Discussion on the Health Care System


The reasons for the underinsurance vary from income to ethnicity, age, and education. While several social factors can affect a person’s inability to be fully insured, the main of them are employment features and a high price of deductibles. The employment factor implies that citizens with a low-income employment are more likely to be insurance-exposed. According to the study, a considerable number of Medicare beneficiaries were forced to spend a high share of their income on additional treatment (Schoen, Solís-Román, Huober, & Kelchner, 2016). Considering the facts that approximately 150,000 Americans receive their insurance from the employers and that those cover only a narrow area of treatment measures (Collins, Doty, Rasmussen, & Beutel, 2015), it becomes obvious why several citizens remain underinsured. The other major factor of the problem is deductibles, which often appear as a result of the insufficient insurance package. For instance, in 2014, 23% of working adults had an insurance package during the year, but the deductibles were of such high cost that it resulted in out-of-pocket exceeds and, eventually, underinsurance (Collins et al., 2015). The reasons for the phenomena can be discussed a lot, but the solution to it may be more urgent. Today, the USA faces the problem of underinsurance, despite the Affordance Care Act measures to equalize treatment affordability. For eliminating the healthcare accessibility, the government might need to reconsider existing pieces.

Priority Populations

In the approach to healthcare system, such priority populations as racial and ethnical minorities face several struggles (“Priority populations,” 2018). Among these disparities, the most considerable are racial- and ethnical-based biases and social disadvantages which often cause poor-quality care (Fiscella & Sanders, 2016). The main features of the biases can be seen within legislation, placing of the medical resources, policies, and personal physicians’ attitude (Fiscella & Sanders, 2016). As a result, several citizens of such groups experience low healthcare accessibility, underinsurance and unmet medical needs. The social disadvantages can appear in forms of poor-quality services and a lack of healthcare affordance and access (Fiscella & Sanders, 2016). The main groups who are significantly affected by the latter are the citizens from rural areas, who do not have proper access to medical services (Fiscella & Sanders, 2016). The most effective strategy of equalizing healthcare access is the ACA, which tends to provide an even service for each population group. On contrary, the report of Agency for Healthcare Research and Quality shows that the overall changes are slow and insufficient, although several improvements were qualitative both on local and national levels (Fiscella & Sanders, 2016). The conclusion is that the implemented strategies did not shift the disparities drastically, but the progress in reorganizing healthcare system is visible and perspective.

Quality Initiatives

Implementation of quality improvements is an urgent process in the healthcare system. Such initiatives can arrive both from the public and private sectors, and, although they have different approaches, each of them is essential. The governmental strategies of the initiatives are mostly legislative changes. The most significant healthcare act today is the ACA, which continues reforming the medical system to provide equal affordability of the treatment for all population entities. Among its qualitative initiatives, spreading health insurance for several groups and the elimination of the treatment cost disparities are the most efficient (Blumenthal, Abrams, & Nuzum, 2015). The private initiative also causes valuable impact, as the organizations contact with the subjects of qualitative changes and has the opportunity to cooperate. According to the example from the UK research, the patient-organization relationship can make the first an improvement agent (Renedo, Marston, Spyridonidis, & Barlow, 2014). The study also carefully describes how such collaboration can be conducted (Renedo et al., 2014). Analyzing the joint work of public and private units towards a better health system, they are effective as long as they complement each other. The legislation provides a legal basis for the improvements, and the private organizations deliver the innovations to the patients, receiving crucial feedback from them.

Affordable Care Act

The Act since its creation in 2010 managed to cover most of the population with the insurance. It also reformed crucial components of the medical system, such as a change in the pre-existing conditions. The most efficacious aspect of the Act is the increase in access to coverage for minorities. A study of the ACA impact demonstrated an upgrade in health condition, self-reported coverage, and access to primary care, along with poor access to healthcare for rural dwellers (Sommers, Gunja, Finegold, & Musco, 2015). Correspondingly, the Act proves to manage the reformation unequally, but there is an expectation the accessibility can spread in the future. Another solid improvement refers to pre-existing conditions. According to it, the patients who previously had certain preceding disease coverage are eligible to receive it again (“Summary of the Affordable Care Act,” 2017). This change might be crucial for patients with continuously emerging illnesses, such as diabetes or cancer. Alongside the access imperfection, the ACA shows several weaknesses.

The most visible flaws of it are increased healthcare taxation and the employers’ demanding obligatory insurance (“Summary of the Affordable Care Act,” 2017). These aspects may cause hiding actual incomes and cutting working hours. The pieces of the ACA that are a novelty for me are changes in the tax rate on wages and employers’ obligatory insurance with over 200 workers (“Summary of the Affordable Care Act,” 2017). The possible wages over $200,000 I intend to receive imply the 0,9% tax rate (“Summary of the Affordable Care Act,” 2017), and an employer of a major company should provide insurance for every employee (“Summary of the Affordable Care Act,” 2017). By knowing the latter, I can be confident of my future safety within the workplace.


Blumenthal, D. B., Abrams, M. K., & Nuzum, R. (2015). The Affordable Care Act at five years. The New England Journal of Medicine, 372(25), 2451-2458. Web.

Collins, S. R., Doty, M. M., Rasmussen, P. W., & Beutel, S. B. (2015). The problem of underinsurance and how rising deductibles will make it worse: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2014. The Commonwealth Fund, 13, 1-20.

Fiscella, K., & Sanders, M. R. (2016). Racial and ethnic disparities in the Quality of Health Care. Annual Review of Public Health, 37(1), 375-394. Web.

Priority populations. (2018). Web.

Renedo, A., Marston, C. A., Spyridonidis, D., & Barlow, J. (2014). Patient and public involvement in healthcare quality improvement: How organizations can help patients and professionals to collaborate. Public Management Review, 17(1), 17-34. Web.

Schoen, C., Solís-Román, C., Huober, N., & Kelchner, Z. (2016). On Medicare but at risk: A state-level analysis of beneficiaries who are underinsured or facing high total cost burdens. The Commonwealth Fund, 10, 1-16.

Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. JAMA, 314(4), 366-374. Web.

Summary of the Affordable Care Act. (2017). Web.