Healthy People 2020 and Access to Healthcare, Essay Example

Public Health Problem

The Healthy People 2020 is a program that is meant to provide the 10-year national objectives for the comprehensive improvement of the health of all Americans through making positive changes to the population’s access to health care. The performance of the Healthy People 2010  program is based on the leading health indicators that have been selected by the government. Access to health services indicates the probability of receiving medical care whenever required.1 The current report will focus on the issue of access to health services as a leading indicator for Healthy People 2020. In 2012, according to the leading indicators report2, 83.1 percent of people had medical insurance, compared with the target of 100%. According to the National Association of Community Health Centers3, “62 million people nationwide have no or inadequate access to primary care given local shortages of such physicians”. Therefore, even those who have insurance lack access due to high demand and low availability. The Healthy People 2010 report4 states that there are some cultural barriers to access, such as language barriers and concerns about discrimination.

Burden of the Issue

Access to health care services in America is a critical issue because many Americans are losing their lives due to lack of access to specialized medical care. The current number of deaths recorded by the National Health Services Corps (NHSC) amounts to approximately 2,596,993 with the highest deaths resulting from heart diseases and cancer.5 Access to health services acts as one of the leading indicators for Healthy People 2020; hence, there is a need to improve the quality of healthcare services to all people, regardless of their social, economic, and minority status. The burden of the service is propagated by the barriers preventing the equitable access to health services, including the unaccomplished health needs, delays in getting the appropriate care, failure to receive preventive services, and lack of facilities to hospitalize critical patients.6

At the same time, there are various other reasons why people would not seek medical attention, based on health related beliefs and misconceptions.  Health education, therefore, should be a crucial part of all intervention.

The IMS Institute7 states that through improving health care access, several costs associated with healthcare could be avoided. As the authors state: “The avoidable cost opportunity from delayed evidence-based treatment is $39 billion, with a range of $19 billion to $64 billion”.

The Healthy People 2020 initiative has embarked on the reduction of deaths caused by preventable diseases or conditions, such as heart diseases or stroke through the provision of advance medical care before the condition persists.

Access to Healthcare is a Public Health Concern

The access to comprehensive and quality healthcare services is very important to public health, because it ensures there is equitable access to quality health services. The main scope of this indicator of Healthy People 2020 is the coverage of the program, the services description, the time frames for the implementation of the strategies, and the workforce needed to accomplish those tasks (4).  Access to healthcare services in America can be achieved through acquiring health insurance coverage, which ensure that patients easily get the healthcare services they need without facing the burdens of large medical bills. However, the lack of qualified primary heath professionals, and barriers to access also reduce the overall access of the population to healthcare. The recent health care reforms (Affordable Care Act in particular)  focus on extending insurance coverage among low income people in America, however, the availability of facilities is another factor that needs to be reviewed.

Improving access to healthcare services depends on the ability of the government to ensure that people can access the care provided by healthcare facilities. The idea of starting a primary care provider initiative has been of great importance because it has developed a sustainable relationship between patients and their healthcare providers. The impact of this initiative can be witnessed from the increased access to clinical preventive services, which detect diseases earlier at a treatable stage.  

Timeliness is a crucial aspect of health care delivery. The time lag between identification treatment needs and receiving the intervention should be reduced. An increase of healthcare providers ensures that medical services are rendered whenever required, thus, improving people’s health.

At-risk Population

The group most at risk of failure to access comprehensive and quality health care services is the uninsured population. One of the key objectives of the Affordable Care Act, which was meant to increase access to healthcare services, was to reduce the number of uninsured people in the country. Most of the uninsured people are the jobless who have no stable earnings to enable them pay regular premiums for their insurance coverage. A higher mortality rate is recorded among the uninsured population compared to the insured.  The Healthy People 2020 program creates a provision of comprehensive and quality health care services for all. According to the National Association of Community Health Centers (3), the population that has inadequate access to health care has the following characteristics:

• 43 percent are from a low income background
• 28 percent live in rural areas
• 38 percent belong to ethnic minority groups
• Uninsured people are more affected by the shortage of primary care providers than those with Medicaid and Medicare cover.

Potential Interventions

Potential interventions need to be initiated to help address the lack of access to healthcare services, especially for the uninsured patients, and increase the availability of preventive, screening, and health care information services. While increasing the rate of people with health insurance cover would provide patients with the opportunity to visit a health care provider, barriers to access should also be eliminated.

Advantages of the approach:

• Increases coverage rates
• Provides basic access

Disadvantages of the approach:

• Does not deal with the barriers of access

Health care promotion and the review of medical center locations is one of the potential solutions that would help those living in rural areas. Providing insurance for the low income population through the Affordable Care Act indeed helps individuals gain access to primary care. However, it does not deal with the above mentioned barriers to access.

Advantages of the approach:

• Higher access to health care in rural areas
• Expanding health awareness

Disadvantages of the approach:

• Only covers one disadvantaged and underserved group

The final intervention that is recommended by the National Association of Community Health Centers is to increase the number of community health centers in areas where the population is underserved. This would not only provide access to health care for patients living in rural areas, but also help delivering some crucial preventive services, such as Pap smear, blood pressure, cholesterol monitoring, and the delivery of flu shots, for example, for vulnerable at-risk patients.

Advantages of the approach:

• Wider access for uninsured and underserved
• Reliable delivery of preventive services

Disadvantages of the approach:

• High cost of establishment
• High cost of running.

Intervention Selected

Considering the three interventions described above, the most effective intervention is the client-provider oriented intervention based on establishing more community health centers. As an example, through offering free or subsidized cancer screening services to people, the health services department could rescue dying patients who cannot afford this preventive measure. Many healthcare facilities fail to offer screening and prevention services due to a lack of specialized machines or personnel, thus limiting the service to those who can afford the high expenses. Another limitation for the intervention is the numerous side effects associated with both traditional therapies and modern forms of treatment, which limits the number of cancer patients willing to undergo these treatments.

Conclusion

As it has been established, access to healthcare services is one of the main indicators of the Healthy People 2020 program. The identification of the most vulnerable groups has shed light on the Department of Health to shift its focus to the uninsured population, while dealing with the barriers to access, such as the inability to travel, language issues, or cultural differences.  The analysis of the potential interventions has identified that creating more community health centers that provide preventive and patient education services would help expand the number of people with access to regular screening and health care.  Upon full implementation of this intervention, Americans will receive comprehensive and quality healthcare whenever needed.

De, CM. Caring for the Vulnerable: Perspectives in Nursing Theory, Practice, and Research. Sudbury, MA: Jones and Bartlett; 2005

US Department of Health and Human Services. Healthy people 2020. Leading health indicators.2011.

National Association of Community Health Centers. Access Is the Answer: Community Health Centers, Primary Care & the Future of American Health Care. 2014.

U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd ed. Washington, DC: U.S. Government Printing Office, November 2000.

Gilmore, GD, Campbell, MD Gilmore, GD. Needs and Capacity Assessment Strategies for Health Education and Health Promotion. Sudbury, MA: Jones and Bartlett; 2005

Fertman, CI,  Allensworth, DD. Health Promotion Programs: From Theory to Practice. San Francisco, CA: Jossey-Bass; 2010

Aitken, M., and S. Valkova. Avoidable costs in US healthcare: the $200 billion opportunity from using medicines more responsibly. Parsippany, NJ: IMS Institute for Healthcare   Informatics .2013.