Racial Disparities in US Healthcare Access: Addressing the Inequity

Abstract

Institutional Affiliation: Racial Inequality in Access to Healthcare in the United States Introduction Racial inequality in healthcare is a complex multifactor issue that creates disparity in the quality of health services offered to the American people. African Americans are uninsured and underinsured at higher rates than any other racial group in the United States. The lack of coverage impacts on their access to quality health services and creates a social problem for the government and the people (Puaschunder & Beerbaum, 2020). The cost of healthcare is higher for the low-income individuals in the United States as they have to pay higher out-of-pocket charges for their healthcare. Additionally, the total contribution of their income is higher when considered as a percentage of their income. While an average American spends 11% of income on health insurance and out-of-pocket payments, the average for African Americans is 20% (Singh et al. 2017). This disparity indicates that blacks in the United States are spending more of their income on health than other Americans. The affordable care act (ACA) was established to end the disparity in healthcare in the United States by providing assistance to the poor households. The lack of health insurance is still a social problem affecting the African Americans more than people from other races and there is need to expand ACA programs to include more low-income individuals. History of Racial Inequality in Access to Healthcare Healthcare is a critical social welfare issue in the United States and the factor of race plays a key role in the debate. Each government is determined to provide quality health services to its people while focusing on the needs of the all the citizens (Singh et al., 2017). The historical issue of race in America has created disparities in the access to key services in the United States including healthcare. While the average income of the African American households has increased over the past decades, it is still below that of other ethnic communities. The demographic group is the most economically marginalized community in the United States having the highest rates of low-income households in any measure. As of the end of 2020, the poverty rates for African Americans was 21.2% compared to 17% among the Hispanic communities and 9% among white households in the country (Puaschunder & Beerbaum, 2020). The data demonstrates that African Americans are exposed to poverty more than any other race in the United States. The employment status of an individual and the members of a household plays a critical role in the access to healthcare insurance and quality care in general. The major sources of healthcare insurance are private, employer-sponsored, and public health services in the country. Employment rates, therefore, play a critical role in the access to healthcare in the country. People’s incomes determine their capacity to pay for private health insurance and their access to employer-sponsored healthcare cover. Additionally, the employment status of a community impacts on how families afford to pay for out-of-pocket services in hospitals. As of 2020, the unemployment rate for African Americans aged 16 years and above was 6.6% while that of the Hispanic communities was 5.4%. Among the Asian Americans, the unemployment rate was 3.3% while the rate among the whites was 3.6% (Singh et al. 2017). There has been an increase in the access to employment for the African Americans since the era of the Civil Rights Movements in the 1960s. However, the blacks compose of the most unemployment demographic group in the country and this issue has significant implications on their access to health insurance. Inequality in the access to healthcare is a social welfare issue since the African Americans continue to pay more out-of-pocket payments for health services than other groups. This trend has significant implications on the capacity of the African American families to meet other basic needs including housing and food. On average, An American family spends a total of 11% of their annual income for health insurance premiums and the out-of-pocket payments. However, the average cost of healthcare for the African American households is 20% of the annual income (Yearby, 2018). With more blacks being uninsured and underinsured, they spend more resources in the cost of healthcare compared to the average family in the United States. This disparity in expenditure is further affected by the differences in income for the families based on race in the country. The median income for an African American family in 2020 was $41,500 while that of a white family was 65,902 (Puaschunder & Beerbaum, 2020). The difference implies that even when the cost of healthcare was the same for the average white and African American families, there would be a difference in the proportion of income spent on health. African American families pay more of their income for health expenses than any other race in the United States implying that their cost for healthcare is higher. Lack of universal health coverage in the United States is a critical contributor to the inequalities in the access to quality services among Americans based on race. The African American communities in the United States are exposed to higher rates of being uninsured and underinsured since the country lacks universal healthcare. It is the goal of every nation across the world to increase access to health coverage and improve the quality of services offered to patients in hospitals (Yearby, 2018). Major developed economies in the world, particularly in Europe, have achieved universal health coverage for their citizens. Healthcare equality is achieved by establishing programs that ensure all the citizens receive quality health services regardless of their age, race, gender, and ethnicity. However, healthcare is a political issue that involves the allocation of resources towards welfare programs. When the amount of funding for healthcare is directed towards other sectors of the economy such security and military spending, the low-income people in the country suffer. However, the wealthier Americans who pay for private insurance or are fully covered by their employers benefit from more spending in other sectors. The political factors in healthcare in the United States play a critical role in determining who is covered by the available program. Intervention The Affordable Care Act (ACA) signed into on March 23, 2010 by former President Barrack Obama was designed to reduce inequality in the access to healthcare. Known as Obamacare, the bill made provisions targeting the low-income individuals in the United States with the goal of increasing the role of government in health insurance coverage. While most of the benefits were in effect from 2014, the effects of the intervention were felt immediately after the signing by the president (Singh et al. 2017). The goal of ACA was to increase healthcare coverage to the American people and therefore increase access to healthcare among the low-income groups. Since the minorities were the most affected by the lack of health insurance coverage, the bill aimed at providing more access to quality health among the people in this group (Yearby, 2018). While the law made changes to all major aspects of healthcare and access to insurance, individual programs were the most affected by the changes in the ACA. Since the goal of the act was to increase access to care, there were regulations targeting private insurance providers in the United States. While the minorities are the most affected by the lack of healthcare coverage, the problem is worse among the Americans living with pre-existing conditions. The low-income minorities with chronic illnesses are likely to spend more in healthcare than other groups in the United States. ACA was enacted to increase the access to insurance among these groups by restricting the capacity of insurance providers to deny them access. Through these changes, the government ensured that low-income individuals could not be deterred from accessing health insurance by companies offering these services. Moreover, the organizations offering individual insurance could not vary their premiums based on the conditions of the patients (Puaschunder & Beerbaum, 2020). Through this law, states were mandated to provide essential health benefits to all citizens while guaranteeing access to health services for children not covered by their families. ACA increased the expenditure of the state and federal governments in healthcare funds targeting the low-income individuals in the country. A key challenge in the access to healthcare in the United States is that families are likely to spend more in the year when a member becomes ill. Therefore, ACA ensured that the government regulated the actions that insurers would take in response to patient’s illness. For instance, the law required that insurers should not raise the premiums or drop consumers when they became ill. Additionally, ACA required that the organizations providing health coverage indicate an annual maximum out-of-pocket payment for their clients This implied that the insurers would cover any amount exceeding this payment to protect consumers who became ill during the process of care in the health facility (Singh et al. 2017). Organizations providing care were required to protect the consumers from heavy expenditure resulting from their preexisting health conditions or illness at a particular period of the year. Overall, the role of ACA was to increase access to healthcare coverage among the low-income people including the minorities in the United States. The ACA was successful in increasing the access to healthcare coverage in the United States as it halved the uninsured population by 2016. When the benefits of the program came into effect, more low-income people had access to insurance and were able to pay less for quality care (Dickman, Himmelstein, & Woolhandler, 2017). With the insurers required to cover people with pre-existing conditions without raising the premiums, more Americans were able to pay for healthcare cover. The increase in government funding for healthcare through the state and federal programs played an essential role in improving healthcare in the country (Yearby, 2018). ACA was successful in lowering the rate of the uninsured Americans and benefited...