While the United States claims to be one of the most advanced countries in the world, the U.S. happens to be the only developed country to not provide universal healthcare to its citizens (Gunja et al.). Each year, more and more citizens are unable to afford health insurance and are met with poor healthcare experiences due to policies and healthcare disparities. As healthcare inflation continues to rise, finding an effective, affordable healthcare system is imperative to providing a basic standard of living to citizens. The current U.S. healthcare system is defined as a mixed system that is both privately and publicly funded. This mixed system is far behind other forms of healthcare and it is becoming a huge burden on American citizens. While the current system cannot be easily addressed, the United States healthcare system is in desperate need of reformation due to the lack of access, policies, and disparities within the healthcare system.

Accessibility

Improving accessibility to healthcare is the most important aspect of addressing the U.S. healthcare system. Access to quality healthcare is necessary to provide a basic standard of living and to ensure protection from financial debt due to healthcare costs. However, as of 2021, there were over 31.1 million Americans who did not have health insurance (CDC Reports on Uninsured in First Six Months of 2021). This is alarming because it puts people's individual health at risk, threatening quality of life. For example, a study conducted on the accessibility of healthcare revealed that “four in ten U.S. adults say they have delayed or gone without medical care in the last year due to cost” and “about half of U.S. adults say they have difficulty affording healthcare costs” (Kirzinger & Kearney). Medical care without health insurance becomes extremely expensive, drowning individuals in debt. This causes people to delay immediate care and risk further health deficits out of fear of debt; a widespread experience among many low-income families. 

Eligibility to health insurance through employers is another aspect that creates an obstacle to affordable health coverage. Most individuals receive their health coverage from their employers but it is not always an option, especially in states that chose not to advance in Medicaid. Jobs that do not provide any form of health coverage are typically lower-paying jobs which further adds to the cycle of health neglect and crippling debt. However, lower-middle-class individuals are not the only people who suffer from eligibility for health insurance. People with chronic conditions such as diabetes, cancer, asthma, and other common diseases are forced to pay almost five times more health insurance compared to an individual without a chronic disease (Hayes & Gillian). Insurance providers justify this outrageous, exclusionary price by claiming that individuals with chronic conditions require more frequent visits to healthcare providers. While individuals with chronic conditions do require some extra attention, “the US experience of private insurance with targeted, publicly funded social insurance and privately provisioning shows how it drives up costs of care, raises issues of moral hazard, does not lead to comprehensive care, and is exclusionary” (Gupta 28). This system makes it much more difficult for individuals without employer-provided healthcare and individuals with chronic conditions to be able to afford and access quality healthcare plans. The healthcare system instead focuses on profit-driven legislation rather than accessible, comprehensive care for all citizens which is deepening the gap between healthcare access and equality. 

One way to address the accessibility and affordability gap in healthcare is to promote universal healthcare. South Korea is one of the leading examples of an effective healthcare system with exceptionally high-quality healthcare for all citizens. South Korea follows a universal healthcare system funded by the government's National Health Insurance program. This government program not only covers all of their citizens' health insurance but also covers individuals who have been residing in South Korea for over six months (“Healthcare System in Korea”). This additionally protects long-term visitors from out-of-pocket expenses. However, some critics argue that South Korea’s universal healthcare system is slightly blemished. The largest weakness in their system is the lack of a strong primary care system. This makes it more difficult to receive care on a regular basis and gives more control to the government over individual healthcare compared to private insurance. Putting individual health in the hands of the government can lead to longer wait times for elective procedures due to patient demand. However, in light of the big picture, longer wait times for elective procedures are far better than absolutely no treatment for life-saving procedures. Furthermore, the largest controversy regarding universal healthcare is the increase in taxes (Swahn). While the idea of increasing taxes seems unreasonable and unaffordable, South Korea models that it is actually still more effective and affordable than the U.S. healthcare system. Korea has a Medicaid program that exempts low-income families from paying their monthly taxes to the National Health Insurance which provides relief to those who cannot afford the taxes (“Healthcare System in Korea”). This ensures that all citizens receive quality healthcare and mitigates the gap between healthcare access and affordability. Other in-depth studies have revealed that even though South Korea pays taxes for healthcare, the government and citizens as a whole still pay much less in taxes than the U.S. with “S. Korea’s healthcare spending totaling less than 8% of GDP, compared with over 18% for America.  S. Korea pays less than a third per capita for healthcare ($2,543) as does the United States ($11,100)” (Swahn). While Korea’s system is not perfect, it has proven itself very successful. By modeling South Korea’s successful universal healthcare system, the U.S. can mitigate the accessibility gap of healthcare and improve affordability so citizens would be less inclined to ignore life-threatening healthcare needs. 

Accessibility/Policies: Immigrants

As mentioned before, One of the largest concerns about Universal Healthcare is the increase in taxes if the U.S. allows undocumented immigrants to receive the same universal healthcare as tax-paying American citizens. However, as modeled before, South Korea provides immigrants and visitors with the same healthcare as their own citizens while spending much less money on healthcare and taxes. With that clear, policies regarding healthcare for undocumented immigrants are highly neglected and leave many families deprived of health coverage and medical care. With fear of being deported, many undocumented immigrants refrain from getting medical attention, putting their lives at risk when they push back detrimental healthcare needs. Nonetheless, even if they were desperate enough to seek medical attention, undocumented immigrants do not have equal access to health insurance and often cannot even afford to receive the care that they need. Unlike the U.S., other developed countries such as Korea and most European countries have policies that treat all types of undocumented immigrants if they are in urgent healthcare need, providing them with the same care and coverage as their citizens (Jossen 14). These countries also protect undocumented immigrants when they are put in the position of receiving life-saving healthcare treatment. The policies represented by other developed countries emphasize that healthcare should not be withheld from anyone but should be freely available to both citizens and noncitizens. All lives should be valued equally and everyone should have the same access to healthcare when faced with medical needs. The U.S. must follow the example of other successful countries to provide both protection from deportation and adequate healthcare to everyone who resides in the U.S.

Policies 

Many policies intended to remedy the current healthcare system are actually doing the opposite and have posed other issues to the healthcare system. For example, Managed Care aims to provide accessible and affordable healthcare through a “network of providers under a fixed budget and managed costs” (“Managed Care - Health, United States”). However, this system has many limitations focusing on profit-driven legislation rather than affordability as they claim. Managed Care allows insurance companies to determine the type of treatment a patient can receive without any real medical knowledge or experience. This heavily reflects the quality of care a patient receives and can also put the patient at risk if medical care is denied or delayed. Furthermore, many hospitals and pharmaceutical companies overcharge patients with ridiculous prices. For instance, an IV bag is simply sterile salt water that costs between 44 cents to $1 to produce. However, a study conducted by the New York Times interviewed 100 patients and revealed that “the patients’ bills would later include markups of 100 to 200 times the manufacturer’s price, not counting separate charges for “IV administration.” And on other bills, a bundled charge for “IV therapy” was almost 1,000 times the official cost of the solution” (Bernstein). Even individuals covered by private health insurance and public government-funded Medicare programs ended up having to pay out of pocket for the majority of the cost of their treatment. This issue could quickly be fixed by adopting the Universal Healthcare system which would make the cost of medical treatment much more affordable without the inflation from hospitals and private insurance sectors.

Expanding on Medicare, Medicare Advantage offers extra benefits but is also heavily marked up compared to regular Medicare insurance. Medicare Advantage covers about 27% of all Medicare beneficiaries and costs taxpayers between 7-12% more tax than regular Medicare, equivalent to approximately $282 billion over the last three decades (Gale). The goal of Medicare trying to cut medical costs and make healthcare more affordable is counterintuitive as it subsidizes Medicare Advantage plans and makes other citizens pay more. This system is unfair to American taxpayers if the government is only subsidizing one group of Medicare beneficiaries.

Yet another unfair system stems from The Affordable Care Act. The Affordable Care Act strives to provide comprehensive health coverage to low-income households and uninsured individuals by making healthcare more affordable and increasing Medicaid. While the goals of this policy sound relatively good, this policy has many gaps within its system which allows small business owners to not offer health insurance to employees even with the help of government subsidies if they deem it too expensive. Instead of providing employees with health insurance, employers may choose to pay a cheaper penalty which will further deepen the gap between access and affordability (Gale). The Affordable Care Act further makes it possible to evade required expenses with the option to hire more part-time employees instead of full-time employees. Additionally, the Affordable Care Act is run by high-cost insurers, hospitals, and pharmaceutical companies that decide the cost of procedures and lifesaving medicine. So while the Affordable Care Act aims to increase accessibility to healthcare, it does not address the issue of affordability and even decreases accessibility when it creates loopholes for employers.

Disparities

Lastly, healthcare disparities create obstacles for minority groups to get the equal, quality care that they deserve. While universal healthcare addresses most of the issues with the current healthcare system, it does not drastically change the issue of healthcare disparities. Universal healthcare can improve access to healthcare for different socioeconomic groups and mitigate the wealth disparity within the system, but it cannot change the underlying racism and ethnic disparities. For example, national data studies have revealed “higher rates of morbidity and mortality among individuals from racial/ethnic subgroups compared to Whites” (Whitt-Glover 1). Microaggression and underlying racism often result in poorer health outcomes due to unequal access and subquality care. Moreover, different ethnicities are more susceptible to certain diseases compared to white people. Improper education on different diseases and races can pose a threat to these minorities and risk misdiagnoses. To further illustrate, “Blacks are 10 times more likely than whites to contract AIDS, American Indians and Alaska Natives are two times more likely than whites to lack prenatal care… and Hispanics are reporting 3.5 times more new AIDS cases” (Harris 6). Most diseases are researched and studied in White-male individuals. While there is very little difference in the genetic makeup of different races, many genetic disorders appear more frequently in different ethnic groups. Compared to the majority (Whites), minorities are often overseen and vulnerable to misdiagnoses and improper treatment, especially if a language barrier is involved. 

One long-term solution to combating racial disparities within the healthcare system is integrating more intercultural competence into the medical field. Integrating more diverse individuals in the medical field can help patients of different backgrounds feel more comfortable and relate to their caretakers. Hiring more individuals of different ethnic backgrounds can additionally overcome language barriers and reduce the need for interpreters that often delay care time. Lastly, teaching medical personnel about the cultural differences and commonality of certain diseases that are less susceptible in White people can potentially save lives and bring more awareness to doctors who treat these minorities. By strongly implementing these practices in medical schools and hospitals, more doctors, nurses, and other medical personnel will be able to recognize the different medical situations and keep an open mind on diseases that may be rare in White individuals but more common in other minority races. Overcoming health disparities can save millions of families from the financial burden of medical costs and can also effectively treat, prevent, and catch diseases early. This could help overcome the generations of barriers that prevented minorities from accessing the same quality healthcare to achieve a healthy life. 

In order to provide all Americans with the same access to achieving a fulfilling and healthy life, the accessibility, policies, and disparities within the current healthcare system need to be thoroughly addressed and reformed. Healthcare inflation has become a huge problem in modern-day society and has been burdening citizens with medical debt. The U.S. pays a significantly greater amount of governmental money and out-of-pocket money in healthcare which is taking tax money and personal money from citizens. Universal healthcare modeled by South Korea clearly shows that this does not have to be the case. South Korea and many other countries have been successful in making quality healthcare both accessible and affordable whilst still paying less GDP in healthcare compared to the United States. Private and mixed healthcare systems have proven themselves to be unsuccessful, providing subpar care and failing to provide essential services. While the government and medical field have been actively trying to improve the healthcare system by incorporating new policies, many have been unsuccessful in addressing the underlying issues within the healthcare system. Instead of creating more policies, the U.S. should focus on reforming the entire current healthcare system to address issues head-on. There will never be a right time to throw out the current healthcare system and replace it with universal healthcare or a different system. There will definitely be conflicted views and citizens who do not want a new healthcare system. While the current system has been working for some lucky citizens, the majority of Americans are struggling with the accessibility, affordability, and disparities within this system. The United States should strongly consider reforming the entire healthcare system to provide the best possible care to all of its citizens in order to pursue longevity and happiness. 

Works Cited

Bernstein, Nina. “How to Charge $546 for Six Liters of Saltwater.” The New York Times, The New York Times, 25 Aug. 2013, www.nytimes.com/2013/08/27/health/exploring-salines-secret-costs.html?pagewanted=all&_r=0. Accessed 7 February 2024.                                                                            

“CDC Reports on Uninsured in First Six Months of 2021: AHA News.” American Hospital Association | AHA News, 17 Nov. 2021, www.aha.org/news/headline/2021-11-17-cdc-reports-uninsured-first-six-months-2021.  Accessed 7 February 2024.

Gale, Arthur. “Failed health care policies portend bleak future for physicians & patients.” Missouri medicine vol. 110,4 (2013): 276-80. Accessed 28 January 2023.

Gunja, Munira  Z., et al. “U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes.” U.S. Health Care from a Global Perspective, 2022 | Commonwealth Fund, 31 Jan. 2023, www.commonwealthfund.org/publications/issue-briefs/2023/jan/us-health-care-global-perspective-2022.  Accessed 7 February 2024.

Gupta, Anil. “Universal Access to Healthcare: Threats and Opportunities.” Economic and Political Weekly, vol. 46, no. 26/27, 2011, pp. 27–30. JSTOR, www.jstor.org/stable/23018636. Accessed 17 January 2023.

Hayes, Tara. “Chronic Disease in the United States: A Worsening Health and Economic Crisis.” AAF, 10 Sept. 2020, www.americanactionforum.org/research/chronic-disease-in-the-united-states-a-worsening-health-and-economic-crisis/#:~:text=Direct%20Costs.  Accessed 7 February 2024.

Harris, G. L. A. “Cultural Competence: its Promise for Reducing Healthcare Disparities.” Journal of Health and Human Services Administration, vol. 33, no. 1, 2010, pp. 2–52. JSTOR, www.jstor.org/stable/25790773.  Accessed 7 February 2024.

“Healthcare System in Korea.” HIRA, www.hira.or.kr/dummy.do?pgmid=HIRAJ010000006000#:~:text=The%20health%20security%20system%20in,are%20insured%20and%20government%20subsidies. Accessed 28 January 2024. 

Jossen, Marianne. “Undocumented Migrants, Healthcare and Health.” Undocumented Migrants and Healthcare: Eight Stories from Switzerland, 1st ed., vol. 6, Open Book Publishers, 2018, pp. 7–24. JSTOR, www.jstor.org/stable/j.ctv4w3srn.5. Accessed 6 February 2024.

Kirzinger, Ashley, Audrey Kearney. “KFF Health Tracking Poll – March 2022: Economic Concerns and Health Policy, the ACA, and Views of Long-Term Care Facilities.” KFF, 31 Mar. 2022, www.kff.org/health-costs/poll-finding/kff-health-tracking-poll-march-2022/. Accessed 17 January 2023.

“Managed Care - Health, United States.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 12 Aug. 2022, cdc.gov/nchs/hus/sources-definitions/managed-care.htm. Accessed 6 February 2024.

Swahn. “A Glimpse at South Korea’s Healthcare System.” Georgia State University, 15 Feb.  2021, sites.gsu.edu/gsuglobalhealth/2021/02/15/beyond-k-pop-a-glimpse-at-south-koreas-healthcare-system. Accessed 28 January 2023.

 Whitt-Glover, Melicia C. “Diversifying the Healthcare Workforce Can Mitigate Health Disparities.” Journal of Best Practices in Health Professions Diversity, vol. 12, no. 1, 2019, pp. iii–vi. JSTOR, www.jstor.org/stable/26894222. Accessed 6 February 2024.