The US healthcare system is designed to improve the health of the national demographic by treating, preventing, detecting, and ameliorating health conditions and illnesses. There are several concepts that the health sector is based on when it comes to care provision. Namely, patient safety, maintaining one’s good quality of life, following patient-centered care, and basing approaches on equity are several of the multiple aspects at the core of healthcare. In this paper, equity will be discussed from the perspective of the Patient Protection and Affordable Care Act and the Healthy People 2030 framework.
US Healthcare System
While the US Healthcare System is not fully publicly funded, specific policies and legislative implementations create circumstances in which all individuals can access medical services. According to researchers, limitations exist based on the divisive system in which a specific percentage of the population accesses care based on public insurance while the second demographic relies upon private ones (Crowley, Daniel, Cooney, & Engel, 2020). While the system operates based on insurance coverage, this does not imply that certain individuals cannot qualify to receive high-quality care. Moreover, individuals who cannot enter the workforce due to health reasons require frequent medical attention, treatments, and preventative procedures.
As a result, several acts have been implemented to widen the array of Americans receiving health services. Namely, Medicare, Medicaid, and the Patient Protection and Affordable Care Act. While the first two policies were initially installed in the 60s, the Affordable Care Act was implemented in 2010 and is both an extension of existing opportunities and a new policy allowing more people to access care (Zhao et al., 2020). Thus, the Act plays a major role in the equity aspect of the healthcare system in the US.
Affordable Care Act
The Affordable Care Act is a policy among the multiple aiming toward the maximization of healthcare accessibility. The act provides numerous opportunities for individuals who are uninsured either due to pre-existing health issues or low income (U.S. Department of Health & Human Services, 2022). Thus, the policy has been implemented based on the healthcare goal of creating accessibility for all. It is also vital to mention equity when it comes to the Affordable Care Act. Since the policy generates fewer limits while accessing mental health care, cancer treatment, and similar resources, equity as a framework is being reinforced. Based on the implementation, the unique healthcare needs of each individual are to be considered and approached accordingly.
Public Health Framework
Accessibility, which is partially covered through the aforementioned Affordable Care act, is reinforced through public health frameworks such as Healthy People 2030. The framework is intended to address the most current public health needs by issuing aspects that are to be considered during health policy implementation. The Healthy People 2030 framework includes the goal of minimizing health disparities (American Academy of Family Physicians, 2022). Based on the premise, the aim is to achieve an equitable system in which all demographics, communities, and groups can receive high-quality care despite income, race, age, and sex differences. The public initiative directly correlates with the Affordable Care Act from the perspective of addressing certain challenges that limit individuals from accessing the needed resources. Thus, the act and the framework are similar in relation to the objective of achieving equity.
As mentioned prior, the US healthcare system is not fully publicly funded, which is not a limitation in regards to accessibility based on the change towards equity and the policies implemented to reach this goal. However, it is essential to mention that despite the efforts, disparities exist and are extensively analyzed by researchers. An example is disparities in cancer mortality. Studies show that cancer mortality is higher in rural America compared to urban regions (Yabroff, Han, Zhao, Nogueira, & Jemal, 2020). On the one hand, the finding may illustrate existing disparities and a lack of access to healthcare in rural areas. However, since factors such as socioeconomic and cultural circumstances, it is unclear whether such differences are based on a federal inability to create an equal system of more subjective actions. Another research highlights that from the 29 examined states and subsequent healthcare authorities, equity is a written objective in half the cases (Cleveland Manchanda, Sanky, & Appel, 2020). However, it is unclear whether the lack of written evidence and formalities de facto impact state-level health aims towards equity. Hence, the limitations do not generate extensive harm in regard to the public framework for accessible care.
The US healthcare system is based on accessibility, and the implementation of policies and formulation of frequent frameworks highlight the importance of the concept. Currently, the Affordable Care Act allows multiple low-income or chronically ill individuals to access much-needed health services. Moreover, Healthy People 2030 is a framework identifying accessibility as one of the goals for the next decade in healthcare. As a result, more people are able to access health-related resources and services, which, in turn, positively affects the health of the general population.
American Academy of Family Physicians. (2022). Healthy People 2030 Framework. Web.
Cleveland Manchanda, E. C., Sanky, C., & Appel, J. M. (2020). Crisis standards of care in the USA: A systematic review and implications for equity amidst COVID-19. Journal of Racial and Ethnic Health Disparities, 8(4), 824-836.
Crowley, R., Daniel, H., Cooney, T. G., & Engel, L. S. (2020). Envisioning a better U.S. Health Care System for all: Coverage and cost of care. Annals of Internal Medicine, 172(2_Supplement).
TU.S. Department of Health & Human Services. (2022). About the ACA. Web.
Yabroff, K. R., Han, X., Zhao, J., Nogueira, L., & Jemal, A. (2020). Rural cancer disparities in the United States: A Multilevel Framework to improve access to care and patient outcomes. JCO Oncology Practice, 16(7), 409-413.
Zhao, J., Mao, Z., Fedewa, S. A., Nogueira, L., Yabroff, K. R., Jemal, A., & Han, X. (2020). The Affordable Care Act and access to care across the cancer control continuum: A review at 10 Years. CA: A Cancer Journal for Clinicians, 70(3), 165-181.