Application of Public Health Concepts for the Uninsured

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Introduction

Medical insurance is an essential phenomenon since it implies many advantages. For example, they include the protection against high and unexpected medical costs, more accessible preventive care, and others. That is why it is not a surprise that a continuously growing number of people utilize this option. However, multiple people do not have health insurance, and it does not mean that they do not understand the potential benefits. The issue refers to the fact that many individuals cannot afford insurance for many reasons, and the government takes specific efforts to address the situation. It relates to the actions that are aimed at reducing the cost of insurance to ensure that low- and middle-income citizens can also get it. This strategy leads to positive results since the number of uninsured people keeps reducing.

The information above stipulates that insurance and its positive impact are popular topics in the research field. However, it is impossible to mention that this knowledge area does not imply any gaps or inefficiencies. The problem occurs because the current efforts are insufficient, and the number of uninsured people is still enormous in the United States. It means that additional measures are necessary to get a more in-depth insight into the problem and expand the research field. One should admit that any offer should rely on evidence to ensure that the achieved results will be reliable and effective. Thus, the given case report will justify that the questionnaire is the most suitable research instrument to address the literature gaps regarding the uninsured and advocate for social justice, equity, and ethical healthcare policies.

Brief Literature Review

The absence of medical insurance is a significant problem for the whole healthcare industry in the United States. According to the Kaiser Commission on Medicaid and the Uninsured (2015), “the number of uninsured nonelderly Americans in 2014 was 32 million” (p. 1). This fact means that a significant portion of the US population feels difficulties with accessing healthcare services. However, it is necessary to note that these people include members of specific groups. For example, low-income individuals are the leading representatives of this vulnerable population because they cannot afford to purchase insurance. Furthermore, members of minorities are more likely to be uninsured compared to non-Hispanic whites (Kaiser Commission on Medicaid and the Uninsured, 2015). In addition to that, the Committee on Health Insurance Status and Its Consequences et al. (2009) report that different states have various uninsured rates. It means that the whole nation suffers from the problem under consideration.

The information above allows supposing that a high number of uninsured individuals implies essential disadvantages. As for people, they cannot easily access medical services and are subject to financial burdens from unexpected health issues. The Committee on Health Insurance Status and Its Consequences et al. (2009) also admit that patients without medical insurance undermine the healthcare system’s financial stability. There is no doubt that the US government understands it and takes measures to address the problem.

Since the problem of the uninsured is of the federal level, a comprehensive approach is necessary to improve the situation. Thus, the Affordable Care Act (ACA) seems suitable here because this policy aims to reduce the number of uninsured individuals. The Kaiser Commission on Medicaid and the Uninsured (2015) shows that the ACA resulted in a 9-million decrease in the uninsured population in 2014. In addition to that, Davidoff et al. (2018) stipulate that the ACA improved Medicaid eligibility among patients with cancer and without this diagnosis. Irrespective of this, the problem of the uninsured remains topical for the United States, and the following sections will offer a deeper insight into the issue.

Theoretical Perspective

It is reasonable to consider the issue through a specific theoretical lens to understand why there are so many uninsured citizens in the US. For this paper, the Andersen healthcare utilization model seems appropriate. Ronald Anderson developed this theoretical approach in 1968 and worked to improve it together with other researchers (Houle et al., 2001). This conceptual model stipulates that individuals decide on whether to utilize health services based on multiple factors. Anderson stated that there are predisposing (education, ethnicity, age, and others), enabling (family support, income level, and so on), and need (current health status and the number of health problems) factors (Houle et al., 2001). It means that this model takes a comprehensive approach to identify how people utilize health services.

This information denotes that the problem of the uninsured exists because people have different abilities regarding access to medical insurance. For example, representatives of minority groups account for an essential portion of the uninsured population, meaning that specific efforts should be taken to improve this group’s situation. In addition to that, the given theoretical framework helps understand that the combination of multiple factors aggravates the given case. For example, it means that if a Hispanic individual has a decreased income level, this person’s probability of being uninsured increases essentially.

Synthesis of Literature Findings

The information above stipulates that the issue under analysis is a severe problem for the United States because many citizens remain uninsured. They typically include low-income individuals and representatives of minority groups. The presence of the uninsured population implies adverse consequences both for them and the whole healthcare industry. On the one hand, the absence of medical insurance denotes that people cannot address their health issues, which leads to deteriorated public health. On the other hand, the entire medical system faces challenges because uninsured individuals are responsible for uncompensated care, which makes local and state authorities cover these healthcare costs. Consequently, medical institutions lose their fiscal stability, contributing to decreased quality of service.

The application of the Andersen healthcare utilization model shows that no single phenomenon causes the problem. A cohort of different factors is responsible for the presence of many uninsured individuals. The scientist explains that a person’s characteristic features play a crucial role in shaping their access to healthcare services, including medical insurance. This idea refers to the fact that medical insurance rates vary for people of different ethnicities, ages, employment statuses, and others. That is why it is impossible to take a single action or implement a specific rule to make health insurance affordable for everyone, irrespective of their characteristic features.

Summary of the Case

To summarize the case, one should admit that the US authorities understand the importance of the problem under consideration and take specific efforts to improve the situation. The ACA is the leading instrument to make healthcare insurance more affordable for low- and middle-income individuals of states that expand Medicaid. However, it is possible to mention that the current actions are insufficient because millions of Americans cannot obtain medical insurance. It denotes that some gaps or inefficiencies exist in the research field, and the following section will comment on these barriers and possible ways to remedy them.

Gaps or Inefficiencies in Research and Their Solutions

Even though the uninsured population represents a significant problem in the United States, the research field has some gaps in addressing the issue. The first of them refers to the fact that “individuals eligible for assistance may not sign up for coverage due to several factors” (Kaiser Commission on Medicaid and the Uninsured, 2015, p. 4). These factors are multiple, and one of them includes a lack of knowledge about their eligibility. However, there are no scientific articles that would identify what specific elements make eligible individuals refrain from purchasing insurance. Consequently, the absence of these data can minimize the effectiveness of any efforts to fight against low insurance rates because it is not known what barriers should be overcome.

The second inefficiency is the continuation of the gap described above. It relates to the fact that it is not evident what is the most suitable and effective way for individuals to obtain information regarding medical insurance. The possible options are leaflets, brochures, video advertising, external advertising, and others. Even though some articles, including the work by Barnes and Hanoch (2017), explain what requirement leaflets should meet, they do not evaluate how successfully they educate people. It means that it is possible to distribute the given information via numerous channels, but no studies compare their efficacy. The absence of these data results in significant challenges for authorities and health insurance providers since they do not know which specific way of distributing the information to choose to cover as many individuals as possible.

The information above stipulates that specific solutions are necessary to remedy each gap. In both cases, the task is to collect information from individuals and synthesize it, meaning that the same activity can meet the requirements of the two gaps. It is only possible to achieve successful outcomes if current and reliable evidence is involved. Thus, it is necessary to choose a suitable approach to obtain such data, and an online questionnaire seems an appropriate option. The proposed solution will address the two gaps by relying on evidence. One should state that this research instrument has the potential to collect the data that would explain why eligible individuals represent the uninsured population. At the same time, the questionnaire seems the most suitable approach to compare the effectiveness of various communication channels and find a useful way for authorities and health insurance companies to provide individuals with information.

Evaluation of the Selected Research Instrument

At this point, it is reasonable to comment on the advantages of online questionnaires. Firstly, this research instrument makes it possible to reach many respondents without the necessity to take enormous efforts. It is so because individuals should only answer the required questions via the Internet, while all the necessary calculations will be made automatically. Secondly, the method under consideration is economically beneficial for scientists (Regmi et al., 2016). It refers to the fact that online questionnaires mean that researchers do not need to travel to meet with respondents physically. Everything they need is to provide the individuals with the link to access the questionnaire. Furthermore, it is not necessary to create an extended team to organize such research. Finally, Regmi et al. (2016) report that short time frames are another significant advantage of the research instrument under consideration. This information stipulates that questionnaires are worth considering when researchers want to collect reliable evidence quickly and efficiently.

Simultaneously, one should present the rationale to support the selection of the questionnaire for the given case. The proposed research instrument is suitable because it is necessary to reach many citizens from different states. Other data collection approaches would involve essential spending to cope with the task. Furthermore, the questionnaire will ensure that the current data are used, which is critical to generate reliable conclusions. It is so because the data analysis procedures take limited time frames even for large portions of data, meaning that the situation will not significantly change while the information is processed. Finally, the use of a questionnaire minimizes the probability of error since this research method implies simple data analysis processes. These details demonstrate that the questionnaire is a suitable option to accumulate evidence regarding the uninsured population.

Advocating for Social Justice, Equity, and Ethical Healthcare Policies

One can admit that the given case report advocates for essential phenomena for uninsured populations. Firstly, it refers to the fact that the proposed solution promotes social justice. According to Brady (2019), this term stands for just and fair distribution of wealth and resources among people. In other words, the present case report tries to ensure that no one is disadvantaged based on their social determinants, including education, employment, socioeconomic status, and others. It refers to the fact that the proposed questionnaire to identify the most effective ways of distributing health insurance information can reveal that, for example, many people obtain these data from their employers. It denotes that the unemployed population is disadvantaged because its representatives do not achieve this information. Thus, the case report can identify this problem, which will be a significant step toward achieving social justice.

Secondly, the issue of equity is also addressed in this paper. Brady (2019) explains that this phenomenon relates to the absence of disparities regarding access to health services. Similar to social justice, equity in the healthcare industry means that all people have the same access to medical services irrespective of their characteristics, including race, ethnicity, gender, and others. Thus, the case report addresses this issue because the described research instrument can demonstrate that representatives of a specific minority group tend to refrain from purchasing insurance even when they are eligible for it. Consequently, the case report can generate information that will highlight the presence of inequities in the healthcare industry, which will make it possible to eliminate the existing problems.

Finally, the given case report advocates for ethical healthcare policies and leads to some advantages. It refers to the fact that these principles stipulate that medical services should be of high quality and universal access. Thus, it has already been mentioned that this paper aims to identify the existing barriers for different groups of the population to get medical insurance. The supreme objective is to ensure that every citizen can afford to be insured irrespective of their peculiarities.

Final Thoughts

Medical insurance is significant in the healthcare industry since it ensures that people have guaranteed access to medical services and can cope with unexpected health issues. Furthermore, this phenomenon is beneficial for the medical system because it reduces the amount of uncompensated care, improves public health, and increases the fiscal stability of medical establishments. However, many individuals remain uninsured for many reasons, including an insufficient income level, a lack of knowledge, and others. The existing literature also demonstrates that the presence or absence of insurance depends on people’s ethnicity, employment status, and living place. These findings are in line with the Andersen healthcare utilization model, explaining that a myriad of factors determines people’s access to medical services. That is why authorities try to improve this situation, and the Affordable Care Act is a suitable example because this policy is designed to reduce the number of uninsured in the United States.

Even though the Affordable Care Act resulted in a significant decrease in the number of uninsured people, many citizens do not have health insurance. The given case report suggests that this state of affairs is critical because of the existing gaps in the research field. Firstly, it is a problem that eligible individuals do not sign for coverage, and it is not known for sure what factors are responsible for this situation. Secondly, the research area is inefficient because it has not been analyzed what the best way for individuals to obtain information regarding their insurance is. In other words, it is not known how the authorities and health insurance companies should distribute data to ensure that the highest possible number of individuals achieve it. That is why the case report offers to use questionnaires to obtain this information. This research instrument implies a few advantages that will bring social justice, equity, and ethical healthcare services to the uninsured population.

References

Barnes, A. J., & Hanoch, Y. (2017). Knowledge and understanding of health insurance: Challenges and remedies. Israel Journal of Health Policy Research, 6(40), 1-3.

Brady, J. (2019). Social justice, health equity, and advocacy: What are our roles? In J. Coveney & S. Booth (Eds.), Critical dietetics and critical nutrition studies (pp. 143-159). Springer.

Committee on Health Insurance Status and Its Consequences, Board on Health Care Services, & Institute of Medicine. (2009). America’s uninsured crisis: Consequences for health and health care. National Academies Press.

Davidoff, A. J., Guy Jr., G. P., Hu, X., Gonzales, F., Han, X., Zheng, Z., Parsons, H., Ekwueme, D. U., & Jemal, A. (2018). Changes in health insurance coverage associated with the Affordable Care Act among adults with and without a cancer history. Medical Care, 56(3), 220-227.

Houle, L. G., Salmoni, A. W., Pong, R. W., Laflamme, S., & Viverais-Dresler, G. A. (2001). Predictors of family physician use among older residents of Ontario and an analysis of the Andersen-Newman behavior model. Canadian Journal on Aging, 20(2), 233-249.

Kaiser Commission on Medicaid and the Uninsured. (2015). Key facts about the uninsured population [PDF document]. Web.

Regmi, P. R., Waithaka, E., Paudyal, A., Simkhada, P., & van Teijilingen, E. (2016). Guide to the design and application of online questionnaire surveys. Nepal Journal of Epidemiology, 6(4), 640-644.

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