Healthcare is an important aspect of everyone’s life. In America, there is no regulated healthcare option that citizens have. There are many private healthcare providers, as well as a few government provided ones, namely Medicare and Medicaid. It is fair to reason that because there are so many different options for healthcare, there are many different qualities of healthcare as well. Accessibility of healthcare also varies with location as well. Ninety seven percent of America’s land is rural. This can significantly affect a person’s access to healthcare. These aspects of American healthcare, along with a continuing nationwide shortage of doctors, as well as the further exacerbation of accessibility issues by climate change, clearly show that lack of access to healthcare is a wicked problem that there is no one complete solution for.
Let us look at a small rural town in the heart of Iowa- Decorah. For many residents, visiting a hospital is a serious financial choice that needs to be made, as over twenty percent of residents have no form of health insurance. This makes any trip to any doctor for any reason a difficult choice to make as the only part of healthcare that is stable across America is that it costs a lot of money. This is only for primary health. When it comes to other services, such as dental, mental, or eye health, many insurance plans do not cover the costs. This leads to many people visiting a primary care doctor only to get referred to a specialist that is not covered on their employer’s healthcare option. Knowing this, it should make sense that in the same town, less than twenty percent of people had received any type of mental health care from 2015 to 2016. This is combined with much less Decorah citizens visiting a specialist. Keep in mind that these are pre-pandemic numbers. After COVID-19, nearly seventy percent of Americans are living paycheck to paycheck, which only further shines the light on the problems with access to healthcare.
In addition to the pandemic causing people to lose their jobs, it also caused another major problem regarding healthcare for many Americans. Kaiser Health Network, a healthcare provider in the United States found “Most Americans- 162 million- get health insurance through their employers. Sixty percent of employers offer health benefits, according to a new survey by the Kaiser Family Foundation and the Health Research and Educational Trust.” Unfortunately, with the millions of jobs that were lost, many people found themselves without a job and without access to healthcare almost overnight. Now that the impact of the pandemic has lessened, many of these people probably have access to healthcare again, but this raises the question- what if something like this happens again? While there are relatively few examples of pandemics, there are many examples of people losing their jobs, and thus their access to healthcare. There is also the issue of limitations to a person’s ability to work. For the county that Decorah falls under, over fifteen percent of people have an issue that is severe enough to keep them from working. This is just yet another example of a problem that is caused by the privatization of healthcare.
When talking about access to healthcare, there are a couple of components that make up the concept. First, as discussed previously, there is the ability to financially access healthcare. The other part of access is the physical ability to go to a hospital. Many locations in America are far from any hospital or medical facility. This is an example of an entirely different type of problem on its own pertaining to spatial injustice. Nonetheless, it is still significant for the purpose of identifying barriers to accessing healthcare services. Another example of a physical barrier to accessing healthcare is climate change. This might seem strange at first, as climate change does not directly constitute a barrier to healthcare; however, climate change is a strong indirect driver of lack of access to healthcare. With the rise of climate change, there is also a rise of floods, droughts, unpredictable weather, extreme temperatures, etc. Floods are the strongest contributor as floods typically affect the roads and getting supplies to hospitals. So not only does climate change contribute to not being able to access hospitals, but it also affects the hospitals themselves as they need to ration their supplies.
Overall, it is clear that there are many barriers to healthcare that affect many different people. From the way that American healthcare is structured, to the location of the land you own, to climate change, there are many examples of factors that contribute to whether you have proper access to healthcare. For the nearly half of Americans who get healthcare from their employers, they are at the mercy of the companies that they work for regarding their health. While the private healthcare system is useful for generating profit, it is easy to see that for many Americans it creates an unstable situation due to their ability to get healthcare being easy to change. Though there are many problems regarding access to healthcare, it is important to be resilient as change is possible. With the creation and current expansion of the systems thinking model, the possibility of finding better ways to operate complicated systems as well as resolving some of their issues is growing faster with time.