Access to Health Remains an Issue in America: Hospital and Health - Research Paper Example

 Access to Health Remains an Issue in America: Hospital and Health Abstract There are disparities on access to hospital and health in American based on race and geographic location. The inequality of access based on race and geographic is not recognized by many but this is indicated by health data. The effects on health status and mortality are serious and the concern deserves attention. To address the concern, the key work is to enlist the participation of the disadvantaged in the formulation of policy of policy proposals. Access to Health Remains an Issue in America: Hospital and Health The science of medicine has advanced in America and worldwide. However, just as in other parts of the world, access to health remains an issue in America. There are two dimensions related to America’s access to health and hospitalization. The first dimension involves race. The second dimension involves geography. Description of the Problem of Health Access Races allegedly vary with regard to their access to health. According to the Committee for the Elimination of Racial Discrimination (CERD), there are disparities on health care enjoyed based on race (2008). CERD (2008, p. 10) elaborated that through Figure 1 below that only 8% of white Americans believe they received poor or fair health compared to 14% for Hispanics and 15% for African Americans. Figure 1. Race and health status Source: CERD 2008, p. 10 Meanwhile, Americans across the United States do not have equal access to health care. Some states are spending as low as about US$5,200 per capita while others are spending as high as US13,000 per capita for health care in 2005 (US Congresional Office, 2005). This is shown in Figure 2. Figure 2 also shows that those with the highest spending for health services tend to be highly clustered and concentrated. This can be a sign that those with the highest spending for health are concentrated where the economies are more vibrant. Those with the highest spending for health also tend to be along the coast. Figure 2 indicate that American access to health is far from equal. Moreover, the larger parts of the distribution are those with the lowest spending for health. The geographical disparity on health spending and the larger area in which spending is low led to a situation in which 46 million or 16% of the US population in 2007 do not have health insurance in America (Carey et al., 2009, p. 23-24). Figure 2. Medical spending per capita in the United States, 2005 Controversies Despite the real relevance of geographic and racial differentials in access to health, Vicker (2009) revealed that the top five concerns for American health is not about racial nor geographic equity with regard to health access. According to Vicker, the main controversies to health issues revolve on performance pay, patient selectivity over health providers, nurse-to-patient ratios, electronic records, and cost (2009). On the other hand, for Ohsfeldt & Schneider (2006, pp. 113-117)), the public discourse should instead focus on the elimination of laws that inhibit markets, development of strategies to evaluate new medical technologies, infusion of transparency in health plans or insurance, redesigning of insurance systems so they can be more sensitive to prices, and improving coordination among public insurance programs. Unfortunately, no influential organization has yet seen the extreme importance of American’s actual access to health and hospital services as the more important issues or as the barometer through which we can assess whether the agenda suggested by Vicker (2009) and Obsfeldt & Schneider (2006) are producing significant impact on health and hospitalization concerns of the American people. Role of the Federal, State, and Local Government Figure 2 or the map that associates health spending with a geographical area implies an important role for the federal, state, and local governments on the health and hospitalization of the American population. As we can see from the map, there are states and local governments who are able to invest only a relatively small amount for health and hospitalization. This implies a role for the federal government. At the same time, it implies that the state and local governments must review their priorities with regard to spending and consider the allocation of a greater amount of government resources to improve hospitalization and access to health among the American people. Impact of the Issue The impact of lack of access involves lives being lost. A large percentage of the lives being lost are infants. Figure 3 shows that the highest infant deaths take place among the African-Americans and the American Indians. Figure 3. Race and infant deaths per 1,000 live births Source: CERD 2008, p. 10 Unfortunately, however, data are not immediately available to show the correlation between the health spending of geographical areas and infant deaths but most likely the situation is highly similar with Figure 3. Policy Proposals and Legislations The concerns that Vicker (2009) and Obsfeldt & Schneider (2006) emphasize implies policy proposals and legislations. Unfortunately, none of the policy proposals that are implied by Vicker (2009) and Obsfeldt & Schneider (2006) will be able to address the serious concerns of disparity of access to health and hospitals based on race and geography. Thus, it is imperative that the concern be addressed directly. Meanwhile, based on the document Healthy People 2010, the implied health priorities of the US Department of Health are those related obesity, tobacco, substance abuse, responsible sexual behavior, injury and violence, mental health, environmental quality, and access to health care. However, based on page 44 of the document or the only page that addresses access, the focus of health access pertain to the elderly and pregnant women. There is no recognition that there are disparities in health care and hospitalization received based on race and location. Thus, the concerns that this work attempted to address are something worth bringing into the attention of policy makers. Recommendations Fundamentally, the problems on any type of access exist because those that are disadvantaged are not empowered. In the issue of health access, for instance, those that have access to health can be said to have missed the boat of participation in the shaping of policies that will ensure their access to health. They have missed the boat under two possibilities. The first possibility is that those who have more access today are either more powerful or have been more able to participate in the shaping of policy. The other possibility is that those who have less access today are less powerful or have simply lost or have diminished their access to health by defaulting on their rights and obligations to participate in the shaping of policy. Whichever the case is, the fundamental solution to the problem is not to lessen the participation of those who have managed to acquire more to health. The federal and state governments as well as local government must pursue a policy of mobilization to enlist the participation of those with less access to health in the shaping of health policies. In the concrete, this could mean that public meetings can be held among the disadvantaged groups or those with less access to health to elicit from among themselves how they could have more access to health. Thus, the federal, state, and local government must hold with as many consultations as possible with disadvantaged group and ask the said groups pointblank how they think they can improve their access to health. This is the strategic action to take. We must hold public meetings with the disadvantage groups and enlist their participation in the shaping of policy. In promoting the participation of the disadvantaged group in formulating policy proposals, the various levels of government can sponsor workshops. The workshops may assess the situation, identify the possible root-causes of disparity of access to health and hospital services based on race and geography. Enlisting the partipation of the disadvantage in the formulation of policy proposal would enable us to see from vantage points that are not possible to stand on without their participation. Bibliography Carey, D., Herring, B., & Lenain, P. (2009). Health care reform in the United States. Working Paper No. 665. Organization for Economic Cooperation and Development: Economics Department. Committee for the Elimination of Racial Discrimination (CERD) Working Group. (2008). Unequal health outcomes in the United States. A report to the U.N. Committee on the Elimination of Racial Discrimination (January). Ohsfeldt, R. and Schneider, J. (2006). The business of health: The role of competition, markets, and regulation. Washington: The AEI Press. US Congressional Budget Office, (2008). Health care and behavioral economics: A presentation to the National Academy of Social Insurance, 29 May. Retrieved June 15, 2010, from http://www.cbo.gov/ftpdocs/93xx/doc9317/05-29-NASI_Speech.pdf US Department of Health. 2000. Healthy people 2010: Understanding and improving health. Washington: US Department of Health. Vicker, S. (2009). Health care: Five trends for 2010. Retrieved June 15, 2010, from http://www.healthnewsdigest.com/news/Forecast_630/Health_Care_Five_Trends_for_2010_printer.shtml Read More