History/Overview

“Medically disadvantaged,” “medically underserved” and “American underclasses” are populations that face large disadvantages, specifically in accessing opportune and obligatory health care services.

Black Americans are not only more likely to be economically underprivileged than White Americans they also experience shorter life expectancies as well. Approximately twenty percent of Hispanic Americans in 2004 lived below the federal poverty line. Not only are they more likely to be uninsured and underinsured, they may not meet Medicaid qualifications making it harder to access medical care. Being foreign born and unable to speak English also creates barriers to access. Asian Americans (people from Far East, Southeast Asia, or the Indian subcontinent) make up one of the fastest growing population segments. Korean-American men have a fivefold incidence of stomach cancer and an eightfold incidence of liver cancer. Beliefs and values of this culture may prevent women from obtaining regular breast cancer screenings and prenatal care. The incidence and prevalence of certain diseases for American Indians/Alaskan Natives such as diabetes, hypertension, infant mortality/morbidity, chemical dependency, and HIV/AIDS related morbidity are all high enough to create concern. Native Americans see seven times more death due to alcohol and 3.5 times more death due to suicide.
The uninsured represent a large, growing portion of Americans. The uninsured tend to be poor, less educated, working in part-time jobs, and/or employed by small firms. They face huge barriers to accessing healthcare. Almost half of the uninsured postponed seeking medical attention because of the cost. Lack of insurance results in a decreased use of preventative services and an increased use of tertiary services.
Millions of children lack appropriate health care. Children who come from low income families (those below the federal poverty line) have lower vaccination rates than those at or above the poverty line. Due to lack of adequate health care, children’s ability to learn can be hindered. Children’s voices are not heard and they are not as well informed as adults.
Even though women have a higher life expectancy than men, they still have higher rates of certain health problems that can result in short and long term disabilities. The main source of insurance coverage for both men and women comes from employment and because women are more likely to work part time, receive lower wages, and have interruptions in their work histories, this places them at a higher risk of being uninsured.
Throughout their lives, people living in rural areas have a higher tendency to not seek health care services. Rural areas don’t provide cost-efficient options for physicians to establish practices; therefore people living in these rural areas face the pressing challenge of fitting health care delivery into their communities.
An estimated 3.5 million people each year will experience homelessness. The economic status of homeless persons is terrible, which means that they lack both the educational and financial resources needed to access health care.
People who are chronically ill or disabled face great challenges when it comes to health care access. In 2005, about ninety million people were suffering from a chronic illness and of those ninety million, 11.9 percent of them had limited access to health care. 75 percent of the total medical costs come from those who are chronically ill or disabled. Chronic illness sometimes leads to disability, and close to 50 million Americans have some sort of disability.
The number of people living with AIDS in the U.S. has been on the rise. 341,332 individuals increased to 425,910 from 2001 to 2005. AIDS is believed to be caused by the human immunodeficiency virus (HIV). With a weakened immune system these individual are prone to opportunistic infections. In 2003, HIV infection was the sixth leading cause of death among person 25 to 44 years of age. The course of AIDS is illustrated by a continual decline in the patient’s physical, cognitive, and emotional function and well being. Therefore, this type of disease requires a range of care that can be quite lengthy and costly.

We believe this population is important because sometimes the voices of special populations aren’t heard. Their vulnerability rests on unequal social, economic, health, and geographic conditions, creating barriers in access to care, financing of care, and racial or cultural acceptance. With health costs are on the rise, the priority of special populations slowly seems to disappear. The care of these individual’s is of utmost importance especially since treatment occurs when the option of primary and secondary prevention does not exist, resulting in increased cost for treatment.


Sources:

(2009, January 15). Specific Populations. Retrieved February 18 2009, from U.S. Department of Health & Human Services Web site: http://www.hhs.gov/specificpopulations/

Office of Information Services, (2009, February 18). National Center for Health Statistics. Retrieved February 19, 2009, from Centers for Disease Control and Prevention Web site: http://www.cdc.gov/nchs/

Office of Management and Budget. Retrieved February 18, 2009, from Department of Health & Human services Web site: http://www.whitehouse.gov/omb/budget/fy2009/hhs.html

Shi, L., & Singh, D. (2008). Delivering Health Care in America: A Systems Approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.

U.S. Department of Health & Human Services, HIV/AIDS. Retrieved February 18, 2009, from AIDS.gov Web site: http://www.aids.gov/

Politcal Stance

Special populations include ethnic minorities, uninsured children, women, people in rural areas, the homeless, those with mental illnesses and disabilities and those with HIV/AIDS. These populations face great hurdles in the health care system.

Our team aligns with President Obama. He is familiar with special populations and the problems they face. President Obama often spoke of his mother’s battle with ovarian cancer. She battled the disease and the insurance companies who refused to pay for her treatments. Obama said, “I know what it is like to see a loved one suffer, not just because they are sick, but because of a broken health care system.” Obama is requiring insurance companies to cover pre-existing conditions so people regardless of illness or disability can receive health care. President Obama understands there is a large underinvestment in preventive medicine. He understands that screenings and immunizations are vital for change from an illness to a wellness system.

Our group values life and care of special populations. We value the quality of care that is delivered; that health care is equal and appropriate and not diminished due to disabilities or race. We also believe in wellness and not just the lack of disease. Special populations have greater risks of health problems and having a wellness approach reduces these risk.
We believe in equal access for special populations. Special populations are disadvantaged and usually do not have access to medical treatment. We believe that health care should be a public resource. Special populations receive and obtain less medical care due to costs and access. As a public resource they would receive the proper care when needed. Lastly, we believe that heath care should be affordable even if you have a disability or need special care as special populations do.
Our beliefs and values will influence cost, access, and quality. Costs will rise because it is more expensive to care for special populations. Special populations require more specialized care including long-term care at the tertiary level. Also, it will cost more to pay for the millions of more people that will be receiving care. Between 9.2 and 9.7 million children are without health insurance and as a result of receiving services, costs will increase. As a public resource there would be an influx of new patients, equaling higher prices and effecting access.
Access for special populations will also be influenced. Special populations do not have the same access to health care as the rest of the population. Many immigrants do not qualify for Medicare or Medicaid. With the influx of special populations it could result in longer waiting lists for health care services.
We hope that the quality of health care services improves over time. We strongly believe in prevention which will eventually lead to healthier lives. By valuing the care and lives of special populations we believe that their overall quality of healthcare will be improved and appropriate.

A study in 2008 interviewed adults with chronic conditions from eight industrialized countries who received health care. The countries participating in the survey represented a mixture of insurance designs and systems. The U.S stood out for the most expensive system and gaps in coverage. The U.S also ranked the highest for negative patient experiences and lowest for access, care, and patient-reported safety concerns. U.S. patients indicated the most that the primary care system had problems with errors, delays, duplications, and higher use of the ER.
People may believe that our political stance may not work in our society. Many Americans value capitalism and entrepreneurism. The possibility of loosing the private sector of health care to the government goes against those two values. Health care is seen as a good or services provided by the people that the individual makes their own choice on. Also, there is a chance that taxes could rise to cover costs and people have expressed many times that they are not interested in higher taxes.
You ask yourselves, why should I believe in this group’s stance towards health care and special populations? According to our text, Delivering Health Care in America: A Systems Approach, a health care delivery system should have two objectives: to enable all citizens access to health care and those services should have quality standards that are cost-effective. Our fragmented system fails on both levels and it greatly affects the special populations. We need to place these individuals at the front of improving our health care system since most of them share a disproportionate amount of national spending.


Sources:

Bivesn, J. & Gould, E. (2008). Obama Health Plan Out Performs McCain Plan in Coverage and Efficiency. Retrieved February 12, 2009. from Economic Policy Institute. https://uwlax.edu/exchweb/bin/redir.asp?URL=http://www.epi.org/publication/entry/pm126/

Obama-Biden. (2008). Healthcare. Retrieved February 12, 2009.
From https://uwlax.edu/exchweb/bin/redir.asp?URL=http://www.barakobama.com/issues/heatlhcare/

Shi, L., & Singh, D. (2008). Delivering Health Care in America: A Systems Approach (4th ed.). Sudbury, MA: Jones and Bartlett Publishers.


The Health Center Program: Special Populations (2008). Retrieved February 12, 2009, from U.S. Department of Health and Human Services. https://uwlax.edu/exchweb/bin/redir.asp?URL=http://bphc.hrsa.gov/about/specialpopulations.htm

The Number of Uninsured Americans Is At An All-Time High.(2006). Retrieved February 12, 2009, from Center on Budget and Policy Priorities.
https://uwlax.edu/exchweb/bin/redir.asp?URL=http://www.cbpp.org/8-26-08pov.htm