Access to personal healthcare and behavioral model of health services use

Access to healthcare means the ability of an individual or a family to avail of medical facilities and treatments if and when they need it most. Today, access to healthcare is available to only the middle classes in the United States. The country, in spite of being the world’s leading economic power, has failed to provide health insurance for a significant section of its population (nearly 50 million citizens) and provides only poor quality healthcare for the rest. For example, among all the advanced economies of the Western world, the United States holds the notorious distinction of poor health outcomes and high healthcare costs. Even our northern neighbor Canada has a better healthcare system, with the help of an effective public option (Krugman, 2010).

The way in which the United States healthcare system works means that universal free basic health care had disappeared. Employers who previously provided insurance coverage for their employees no more have the necessary funds to continue such plans. Drug prices have gone up overall and patients end up paying for services that their condition does not warrant. Another major area of concern is the cuts to Medicaid, which had for so long supported children’s hospitals with nearly half its revenue. Congress’ impending cuts to Medicaid support, though may help reduce the federal deficit, certainly is bad news for pediatric care (Carter et. al. 31). Financial support for research grants is likely to reduce. When eventually these reductions would be enacted, pediatric centers would require tighter budgets in all areas. The one-size-fits-all approach to children’s health care is another area of concern. Children’s special needs and their unique physiology are overlooked in the prevailing medical practices. However, efforts on part of the FDA and other administrative organizations in getting child-friendly devices and methods implemented, is perceived as a move in the right direction. The fact that pediatric services do not generate substantial revenue for drug and equipment companies has been a major disadvantage in pushing for reforms in this area (Tepper & Terry 70).

Even the former chief of the World Health Organization agrees that there is a disconnection between wealth creation and wider access to public health as a result of globalization. This excerpt is from a speech by Dr. Gro Brundtland, the former Director-General of the World Health Organization, at the World Economic Forum on January 29, 2001, emphasizes this point. “Technologies are spreading, communication is worldwide, people know what is available, and yet the dramatic gaps and lack of access become greater and greater. We must look upon the world as a shared responsibility so that we deal with the gaps and help those technologies become available for those who don’t have access. That’s the only way to keep globalization from becoming really unhealthy.” (Brundtland, 2001)

Primary Reference: 

ndersen, Ronald M., Rice, Thomas H., and Kominski, Gerald R. (Eds.). 2nd ed. Changing the U.S. Healthcare System. San Francisco: Jossey-Bass, 2001.

Secondary References:

Brundtland, G. H. (2001, January). Achieving Global Health Equity. Presidents & Prime Ministers, 10, 28.

Burkle, F. M. (2006). Globalization and Disasters: Issues of Public Health, State Capacity and Political Action. Journal of International Affairs, 59(2), 241+.

Eisenberg, J. N., Desai, M. A., Levy, K., Bates, S. J., Liang, S., Naumoff, K., et al. (2007). Environmental Determinants of Infectious Disease: A Framework for Tracking Causal Links and Guiding Public Health Research. Environmental Health Perspectives, 115(8), 1216+.

Mann, J. M. (1997). Medicine and Public Health, Ethics and Human Rights. The Hastings Center Report, 27(3), 6+.

Bodenheimer, Thomas. “Innovations in primary care in the United States. (Primary Care in the United States).” British Medical Journal 326.7393 (April 12, 2003): 796(4).

Coghlan, Andy. “A health fad that’s hard to swallow: dietary supplements are more popular than ever. But we don’t know if they do us more harm than good.” New Scientist 182.2442 (April 10, 2004): 6(2).

Dyer, Owen. “US government rejects WHO’s attempts to improve diet.(World Health Organization).” British Medical Journal 328.7433 (Jan 24, 2004): 185(1).

Tepper, Carl D., and Terry R. Lied. “Trends in Medicaid prescribed drug expenditures and utilization.(Medicaid Highlights).” Health Care Financing Review 25.3 (Spring 2004): 69(10).

Webster, Paul. “US big businesses struggle to cope with health-care costs: General Motors president Rick Wagoner caused controversy when he blamed the US health-care system for his company’s near-bankrupt status. But, as Paul Webster explains, health care and the US and Canadian automotive industry’s economic decisions are increasingly interlinked.(World Report).” The Lancet 367.9505 (Jan 14, 2006): 101(2).

Richmond, Julius & Fein, Rashi (2007), The Health Care Mess: How We Got into It and What It Will Take to Get Out, Harvard University Press.

Krugman, Paul (July, 2009), Why markets can’t cure healthcare, Column in New York Times, retrieved from http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/

Gail R. Wilensky (August, 2009), Healthcare Reform: A Work in Progress, retrieved from http://www.hfma.org/hfm/2009archives/month08/HFM0809EOW.htm>