An Uninsured Uncertainty: Health or Wealth?

Authored by Priya Bhashyam, Biomedical Engineering ‘25

Art by Michelle Zhang, Biological Sciences and Information Science '25

Is money really worth more than a human life? Access to healthcare is a fundamental right that should be given to anyone, regardless of race, socioeconomic status, gender, or any other factor. The United States is a leader in healthcare and biotechnology, leading as an example for many countries. However, the high cost of care has created a significant barrier for uninsured individuals seeking quality healthcare. With rising unemployment rates, the high cost of healthcare, and the limitations of healthcare insurance programs, many uninsured individuals have decreasing options for accessible medical care.

In 2018, 27.5 million people, or about 8.5% of America’s population, were uninsured; this has been an increasing number since previous years. This trend also aligns with the increasing unemployment rate during those years. Many individuals lose their employer-sponsored health insurance when unemployed, leaving them without coverage for necessary medical services [1]. This case was especially prominent during the pandemic when unemployment rates were at an all-time high, while medical services became an increasing necessity.

Without health insurance, the high costs of healthcare present in the United States create a noticeable barrier preventing a large group of people from accessing medical care. In addition, uninsured individuals are less likely to obtain preventative services and will more likely deny or delay necessary medical care due to financial concerns. This results in a horrifying cycle where illnesses worsen and the related health costs increase drastically [2].

So is insurance the medicine that fixes all problems? Unfortunately not, as many insured individuals still face similar problems to those who are uninsured. Different healthcare insurance programs have different limitations, requirements, and networks that might prevent those individuals from accessing their unique healthcare situation. For example, people with high deductible health plans or limited networks may need help accessing care, especially for specialty services or medication [3].

Those without access to insurance have alternate options to still have the resources to access healthcare. Federally qualified health centers (FQHCs) are community-based organizations that provide primary care services to underserved populations, including uninsured individuals. These centers can be supported by federal funding and offer services on a sliding fee scale based on personal income. However, due to being available to such a large number of people, FQHCs tend to have limited capacities and long wait times, which reduces accessibility [4]. Another well-known option for uninsured individuals is Medicaid, which offers coverage to low-income individuals. However, not all states have Medicaid coverage under the Affordable Care Act, and even in the states that do accept Medicaid, eligibility requirements can vary drastically across states [5]. As a result, many uninsured individuals rely primarily on emergency department services as their only means of accessing healthcare. However, using emergency services for non-emergency care only increases costs and unnecessary wait times [2].

Accessibility to healthcare is a complicated issue that many human rights advocates, healthcare professionals, politicians, and so many others are attempting to solve in the modern day. However, with the high costs of healthcare in America, the contradicting political opinions on healthcare, and simply the difficulty in appeasing the majority of the population, it has been a series of ongoing debates. Potential solutions to address these issues could be increasing access to affordable healthcare insurance, expanding funding for FQHCs and other low-cost services, and increasing access to preventive care services to lower future medical costs. Currently, steps are being made to move towards a future where everyone will have access to necessary medical care without having to weigh their life against money, but a lot must happen before this is true.

Works Cited

1. Cohen, R. A., Cha, A. E., Martinez, M. E., Terlizzi, E. P., Division of Health Interview Statistics, & National Center for Health Statistics. (2020). Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2019. National Center for Health Statistics. https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202009-508.pdf

2. Micheal McWilliams, J. (2009). Health consequences of uninsurance among adults in the United States: Recent evidence and implications. Milbank Quarterly, 87(2), 443–494. https://doi.org/10.1111/j.1468-0009.2009.00564.x

3. Institute of Medicine (US) Committee. (2003). Spending on Health Care for Uninsured Americans: How Much, and Who Pays? In Hidden costs, values lost: Uninsurance in America. essay, National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK221653/

4. Huang, J., Birkenmaier, J., & Kim, Y. (2014). Job loss and unmet health care needs in the economic recession: different associations by family income. American journal of public health, 104(11), e178–e183. https://doi.org/10.2105/AJPH.2014.301998

5. Getzen, T. E. (2000). Health care is an individual necessity and a national luxury: Applying multilevel decision models to the analysis of Health Care Expenditures. Journal of Health Economics, 19(2), 259–270. https://doi.org/10.1016/s0167-6296(99)00032-6