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Equity in Healthcare in the USA

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Introduction

The healthcare sector in the USA has been under constant revolution, and one of the areas that have been most affected is equity in the provision of healthcare. Historically, many Americans have suffered injustice in healthcare on the basis of their race or ethnicity, immigration status and socio-economic status. To date, several steps have been taken to address these injustices, and they have had a significant impact on the state of equity in healthcare in the USA. However, even today, there are still several pieces of evidence that point to the fact that many Americans are still victims of inequality and injustice in the healthcare sector. This article will expound on the disparities experienced in the healthcare sector and review the steps that have been taken to alleviate these disparities. Moreover, this article will explore what the future holds for equity in the healthcare sector in the USA. The country has been in search of healthcare equity for a long time and yet several disparities arising from ethnic, socio-economic and immigration factors persist. However, going by tremendous progress that has been made, gender equity in the US is in sight.

Background

The healthcare sector in the USA has not managed to attain equity until today. Despite the concerted efforts to bring equity in healthcare, several injustices persist, stemming from ethnic (racial), socio-economic or even immigration status (Crocker, Dobrowolsky, Keeble, Moncayo  & Tastsoglou,  2007). Racial and ethnic disparities in the provision of healthcare date back to the era of slave trade. Minority groups, especially the African Americans, suffered several forms of injustice. One of the most prevalent, shocking and inhumane forms of injustice is injustice in healthcare. Among several things that civil groups fought for throughout the nineteenth and twentieth centuries was equity in the provision of healthcare. Famous African American leader Martin Luther King Junior captured this situation succinctly in one of his statements. He claimed that inequality and injustice in healthcare was the most shocking and inhumane form of inequality. To date, several steps have been made in order to bridge the gaps. However, the same inequalities have kept haunting the healthcare sector. Nowadays healthcare disparities arising from racial, socio-economic and immigration status continue to dog the healthcare sector.

Ethnic disparities

Racial discrimination in the provision of healthcare is a notorious form of disparity in healthcare. No matter the stopgap measures that have been taken to stem the number of uninsured individuals, the number has continued to rise apace. Ethnic minorities have continued to suffer discrimination in the provision of healthcare. This discrimination has stemmed in part from the ingrained injustices that minority groups, especially African-Americans, have endured historically (Delgado & Stefancic, 2011). Much has been postulated as to the source of these racial and ethnic disparities in healthcare. One plausible argument is that disparities arise from the operation and characteristics of healthcare system, process of care (for example, the provider-patient relationship) as well as legal and regulatory backdrop (Strumpf, 2011).

Ethnic disparities in the healthcare sector are hard-boiled and deep-rooted ijustices that have proved hard to take away. The best demonstration of this is that a fifth of all African Americans lack health insurance cover, and African American communities also suffer the highest levels of chronic diseases. Moreover, most African American communities live in the areas where access to affordable food is limited and safe and healthy places to live are few. These are demonstrations of the state of inequity in the healthcare sector.

Several steps have been taken in an attempt to bring about parity as far as provision of healthcare to different ethnic communities in the USA is concerned. Some of the most significant ones led to the signing of Medicare and Medicaid programs into laws in 1965. President Truman steered the revolution in healthcare insurance since 1945, and the hallmark of his efforts was signing into the law of Medicaid and Medicare programs.

In recent times, other certain laws have been passed in order to ensure that children of all races have an equal opportunity to access proper health care and to be healthy. The most recent of these laws is the “Affordable Care Act”, which is expected to expand the health coverage of Americans by about 34 million. The act has come with several incentives that will ensure that disparities in healthcare have been offset.

Disparities arising from the immigration status

The immigration status is perhaps only second to the ethnicity as a pillar of discrimination (Light, 2012). The number of people who suffer health-related injustices due to their immigration status is so high that it approaches the number of people who suffer the same injustices due to their ethnicity.

Many immigrants lack health insurance cover. In a country such as the USA, where healthcare is too expensive to pay for from the pocket, insurance cover is essential. The fact that most immigrants lack such cover puts them at risk of being locked out of many healthcare services. The fact that most immigrants are far away from their home countries and therefore their families and friends make them extremely vulnerable. This makes it highly likely for them to get stranded in a foreign country.

The stem of most immigrant problems as far as healthcare is concerned is the fact that immigrants do not have sufficient representation in the law-making bodies. Therefore, their needs are inadequately represented at every level of decision-making. What makes the situation even direr is that programs that were initially meant to provide health insurance cover for the immigrant population have been scraped or modified. One of such programs is Medicaid. The eligibility for Medicaid was made much stricter than it had previously been, and this locked out several immigrants from healthcare services.

The window of relief for immigrants is that welfare of immigrants is currently being taken care of at the state level. Different states have taken different steps to ensure that immigrants have health equity. Discussing health disparities of immigrants therefore becomes a complicated issue because of variations of each of the steps that each individual state takes in order to alleviate health disparities affecting immigrants.

Disparities Arising from Socio-Economic Status

Health disparities stemming from the differences in the socio-economic statuss of Americans are some of the grossest and most prominent. The economically privileged people seem to receive the best healthcare while people who are lower on the socio-economic ladder seem to be deprived not only of the best healthcare but also some essential aspects of healthcare.

Some insurance policies are too expensive for the average person to afford. Interestingly, some of provisions of these policies comprise the most essential services that can be provided in healthcare (Taylor & Maslove, 2009). People who are unable to afford such policies often find themselves in the middle of health crises when they realize that their policies do not cover what they initially thought they covered. This issue could be viewed from two angles. The first one is purely an insurance issue. The second angle is that of socio-economic differences that give people different capabilities of receiving quality healthcare.

Some measures have been taken to reduce these disparities. The most prominent measure is, perhaps, creation of Medicaid, Medicare and other related programs which offer a safety net for the poor people and afford them access to the most essential services. Moreover, insurance education has improved so that people are fully aware of the terms of their policies before they subscribe for them.

General Steps Taken by the Federal Government to Reduce Healthcare Disparities

The federal government has tried to link equity to the quality. The establishment of equity in healthcare often comes hand in hand with a proportionate reduction in the quality of healthcare (Tonoyan, & Muradyan, 2012). Therefore, the federal government has initiated quality assurance checks to ensure that the improvement of equity in healthcare in the USA does not compromise on the quality of healthcare in the USA. The government has also created a robust campaign to establish a culture of equity, diagnose disparities and promote innovation in a search for equity.

Indeed, health equity has been used by many politicians as a political gimmick (Cookson, 2005). Even the current President, Obama, became a sensation when he steered passing of the healthcare bill. This bill championed, among other things, restoration of healthcare equity in the USA through many things.

Conclusion

Health disparities have historically dogged the footsteps of the USA. The most prevalent and common disparities are those that arise from ethnic differences, immigration status and socio-economic status. While several steps have been taken to reduce these disparities and bring about equity in health care, much remains to be done. As suggested, a special body should be formed within the healthcare sector, whose sole purpose will be to identify different forms of disparity, and tackle them from their roots. Such a body should review, for instance, the reasons why disparities still exist among different groups of people in the United States. If, for instance, it is established that healthcare providers still show racial discrimination in the provision of healthcare, legal provisions should be made to deal with people found guilty of such malpractices. Inasmuch as there are several steps have been taken in a bid to bring about equity in healthcare, much remains to be done in order to achieve it. Nevertheless, there is a lot of hope that equity in the healthcare sector will be achieved soon.

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