Equity in Healthcare in the US
Equity in healthcare has been a subject of controversy for a long time. The disparities experienced in the provision and delivery of healthcare across different groups within the population have been the subject of many discussions. Too many Americans are consistently left out of planning, and often, the determining factor of who is included or who is left out boils down to gender, race, immigration status or language. This paper examines the bases for disparities in the provision of healthcare and the possible methods of rectifying these disparities.
Equity in healthcare in the US is examined under two general categories. Horizontal equity is the equal treatment of people who are in almost similar circumstances. On the other hand, vertical equity is the belief that people who are not in the same level (socio-economically) should be treated differently depending on their levels of need. Disparities in healthcare in the US have precipitated in many forms. There are disparities based on ethnic and racial differences among other differences such as sex, socioeconomic status, and environmental influence.
Racial discrimination in the provision of healthcare is a notorious form of disparity in healthcare. Despite the stopgap measures that have been taken to stem the number of uninsured individuals, the number has continued to rise apace. Ethnic minorities have continued to suffer discrimination in the provision of healthcare. This discrimination has stemmed in part from the ingrained injustices that minority groups, especially African-Americans, have endured historically. Much has been postulated as to the source of these racial and ethnic disparities in healthcare. One plausible argument is that disparities arise from the operation and characteristics of the healthcare system, the process of the care (for example, the provider-patient relationship) as well as the legal and regulatory backdrop (Strumpf, 2011).
The major factors affecting the delivery of healthcare to patients depend on the patients’ expectations as well as the expectations of the healthcare providers. Moreover, these expectations are shaped by professional training and experience, social experiences and broader societal norms and cultures. The personal discretion of the healthcare provider as to what level and quality of healthcare that the patient should receive plays a significant role in disparities within the healthcare system. One illustration of this is that clinicians typically have several diagnostic and therapeutic options. However, their ultimate choice of treatment does not firmly rest on empirical evidence. Their choice is often influenced by social norms that are shaped by racial and ethnic stimuli.
Besides personal reasons, political and legal influences play a large part in the ethnic disparities in healthcare provision. Historically, African Americans have suffered racial injustices of all sorts. The political environment was extremely hostile against people of races other than whites, especially the African Americans. The political atmosphere has a heavy bearing on the provision of healthcare. The political system determines medical trainees, the insurance policies, the prices paid and the neighborhoods around which the best hospitals are built. The historical racial injustices have impacted virtually all aspects of healthcare, and this has led to a lasting discrimination in the provision of healthcare.
Aside from racial and ethnic disparities in the provision of healthcare, another pillar of discrimination and lack of equity in the provision of healthcare is the immigration status (Light, 2012). Immigrants have long suffered lack of insurance coverage that is critical to the provision of healthcare in the US. This has limited the range of healthcare services that they can receive from different hospitals. Previously, federal programs such as Medicaid catered for the health needs of the immigrant population. However, legislative changes rendered eligibility for Medicaid much stricter than they had previously been, and this has affected provision of healthcare to immigrants. In addition, the provision of medical aid is provided to immigrants at the state level. Therefore, the disparities that affect the healthcare sector vary from one state to another.
Equity in healthcare within the United States is still far from being achieved. Disparities in the form of racial and ethnic stratification, immigrant status and economic status are still rife. Furthermore, programs such as Medicaid have come up to try and reduce these gaps in the provision of healthcare. However, much still remains to be done in order to achieve acceptable levels of equity in the provision of healthcare.
As already mentioned, equitable provision of healthcare is not entirely out of reach. Programs such as Medicaid and Medicare have been set up in order to cater for groups of the population that are underserved in the provision of healthcare. The federal government has done much to stem the obvious disparities that have pervaded the healthcare sector. Such bodies as the NSS have been given the mandate to ensure that the provision of healthcare is satisfactory among all US citizens. It is important to mention that much has been done in order to ensure that the provision of healthcare is equitable, and the government, despite all its shortcomings, is moving in the right direction