Research Proposal on "Health Expenses Resulting in Poverty"

Research Proposal 12 pages (3343 words) Sources: 8

[EXCERPT] . . . .

Healthcare Poverty

Health Care Reform, Poverty and America's Uninsured

For the more than 40 million Americans who do not have health insurance coverage, the consequences of a prolonged illness or a severe injury can be financially devastating. The prohibitively high cost of hospitalization, medication, treatment, laboratory testing, surgical procedures and the use of medical equipment can ultimately produce an economic burden that cannot be sustained by the individual payer. This reality is only compounded by the nature of the health insurance industry in the U.S. Here, an absence of regulation over costs such as health insurance premiums and a lack of oversight over insurance company denial rights tend to reflect a legal hierarchy with highly socioeconomic implication. The result is a private healthcare system and a public health context in the midst of a crisis. While most modernized and developed nations offer some form of socialized healthcare, American healthcare has become virtually inaccessible to a substantial fraction of the population. Thus, when pressing medical needs afflict members of this population, the cost can be sufficient to induce poverty. As the research proposal here proceeds, it will be under the assumption hypothesis that the Health Care Reform (HCR) signed into law by the Obama Administration and currently threatened by the sweeping midterm victories of the President's Congressional Republican opponents is highly compromised and will not go far enough to protect the uninsured from descending into poverty. Research will intend to examine the experiential differences of the insured and uninsured in light of the legislation with the expectation that a significant economic gap will still remain such that the latter are still at high risk of descending into poverty.

Statement of Problem:

The primary problem facing the American healthcare system and public health in general is the intercession of poverty and a lack of health insurance coverage. As the research proposal conducted here will demonstrate, there is a clear and reciprocal relationship between a lack of healthcare coverage and flirtation with the poverty line. So is this reported in the article by Reece (2010), which argues that "costs skyrocket when you're treating poor patients. When poor patients, who are sicker than most in the first place, go home, after being treated, they often return to their doctors sicker than ever because of miserable conditions at home. That's why Medicare costs are highest in cities with poverty ghettos and in poor regions, such as the American South. Poverty is the main reason for regional cost spikes." (p. 1)

This helps to highlight the inverse, which is that cost spikes only further stimulate the cycle of poverty by making health insurance inaccessible to those with limited means and by imposing medical costs that cannot be absorbed by the average working-poor American. It is to this latter effect that the proposed research will devote its focus, contextualizing the discussion within the framework of the debate over President Obama's recently passed HCR package. Therefore, the primary research question asks the following: How will the Obama HCR package reduce or fail to reduce the poverty gap between the insured and uninsured in America's healthcare system?

Justification for Research:

The research proposed hereafter is justified by the need to objectively evaluate the impact of a legislative package that is currently clouded by politicization, commercial interests and philosophical agendas. Indeed, the health care industries various competing interests have far overshadowed the needs of the American public, currently struggling to stay afloat in a recession economy. With jobless numbers soaring, companies cutting costs at the expense of worker health plans and many Americans persisting without healthcare coverage, it is important to critically but fairly assess the HCR package as it relates to issues of poverty. More objective research on the subject may promote an honest and open political dialogue on what works in the new package, what does not work and how legislative improvements can be made. Ultimately, the research is justified by the view that reform on some level had been absolutely necessary, particularly given the reciprocal and causal relationship between poverty and the state of being uninsured. This perspective informs the assumption that a comprehensive evaluation of the current reform package will help to contribute to the discussion on a legislative action that will no doubt require ongoing evaluation and refinement.

Literature Review:

Before entering into a focus on the issue of healthcare disparity in the United States, the literature review requires a basic definition of 'poverty.' As this discussion is to be contextualized by the new legislative package authored by the Obama administration, so to will the definition of poverty be applied by the Obama Presidency's evolving policy. According to new measures, reports the text by Childress (2010), poverty is a label which will apply with greater nuance and specifically to those impacted by burdensome medical expenses. Childress reports that "that measure will use Commerce Department data for expenditures on food, clothing, shelter and other household expenses to develop a poverty threshold for a family of four. That threshold will be compared to a family or individual's income, which will be calculated using both income and in-kind benefits, excluding taxes and other "non-discretionary" expenses like child care and medical expenses." (p. 1)

The article by Childress goes on to argue that this reconsideration of baseline measurements will have a significant impact on the way that poverty is understood. The incorporation of medical expenses into this understanding will promote a far more accurate picture of how prodigious medical expenses brought on by a lack of insurance and the confrontation of a catastrophic injury or illness can stimulate poverty. And indeed, this is a risk that many Americans face everyday. Indeed, the Bureau of Labor Education (BLE) (2001) reports that there is a great disparity between the relative affluence of the United States and the degree to which its health care system has failed to provide affordable coverage to all American citizens. Further to this end, the BLE (2001) reports that "the 42.6 million people in the U.S. currently with health insurance are acutely aware that our health care system is not working for everyone, and there is growing recognition that the major problems of rising costs and lack of access constitute a real crisis." (p. 1)

According to the Bureau of Labor Education, where many established western democracies have seen fit to reinvest budgetary resources into the provision of universal healthcare for their respective citizenries, the U.S. falls shorts on a number of key standards such as these are identified by the World Health Organization (WHO). As noted by the Bureau of Labor Education, the "WHO developed three primary goals for what a good health system should do: 1)good health. . . . 2)responsiveness . . . 3)fairness in financing." (p. 1).

These goals are viewed in the discussion here as interrelated, with research supporting the claim that higher costs in healthcare in the United States are resulting in negative healthcare consequences as well. According to Garber & Skinner (2009), "the efficiency cost of the U.S. health system has also been estimated at 20 -- 30% of healthcare spending, or 3 -- 5% of GDP (Fisher et al., 2003a, b; Skinner, Fisher, and Wennberg, 2005), and according to some studies, avoidable deaths and medical errors are much more common in the United States than in European countries (Schoen et al., 2007; Nolte and McKee, 2008)." (p. 27)

It is thus that the administration of President Obama worked tirelessly in the last year to pass America's first major bill for healthcare reform in half a century. The major overhaul is designed to heighten the level of involvement provided by the government in bringing coverage and access to all Americans regardless of income or other biographical features. This overhaul, though, would be achieved in the face of massive political and economic opposition by those private stakeholders who have had the most to gain from the private nature of the current healthcare industry. The final Healthcare Reform package passed into law by the Obama Administration would be dramatically compromised by the imposition of the many private interests defining the industry. Lobby groups in representation of insurance companies and managed healthcare firms campaigned aggressively against any timers of the Obama bill which could be perceived as socializing healthcare. Warning Americans that the government intended to invade and disrupt healthcare privacy, Obama's opponents would push the legislation toward far more modest reforms. O'Donnell (2010) reports that this was done in contrast to the will and desire of the American people. According to O'Donnell, "an AP article says their poll finds that the number of Americans who wish the health care reform bill went further is double the percentage of those who believe government should have no role in health care." (p. 1)

These findings suggest that though the public elected a leader to office who might push the nation toward socialized healthcare, the grip that private industries have on the healthcare industry are more powerful than the public will. The result is that… READ MORE

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