Application of Public Health Concepts for the Uninsured: The Effects on the Health Sector
Introduction

Application of public health is of major concern to DNP-prepared nurses in their different fields and places of practice. Since the 20th century, public health nurses have been at the forefront of improving the general health condition of different communities by providing unrelenting and selfless services to members of the public. Immunizations, workplace safety, healthier mothers and babies, family planning, and awareness campaign on tobacco health complications are some of the critical areas they have immensely impacted (“The Unique Contribution”). In this present age, top amongst the global health concerns in DNP area of study is the growing number of insured people in the world. The prevalence of life-threatening and disability-causing diseases in society has made having health insurance a necessity. According to World Health Organization (WHO), Ischemic heart disease, stroke, chronic obstructive pulmonary disease, lower respiratory infections and Alzheimer disease and other dementias are some of the top ten global causes of death. The world health body further revealed that out of “the 56.9 million deaths worldwide in 2016, more than half (54%) were due to the top 10 causes” (“Top Ten Cause 2018”).

Problem Statement

Unfortunately, the lack of health insurance has limited many people’s access to adequate healthcare needed to fight the diseases and live a healthy life. In the United States of America, for instance, according to the United States Census Bureau, 28.5 million U.S. residents lacked health coverage (Berchick, Hood & Barnett 2018, p. 1). This situation is not peculiar to the U.S.; it is a global problem which is even worse in developing and low-income countries. Lack of health insurance affects every stratum of national life, especially the economy. The effects, therefore, are felt on the uninsured, the insured and governments at all levels. To this end, it is imperative, therefore, to critically evaluate the effects of the public health concept of the uninsured in the country and propose a result-oriented initiative to resolve the problem.

Literature Review

To have a broad perspective of the effects of this national issue, two reports by reputable health organizations will be revisited. The Institute of Medicine IOM and Kaiser Commission Reports are some of the leading studies that give insights into the increasing rate of the insured population in the country and its negative impacts on the health sector.

In Kaiser’s Key Facts about the Uninsured Population (2018), the publication showed the number of uninsured and the major reasons for their lack of coverage. In addition, it analyzed the effects of lack of insurance, which include low access to healthcare and affordability problem. According to the report, during the economic recession between 2008 and 2010, the number of uninsured nonelderly people rose from 44.2 million to 46.5 million (“Key Facts about” 2018, p. 1). However, the figure was drastically reduced at the commencement of the Affordable Care Act (ACA), which was set up for health coverage expansion especially among low-income earners. However, for the first time since the 2014 commencement of ACA, the number of uninsured increased by more than half a million in 2017. Top among the reasons why people remained uninsured are cost of insurance policy and unemployment. For instance, 45%, 22% and 11% of nonelderly attributed their un-insured status to high cost, loss of a job or changed employers, and loss of Medicaid respectively. Other causes were status change (11%), and ineligibility for coverage (9%). (“Key Facts about” 2018, p. 2).

In the same vein, the IOM report, “America’s Uninsured Crisis: Consequences for Health and Health Care” (2009), also showed uninsurance crises in the U.S. The study provided answers to three key questions which were: What are the dynamics driving downward trends in health insurance coverage? Is being uninsured harmful to the health of children and adults? Are insured people affected by high rates of uninsured in their communities?...…data presentations on the effects of uninsured in the health sector, the underinsurance in the country also needs to be looked into. There still exist in the country, a good number of insured but underinsured individuals. This set of people might have health coverage but their health insurance offers very limited financial protection. It is not enough to only have health coverage; an insurance policy must be suitable and protective enough to provide coverage during any form of health challenges. Due to lack of data, it has hitherto been difficult representing and arguing this cause in public discourses. The context of health coverage representation henceforth should be approached from a three-prong perspective – the insured, the uninsured and the underinsured. Studies need to be carried out to substantiate the figure of this proposed demographic with the views to offer more robust and absolutely reliable health coverage that will be inclusive to all. It is, therefore, of utmost importance that the government, experts and policy analysts in health sector approach this with all sense of responsibility.

Recommended Research Instrument

To ensure the reliability of this proposed study, a qualitative research method should be employed. This research instrument will be the most suitable in this regard as it will accord the researchers the opportunity of one-on-one communication with the affected persons. With qualitative research method, there will be a near accurate data representation of the number of the underinsured not only in the country but at the community level.

Conclusion

The cases as presented in the reports showed that there is a need for action at all levels. Just as recommended by the IOM report committee, it is the responsibility of both the government and private sector leaders to intensify effort in achieving health insurance coverage to every member of the public. Living without health coverage is detrimental to people’s health. Without a pragmatic approach, low access to health care will continue to worsen the public health in the…