Expanding Insurance: Improving Healthcare Access

Introduction

Health insurance is a critical component of healthcare systems, as it provides financial protection and improves access to healthcare services. However, despite the positive impact of health insurance, millions of people in the United States remain uninsured. This issue is particularly pressing as those without insurance tend to experience worse health outcomes and higher mortality rates.

To address this issue, it is essential to implement strategies that expand health insurance coverage. This can be achieved by reducing costs, such as premiums and co-pays, and increasing awareness of the benefits associated with health insurance. Additionally, simplifying enrollment and reimbursement procedures can also encourage more people to sign up. Furthermore, it is crucial to ensure that individuals have access to high-quality healthcare services, as dissatisfaction with the quality of care can lead to dropout.

By implementing these strategies, we can improve healthcare access and protect individuals from the financial risks associated with diseases. This will ultimately contribute to better health outcomes and improved quality of life for people across the United States.

Reduce out-of-pocket costs

Out-of-pocket costs refer to medical expenses that are paid for by the patient, rather than being covered by insurance. These costs can include copayments, deductibles, and coinsurance for covered services, as well as all costs for services that aren't covered.

• Research prices on health insurance plans and specific procedures: The lack of price transparency in healthcare has been cited as the primary reason why Americans spend too much on it. However, many insurers have improved their price comparison tools in the last few years, using GPS technology to help consumers estimate the cost of care from in-network providers nearby.
• Speak up and discuss financial concerns with your doctor: Many are unaware that it is possible to negotiate a lower price for healthcare services, particularly if there are other providers in your area who can provide the treatment you need. Ask your doctor how much you will be charged and whether there’s any room for accommodation.
• Save the emergency room for emergencies: For life-threatening conditions and injuries, you should always head to the emergency room (ER). But if you’ve got a cold or a broken finger (and it’s not the middle of the night), visiting an urgent care center or scheduling a same-day doctor’s appointment will cost less than relying on the ER.
• Explore cost assistance or prescription drug discount programs: Even if you have prescription drug coverage, the cost of medications can add up quickly — especially if you take multiple medications. Whenever possible, request the generic version of a prescription drug, as the difference in price between a generic drug and a branded drug is significant.
• Choose doctors and providers who are in-network: Receiving care from an out-of-network provider is the most expensive mistake which healthcare consumers unwittingly make. The cost differences can be enormous. If you have health insurance, your insurance company has negotiated special rates with a network of healthcare providers.
• Utilize telemedicine: Thanks to digital technology, it’s now possible to “see” a doctor, or receive an affordable medical consultation at the drop of a hat, no matter where you are. As high-deductible plans become more common, more consumers are taking advantage of telemedicine to save money on healthcare costs.
• Use a flexible spending account or health savings account: If your employer offers a Flexible Savings Account (FSA) or Health Savings Account (HSA), consider using it to pay for your healthcare. Both HSAs and FSAs allow people who are insured to set aside pre-taxed dollars to pay for healthcare costs which fall under “qualified expenses”, including deductibles, copayments and coinsurance, and monthly prescription drug costs.

Expand insurance to cover health care costs

Reducing health care costs

High out-of-pocket costs are a huge barrier to accessing healthcare. When people have to choose between paying for food and rent or paying for healthcare, many forgo healthcare. This is an unacceptable choice that is disproportionately forced onto people from low-income families.

Around 30% of Americans cite high out-of-pocket health care costs as a barrier to treatment. High health care costs are an especially pernicious problem in the US relative to other countries. The US has the starkest income-based health disparities when compared to other developed nations.

The rising costs of medical care are putting it out of reach for many. This is coupled with the growing number of high-deductible plans, which require people to pay quite a bit out of pocket before the insurance kicks in, and you have an economic situation that requires many people to turn away from needed health care just because of the cost.

Reducing insurance costs

The cost of insurance continues to rise, and many companies are no longer able to offer it as a benefit to their employees. Shopping for insurance in the private market often leaves people with expensive policies and high-deductible plans. For some, this is an expense they simply cannot afford.

Government initiatives

Government initiatives designed to help uninsured individuals secure health care coverage through state and federal programs are helpful in lessening the impact of uninsured status as a barrier to health care coverage.

Medicaid expansion

Medicaid expansion has increased health care accessibility for many. In January 2020, 35 states and the District of Columbia had expanded Medicaid. The result? Adults aged 18 to 64 years old living in Medicaid expansion states were more likely to be insured, more likely to have private insurance, and more likely to have public coverage compared to adults living in non-expansion states.

Telehealth services

Telehealth provides remote access to physicians and other medical service providers to patients without a physical clinic in their area. Through videoconferencing and cloud-based data, doctors can communicate across large geographic distances to better coordinate care for patients. In rural areas, telehealth allows small-town doctors to connect their patients with specialists to help them provide better overall care. Once the technology is in place, it’s also a more affordable option for those facing cost concerns. It can eliminate the need to travel to the doctor for routine checks, giving patients the power to connect remotely for these checkups.

Mobile clinics

To address issues with transportation due to geographic barriers and improve access to care, the US health care system is increasingly investing in alternative treatment sites. Instead of traveling to a hospital, many patients can now access care at mobile clinics closer to where they live and work.

For example, during the COVID-19 pandemic, many states deployed mobile clinics built inside of vans and trailers to rural areas — providing testing and treatment resources for communities with limited access to health care services. Patients were able to drive up to these clinics and seek care while staying inside their vehicles.

Extend telehealth services

Telehealth services have been a vital tool in improving healthcare access, especially for those in rural areas. Telehealth provides remote access to physicians and other medical service providers for patients without a physical clinic in their area. This is especially useful for people living in rural areas, who may have to travel long distances to receive care. Telehealth services can be delivered via videoconferencing and cloud-based data, allowing doctors to communicate across large geographic distances to better coordinate care for patients.

Telehealth services are also more affordable than in-person appointments, as they eliminate the need to travel to the doctor for routine check-ups. This is especially beneficial for those facing cost concerns.

The U.S. Department of Health and Human Services has taken steps to expedite the adoption and awareness of telehealth during the COVID-19 public health emergency. Some of these telehealth flexibilities have been made permanent, while others are temporary. For example, the Consolidated Appropriations Act, 2021, and the Consolidated Appropriations Act, 2022, authorized an extension of many of the Medicare telehealth flexibilities that were in place during the COVID-19 public health emergency through December 31, 2024.

Additionally, the Telehealth Extension and Evaluation Act, introduced by U.S. Senators Catherine Cortez Masto and Todd Young, would allow the Centers for Medicare & Medicaid Services to extend Medicare payments for a broad range of telehealth services, including substance abuse treatment, for an additional two years. This bill would also commission a study on the impact of the pandemic telehealth flexibilities to better inform Congress' work to make telehealth flexibilities permanent.

Invest in mobile clinics

Investing in mobile clinics can improve access to healthcare by providing care to those who are unable to travel to traditional clinics. Mobile clinics can be particularly beneficial for vulnerable populations, such as those with chronic illnesses, and those in rural communities.

Mobile clinics can be set up in vans, RVs, and trailers, and can be independent or extensions of existing healthcare organisations. They can provide a wide range of services, including urgent care, primary care, and preventive health support.

During the COVID-19 pandemic, mobile clinics played a crucial role in reaching displaced and isolated individuals, providing care services directly to patients who needed them. They also helped reduce the number of emergency room visits, saving patients money and helping to avoid overcrowding in hospitals.

Mobile clinics are beneficial in that they can be tailored to the needs of specific communities. They can also help to improve health outcomes and reduce healthcare costs. For example, a study found that mobile clinics in Massachusetts were associated with cost savings from lowering blood pressure and reducing emergency department use.

Improve cultural responsiveness

Improving cultural responsiveness in healthcare is a continuous process of learning, self-exploration, and reflection. It involves being open to new ideas that may conflict with one's own beliefs, values, and customs, and being able to see these differences as equal. It also means being respectful of everyone's backgrounds, beliefs, values, customs, knowledge, lifestyle, and social behaviors. Here are some ways to improve cultural responsiveness in healthcare:

• Promote awareness and education: Healthcare professionals should identify their beliefs and build awareness of their own culture to improve their cross-cultural awareness. This will make them more open to unfamiliar attitudes, practices, and behaviors. It will also help them collaborate with patients and respond with flexibility.
• Provide cultural competency training: Cultural competency training can help healthcare providers improve their intercultural communication skills and respond to cultural differences with greater agility. It can also help organizations identify policies or practices that act as barriers to different communities and adjust them to meet diverse patient needs.
• Improve language accessibility: Language barriers can complicate communication between patients and providers, affecting the accuracy of a patient's description of their symptoms or a provider's explanation of diagnoses. Healthcare organizations should ensure language accessibility by providing interpreters or translation services.
• Recruit and retain diverse team members: Recruiting and retaining team members who reflect the cultural diversity of the patient population improves cultural responsiveness. When patients encounter team members who share their culture, they tend to feel more welcome and understood. Diverse team members can also share their insights with colleagues, enhancing everyone's ability to deliver culturally competent care.
• Develop respectful relationships: Developing respectful relationships with individuals, families, and communities is essential for empowering people to manage their health. This involves understanding the patient's motivations, beliefs, needs, and preferences, which leads to better communication and trust.
• Develop a cultural support plan: A cultural support plan should include the patient's cultural group, important social rules, and any significant events that could impact their ability to manage their health, such as past or ongoing trauma. This plan can be adapted to the individual's needs and updated regularly.

Frequently asked questions