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Americans in the US face multiple barriers to healthcare delivery related to cost, quality, and access. In the reviewed scenarios, we have Raymond, a 54-year-old skilled worker with no insurance, and Emmanuel, a 55-year-old office manager with insurance. They face different challenges related to their healthcare. Raymond’s main barriers include costs and access to proper healthcare. Since he is uninsured, he has to pay the exorbitant costs out of pocket (Beik et al., 2020). Prices prevent him from receiving regular and consistent healthcare. In addition, the prices for gas add to these ongoing expenditures, making the cost situation even worse.
In regards to accessibility, Raymond’s situation is worsened by being in a rural area. The nearest hospital is 30 miles away, which is the reason why gas prices are considered in the first place. Overall, these two factors combine together to create an unfavorable situation (Beik et al., 2020). Emmanuel’s situation is much different due to his having access to quality healthcare covered by insurance. There are no barriers present in his scenario – he has regular healthcare checks, receives referrals from his primary care providers, and his issues are covered by insurance.
Both case studies demonstrate how having insurance influences the decisions related to costs, quality, and access. In Raymond’s situation, had he been insured, he would have had funds to afford the gas to drive to the hospital and receive healthcare in a timely and appropriate manner. Thus, it is easy to see how insurance affects costs, which in turn affects accessibility, which influences the quality of care in a negative way (Bonewit-West & Hunt, 2019). Emmanuel does not have such problems – he lives in a big city, where access to care is readily available, and his insurance covers the majority of the costs (Bonewit-West & Hunt, 2019). Had he had no insurance, the situation might have been different, with him having to carry a greater burden due to managing his risks for Type 2 diabetes.
Potential health outcomes for each scenario are as follows: If nothing changes, Raymond’s situation is going to get worse. His lack of consistent care would result in increased hypertension and a greater likelihood of developing pulmonary embolisms and heart disease. Emmanuel, on the other hand, is at no risk of that and has a better chance of managing his diseases before they become chronic. Unless Raymond gets insurance, he will not have the opportunity to receive the care he needs.
References
Beik, J. I., & Pepper, J. (2020). Health insurance today-e-book. Elsevier Health Sciences.
Bonewit-West, K., & Hunt, S. (2019). Today’s medical assistant-e-book: Clinical & administrative procedures. Elsevier Health Sciences.
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