Access to health care has been in the Health care debate from the outset. A goal of health reform is to provide most Americans with the opportunity of having an insured benefit to some combination of acute and preventive health services. The focus has been on the uninsured members of our society as well as the insured members who have benefit limitations in the form of pre-existing conditions, etc.
Laws prevent denying people access to care when they present to emergency rooms with acute problems. Laws also prevent hospitals from transferring uninsured and under insured patients to other facilities when they present with acute problems and have the medical staff expertise to address the problem. According to filed reports by the American Hospital Association, over $34 billion dollars of actual cost were spent in 2007 delivering care for charity and bad-debt write-offs. And, there are federally qualified health centers in many medically under served regions that receive subsidies to deliver care for under insured and uninsured individuals. Unfortunately for some, laws don't prevent providers from taking an uninsured individual into bankruptcy because of their inability to pay. Herein presents a possible target opportunity.
Health care providers are in short supply overall and tend to congregate in certain areas to a much greater extent than others. There is no guarantee that having an insurance benefit will guarantee provider availablility for more than hospital based emergency services available already with or without an insurance benefit. Look at almost any low income area in the United States and you will find shortages of health providers of virtually all types.
So, having more insurance cards dispensed and having more benefit mandates imposed on existing plans does not guarantee more care will get delivered or be better distributed. Hence, there is a disconnect between access to some form of insurance and access to more care options. What are the key issues identified to address this disconnect, and how? As you identify the issues you believe important, together we can dialogue as the importance of each and look a possible options. Thanks for your thoughts!
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The first step to providing greater access to health care in this country is to encourage medical schools to admit larger class sizes. It is simply impossible to promise coverage and care to all when there is an enormous shortage of people and facilities delivering that care. If the government is so intent on using taxpayer money to fund its insurance programs, some of that money should get allocated to provide incentive to health care providers who are willing to work in under served areas (programs like these do currently exist, but they often do not seem "worth it" to new physicians). The best way to create change in the system is to rebuild it from the top down and begin by creating more physicians and expanding/updating hospitals. Only then can the foundation for insurance reform be put in place.
Well said! Increasing the supply of medical professionals, upgrading and building efficient facilities, and leveling the payment structures would profoundly improve access, quality, and possibly efficiency. Some economists have posited that pricing of government sponsored care below the price of delivery has had a major impact on the poor distribution of doctors.
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