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The Struggle for Universal Healthcare Access in the U.S.: An Ongoing Challenge

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Anthony Raphael
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The Struggle for Universal Healthcare Access in the U.S.: An Ongoing Challenge

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The Current State of Healthcare Access

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Despite improvements in insurance rates brought about by the Affordable Care Act, the U.S. healthcare system continues to struggle with achieving universal healthcare access. Findings from a Commonwealth Fund report indicate that a significant 43% of working-age adults in the U.S. were inadequately insured in 2022, leading to high out-of-pocket costs, difficulty affording healthcare, and medical debt. While the number of uninsured Americans has decreased, it remains stubbornly high and may be rising once again. This lack of universal access to healthcare is a pressing issue that needs to be addressed.

The COVID-19 Impact and the Medicaid Dilemma

The Covid-19 pandemic initially resulted in reduced numbers of uninsured people. However, as the public health emergency ended, more than 10 million people were dropped from Medicaid rolls. This has further exacerbated the healthcare access problem. Additionally, with many immigrants who had their coverage protected during the pandemic now finding themselves ineligible, the challenge of reviewing Medicaid enrollees' eligibility has added another layer of complexity to the situation.

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Proposed Solutions Towards Universal Healthcare Access

Experts suggest various solutions to address this issue. One such proposal is the automatic enrollment in a basic plan as a step towards universal access. Defining basic healthcare services and ensuring coverage of essential health benefits with non-discrimination are crucial in establishing universal healthcare access. This could potentially alleviate the high out-of-pocket costs and medical debt experienced by many uninsured and underinsured Americans.

The Role of Single Payer or Multiple Payers

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Another proposed solution revolves around the concept of coverage by a single payer or multiple payers. This approach, however, prompts the ongoing debate around compulsory purchase of coverage and the restoration of essential benefits for large-group and self-insured plans.

California's Approach to Expanding Healthcare Access

California, in an effort to provide universal healthcare to all residents, is expanding health care coverage for low-income immigrants, including those living illegally in the state. This move, although costly, aims to close a gap in healthcare access and save the state money in the long run by providing comprehensive and preventative care to those who were previously ineligible for most coverage. However, this expansion has been met with concerns about the economic ramifications, especially considering California's current budget deficit.

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The Business of Healthcare: Cherry-Picking Patients

While improvements are made on one end of the spectrum, issues persist on the other. For instance, Universal Health Services, a for-profit health system, has been reportedly cherry-picking patients based on how much they will be paid by insurers. This ethically questionable practice brings to light another aspect of the healthcare crisis that needs to be addressed.

The Need for Urgent Healthcare Reform

The current state of the U.S. healthcare system underscores the urgent need for reform. The challenge of achieving universal healthcare access is not one that can be solved overnight. It requires a comprehensive approach that includes policy changes, increased funding, and a commitment to ensuring that all Americans, regardless of their socio-economic status, have access to quality healthcare.

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