The Importance of Healthcare Policy Reform in the U.S.

It is no secret that the domestic healthcare policy in the United States could use some reform. Currently, there is no cohesive healthcare system in the country that ensures citizens can access affordable healthcare and equitable treatment. Although there have been attempts through initiatives such as the Affordable Care Act (ACA) to increase the accessibility of healthcare, there are further changes to American public policy that could reach the end goal of providing healthcare to all Americans. 

One change to public policy that would help bridge the gap of accessibility is an expansion of the eligibility criteria for assistance programs like Medicaid. Medicaid, a need-based system, assesses eligibility on income in which “the federal government employs a concept called the poverty line” to define what income qualifies a family as ‘poor’ (Abernathy, 2022). Unfortunately, the poverty line is not representative of the actual cost of living in the U.S., meaning many low-income individuals do not qualify for the program. 

For example, in 2020 the income qualifications for being below the poverty line was about $26,000 (Abernathy, 2022). However, according to the Economic Policy Institute, a family of four in the Baltimore/Columbia/Towson metro area would need about $100,000 a year for a “modest yet adequate standard of living” (2024). This amount of income for a family of four is what it takes to care for a lower-middle-class family of four in Maryland. It certainly is not as wealthy by any means when you consider covering expenses for four people. This still wouldn’t ensure the family could afford out-of-pocket medical expenses without insurance.

 The financial expectations versus the reality of the cost of living show a significant disparity from the poverty line and expose a gap in coverage for people who do not make enough to afford healthcare, even considering the increase in the poverty line since 2020. If public policy were to expand the eligibility requirements from the poverty line to those who are low income yet do not meet the requirements to be considered ‘poor,’ many folks would have access to affordable healthcare. 

Furthermore, the most obvious way in which healthcare could be more accessible in the U.S. is through a universal or national healthcare system. Universal healthcare policies in countries like Morocco are more sustainable than the U.S. healthcare system due to their centralized cost control, equitable access, and efficiency. In Morocco, the government-funded healthcare system allows for negotiated pricing on medications and services, prioritizing preventative care and reducing overall expenditures. This approach ensures that all citizens have access to essential healthcare services, which decreases health disparities and focuses on early disease detection and treatment. Consequently, the system reduces the need for expensive emergency treatments and hospitalizations, leading to a more cost-effective and equitable healthcare environment.

In contrast, the U.S. healthcare system is highly fragmented, leading to higher administrative costs and less bargaining power to control prices. The complexity of dealing with multiple private insurers results in significant inefficiencies and high healthcare costs. Additionally, a substantial portion of the U.S. population remains uninsured or underinsured, causing delayed treatments and increased healthcare expenses due to advanced disease stages. The emphasis on treatment over prevention further exacerbates the issue, resulting in poorer public health outcomes compared to countries with universal healthcare systems.

The variety of private health insurance providers and the high cost of healthcare are constant struggles faced by many Americans. Citizens are either forced to get coverage through employers, government assistance, or pay out of pocket for coverage and the ongoing struggle is a burden. A universal system would not only regulate cost and centralize systems but also offer an opportunity to ensure equitable care for citizens. The U.S. could look to countries like Morocco to implement a successful system. With the current system in place, there are no regulations in place to stop insurance companies from being biased toward clients with already existing or chronic illnesses. Moreover, many citizens are left uninsured, which causes not only a financial but also a mental burden on medical patients who feel uncomfortable seeking care because of the high cost. If policymakers in office re-enter national healthcare on the national docket, it could be a beneficial solution.