– Multidimensional Health Care Crisis Essay, Research Paper
African Americans face a multidimensional health care crisis that affects the young or old, rich or poor. Too many African Americans are uninsured or underinsured. The elderly cannot afford long-term health care leaving the family to care for them. Health care cost is constantly rising and are out of control, reform is the only way out.
The growing number of uninsured and underinsured is on the rise. In 1979, 11 million African americans were uninsured (Jaffe 10). Today, the number is 15 million and it is increasing every year (Jaffe 11). According to the Department of Health and Human Services, thirteen million blacks in America have health care and fourteen million do not (Fitzgerald 31). Also, those who are insured today may be at risk tomorrow if their employer drops coverage, or the head of the household changes or loses their job. Most blacks in the United States who are uninsured simply cannot receive health care at an affordable price because their employer does not offer it and self-insurance cost much more. The lack of adequate insurance can be devastating to families both in financial terms and in terms of timely access to needed health care (Jaffe 12). Altogether, collection agencies report
every year that most blacks are in debt due to unpaid medical bills, because they are not insured or they are underinsured.
African American senior citizens face a health care crisis too. They have worked all of their lives to secure retirement, but their retirement has been threatened because of the rising cost of long-term medical care. Insurance companies have failed to provide affordable long-term care, protection that most senior citizens need. This lack of long term care and affordability has been a serious problem for the health care system. In some cities, the shortage of hospital beds is so serious that it is common for patients to stay in emergency rooms before they can be admitted to an inpatient room (Drake 109). More than one thousand hospital beds are occupied by people who could be better care for in nursing homes or through home health care (Drake 110). Of the disabled elderly 1.3 million reside in nursing homes (Drake 10). These patients are unable to perform two or more of the basic activities of daily living without assistance.
Long- term care is not just a problem for the African American elderly, it is a major burden for their children. According to Drake, 1.6 million elderly citizens live with their children or in their own homes where there children or other family members have to care for them. Few families
are prepared either financially or emotionally to take the responsibility of proving long term-care to their parents. They need to be feed, bathed, dressed, taken to the bathroom and/or transferred from a bed to a wheelchair.
The center and main problem with the U.S. health system is the tax treatment of health costs. In the late 1960’s the IRS ruled that the value of company paid group health plans did not have to be included in a workers taxable income (Fitzgerald 40). This was to be a way to encourage not just blacks but all Americans to go out and get some type of health plan. Although it did work in some cases, it also had two side effects.
The first is that with an employer or company paying most of the bill, and with premiums set for all the workers and not individual, the physician or patient has no say so when considering cost when recommending a test or treatment. This lack of incentive to economize means that price is not a barrier to good medicine, but has caused an explosion in health cost (Fitzgerald 42). The rapid rise in cost has led most employers to cut back on health plans and in some cases dropping coverage for dependents. This has lead to companies having bitter strikes over health benefits.
The second problem with taxes and health care is that while company provided coverage is tax free without limitations, there are no tax benefits for health coverage purchased by the family. A minimum wage worker in a small firm without a health plan is given no tax relief if he buys a minimal insurance policy for his family. T he inequitable tax relief is the major reason that an estimated 15 million African Americans lack any health coverage at all, and others are underinsured (Fitzgerald 42).
According to Ellis, the provision of health care must be separated from the employer/employee relationship. Access to health care should not be in jeopardy if they change or lose their job. Also, affordable health insurance system should receive its revenue from progressive income taxes. Funding through payroll taxes would be less desirable, but should include a wage floor to ease the poor.
In conclusion, African Americans are not healthy. Not because we lack the technological and financial means to be healthy, but because important aspects of our culture and medical institutions are not concerned with well-being. Access to good medical care is financially irrational. A large number of Africans Americans lacks access to care because of extreme medical cost. Reform is the only way to provide affordable and reasonable care for everyone.
Castro, J. “Condition: Critical.” Time 25 Nov. 1999: 34-40.
Drake, Donald. Medical Mayhem. Kansas: Universal Press, 1996.
Ellis, D. “Band-Aids to patch up health care.” Time 17 Feb. 1997: 20-22.
Fitzgerald, Susan. Hard Choices: Health Care at What Costs? Kansas:
Universal Press, 1997.
Jaffe, Mark. Health Care? Who Cares? New York: Harper, 1998.