Uninsured or underinsured individuals and coverage gaps

Uninsured |

Healthcare

The Uninsured in the United States

According to Newport and Mendez (2009) about 17.3% of the American population does not have health insurance. The uninsured are seen in families that work. Studies show that 51% of the families have a working household head that are employed full-time and worked for a full year. These uninsured groups work in firms where insurance coverage is not available, dependant coverage is not available, insurance coverage is not available or employees coverage may be paid yet dependant coverage is too expensive (Newport & Mendes, 2009). Or, the case could be that these uninsured work in a firm which has very little employees. Small firms, which have around 3-9 employees, are seen to least likely offer insurance coverage. There are many issues when it comes to purchasing insurance for small firms. Small firm employers cannot afford comprehensive health coverage for their employees (Newport & Mendes, 2009). For those who do provide health coverage, they can only manage to pay for their employees and not their dependents. If this were the case, employees would be seen paying higher out-of-the-pocket costs for coverage and co-payments. There are no alternatives which are low-cost for dependent coverage. Most of the uninsured in the United States are those from low-income families. Surveys show that 26% of these families live below the poverty guidelines; 41% of these families earn between 100% to 250% of the Federal Poverty Level (FPL) Guidelines. All ethnic groups from the United States suffer from being uninsured. The highest rate of uninsured under an ethnic category is the Hispanic community (Newport & Mendes, 2009). In a study which observed the uninsured from adults which are aged 18 years and older, 41.5% of these uninsured people were Hispanics. 28.6% of the overall group earned less than $36,000/year.

The uninsured are eligible to apply for programs provided by the government to help families with healthcare costs ("The state of health insurance," 2001). There is a program called Medi-Cal which covers low-income families; these families are the ones who generally fall under 100% of the Federal Income Guidelines. However, it is very difficult to obtain benefits as there is a lot of paperwork to be done. The good side is that there are multiple programs in which uninsured families can take part in. 14% and 40% of the uninsured adults and children are eligible for Medi-Cal yet are not enrolled ("The state of health insurance," 2001). The Healthy Families Program is an option for low-income families, as well. This provides low cost health care for children. Healthy Families Program covers low income children until their 19th birthdays; low income being defined as those who earn only 100%-250% of the FPL. This has minimal paperwork and is State as well as Federally subsidized. This type of program does not over-lap No-Cost Medi-Cal programs ("The state of health insurance," 2001). However, only 70% of the uninsured who are eligible for this program are enrolled.

The uninsured will affect organizations such as healthcare facilities ("Improving Health Care," 2004). These healthcare facilities need to review the number of uninsured in the community and create a definition of the problems for the uninsured. The healthcare facilities will need to conduct and examination to find a way to approach the problems the uninsured are facing. These healthcare facilities must create their approach to be reflective of their mission as well as the values of their organization; usually with healthcare facilities this is to provide utmost healthcare to all patients, without discrimination or prejudice ("Improving Health Care," 2004). This can be done with the help of stakeholders within the community to help the healthcare facilities. Communication with these stakeholders as well as the government will help identify the issues the uninsured face. These healthcare facilities should be able to take on the responsibility of providing the government as well as stakeholder's information needed on the uninsured and the issues they face. This will require of the organization leadership in order to facilitate an environment of maintenance for the health of the uninsured ("Improving Health Care," 2004). The information needed to improve ways of running healthcare systems must also be provided; this creates further financial impact of the uninsured on the organization's financial leaders. Risks to the organization are seen if the rates of the uninsured rise; this is seen to go with financial hardships which patients face ("Improving Health Care," 2004). The delivery of healthcare may come as a burden for healthcare facilities, especially the care of the terminally or chronically ill. This burden may result in the delay of care for the uninsured. The possible initiatives which can build strength in the organization to address the risk of healthcare facilities can be seen through the adoption of intensive cost-sharing. This will see cut downs in costs which are in association with medical care.