increasing the cost of health coverage also increases the cost of health care and this causes any Americans to pull out of health insurance programs thus reducing the access of affordable health care to many (Holmgren, Davis, Guterman, & Scholl, 2007). The primary importance of having a health cover is to make health services accessible and affordable. When the cost of having the health insurance is increased, many Americans find it very difficult to afford thus increasing the number of the uninsured. 

Unfortunately, the uninsured population is more likely to have unmet medical needs due to the constraints of cost that the insured Americans. In the same breadth, the uninsured Americans are more likely to ignore referral medical cases and follow up cases for chronic illnesses due to cost as compared to the insured and their needs for prescription drugs is usually unmet (Buchmueller & Monheit, 2009). The top concern for many Americans is to have expanded health coverage and reduced costs of health care and health coverage. This problem can, thus be approached from two dimensions; providing health insurance for the uninsured Americans and reducing the cost of health care and coverage. 

The Importance of Health Coverage   

Having a health cover is importance to Americans as it makes the difference between accessing care or not. It is important to note that most of the people without a health cover suffer from delayed care or go without health care. On the other hand, people who do not have health insurance cover are likely to receive lower quality care due to cost and financial constraints as compared to the health care services received by the insured (Huynh, Schoen, Osborn, & Holmgren, 2006). Lack of health coverage reduces the accessibility of the uninsured to quality health care and increases the charges on their care. Certainly, this increases the percentage of the people who die in America due to the lack of health coverage. 

As the time that a person goes without health coverage increases, their health is likely to deteriorate since they are likely to have unmet medical needs and skipped needed medical care. The likelihood of not filling a prescription is also increased in the uninsured. This increases seriousness of the health consequences of the Americans who live without a health cover (Freeman, Kadiyala, Bell, & Martin, 2008). Uninsured Americans who are hospitalized receive lower quality care and fewer needed health services which then increases their risk of dying either after discharge or in the hospital than insured patients.

On the other hand, uninsured are likely to seek medical care when their health has deteriorated and the symptoms of their illnesses become serious. This lowers their chances of recovery and survival which then limits their chances of receiving quality care (Buchmueller & Monheit, 2009). Trauma victims who are uninsured do not the full range of medical services they need as they are less likely to get hospital admission which then increases their chances of succumbing to their injuries (Huynh, Schoen, Osborn, & Holmgren, 2006). It can also be noted that the wait times for the uninsured when accessing care is longer than that of the insured. This is especially the case in HIV patients who take a longer time to get drug therapies which are highly effective as compared to the patients with insurance covers. 

The bottom line is that health insurance is important and a necessity for better health outcomes. Having a health cover has a positive association with improved access to quality health care services ranging from acute, chronic, and preventive care services (Schoen, Doty, Collins, & Holmgren, 2005). Lack of health insurance coverage is associated with reduced health status among adults and increased mortality rates due to reduced accessibility to health care. Just like in adults, uninsured children also suffer from poor health outcomes and health consequences as compared to insured children (Buchmueller & Monheit, 2009). Lacking health insurance increases the chances of children to go without the needed medical care such as unmet dental care, mental health counseling or care, and delayed care due to cost. 

Children who lack health insurance have high chances of missing preventive health visits, needed medical care, and do not have a personal nurse or doctor who understands their specific health needs. The problem of uninsured extends from the pressure it exerts on the nation’s health care system by increasing the health burden of American to the family (Buchmueller & Monheit, 2009). The lack of medical insurance cover threatens the family’s financial security since members of uninsured families pay for health care services out of their pocket. This puts a lot of financial burden to the families because uninsured families are likely to have few assets, fewer financial resources, and lower incomes to help meet the higher medical expenses. 

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The Unaffordability of Health Insurance

The mean premium of health insurance in the United States is considerably high, which affects its affordability by most of the young and low income Americans. The escalation of medical insurance premiums increases the cost of health benefits and results in low affordability by many citizens (Collins, Davis, Doty, & Holmgren, 2006). The major problem is that every year, there is a substantial increase in cost of health insurance with up to double-digit percentage increase which then causes most employers to withdrawal health benefits in the payment package of employees. 

The rising cost of insurance premiums and health care hits both the employees and small firms very hard by exposing the smaller risk groups to escalating premium rates. This has made it difficult for most employees and small firms to afford the purchase of health insurance covers (Freeman, Kadiyala, Bell, & Martin, 2008). As a result, the market for health insurance has isolated the small groups thus contributing to increasingly low level of health coverage among the small groups (Schoen, Doty, Collins, & Holmgren, 2005). Due to the tendency of insurers to chase profitability and thus abandoning community rating in favor for experience rating when calculating health coverage premiums has led to skyrocketing health insurance premiums. Health insurance has hence become very expensive for small groups to afford.

Employers have subsequently increased the health benefit costs on the employees by forcing them on managed-care plans. They have also responded by increasing the cost sharing for medical care and insurance premiums on the employees thus shifting more of the medical coverage costs to them (Collins, Davis, Doty, & Holmgren, 2006). Despite the attempts by employers to control their costs by shifting more of the health benefit costs to the employees, the cost continue to increase thus causing more employees and employers to pull out of the health coverage programs. 

Policy Recommendations

Health insurance is important in improving the access of Americans to affordable health care services. However, this is affected by financing problems and lack of affordability to health insurance due to increased costs. This has increased the number of uninsured Americans who have little access to quality health care (Freeman, Kadiyala, Bell, & Martin, 2008). The uninsured population adds to the health burden of the nation when they get care which increases taxes, insurance premiums, and hospital bills of others. The problem can be solved through the provision of universal care to all Americans. Provision of universal care would end cost shifting of health cost to the government, employees, and employers and solve the problem of uncompensated care. Collectively, this would ensure that access to health care is equitable to all Americans. 

The main reason behind an increasing number of uninsured Americans is the rising costs of health insurance which has discouraged employers to contribute to the health benefit programs for the employees. Employers are mostly guided by the need to maintain a competitive edge by lowering their costs. This establishes the need to reduce the cost of health insurance to encourage more Americans to take health coverage and increase the affordability of health insurance by most of the uninsured population. Since participation of employers to health benefit programs, it is effective to encourage their participation by introducing tax credits which would go to the employers who provide health benefits to their employees. 

On the other hand, providing health benefits to workers is a necessary step that can be enacted through law. This would make it an employers’ mandate to provide the workers with health insurance coverage for them and their dependents. This is a privatized solution which would lower the number of the uninsured Americans and lead to a reduced cost incurred by the government in providing health care. This can be subsidized by a national health insurance program to promote universal health coverage. The introduction of the national health insurance scheme by the government would be a comprehensive reform strategy which would reduce the cost of insurance premiums and reduce the number of uninsured.  

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In the United States, health insurance is a scheme that helps in paying for the medical expenses of the insured. Health insurance is very important in improving the access of citizens to primary health care and in the provision of universal quality healthcare to the population. However, a huge percentage of the American population is not insured. Uninsured Americans receive lower quality care and fewer needed health services which then increases their risk of death. The problem of uninsured has significantly been contributed by the rising cost of health insurance and this needs policy reforms to solve the problem. 

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  2. Collins S, Davis K, Doty M, & Holmgren A. (2006), Gaps in health insurance coverage: an all-American problem. New York: Commonwealth Fund.
  3. Freeman, D, Kadiyala, S, Bell F., & Martin P. (2008). “The Causal Effect of Health Insurance on Utilization and Outcomes in Adults“. Medical Care. 46 (10): 1023–32.
  4. Fronstin P. (2006), Workers’ health insurance: trends, issues, and options to expand coverage. New York: Commonwealth Fund.
  5. Holmgren A, Davis K, Guterman S, & Scholl B. (2007), Health care opinion leaders’ views on priorities for the new congress. New York: The Commonwealth Fund.
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  8. Schoen C, How H, Weinbaum I, Craig J, & Davis K., ( 2006) Public views on shaping the future of the US health system. New York: Commonwealth Fund.
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