Discussion 4 :Economics peer responses

Respond to at least two classmates who identified different areas of disparity than your own. Do you agree or disagree with their assessment of the impact of economic policy on the disparity? Does the disparity discussed have a microeconomic or a macroeconomic impact on health care?

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Trina Cox
Disparity in healthcare can be defined as, “differences between groups in health insurance coverage, access to and use of care, and quality of care” (Orger & Artiga, 2018). There are various healthcare disparities; however, the key areas of disparity I have chosen to identify and analyze include health insurance coverage, quality of care, and gender. As most people already know, health insurance is a type of insurance coverage that is designed to cover an insured person’s medical expenses (such as hospital, doctor, laboratory and pharmacy services). Although the number of uninsured Americans have decreased drastically since the passing of ACA, disparities in this area still exist. Some individuals’ annual incomes still are not enough to pay the low premiums that may be required of them to have access to health insurance coverage.
Quality of care can be described as, “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (AHRQ, 2017). Although it is an unethical act displayed by healthcare professionals; in some areas, all patients are not treated equally with regards to quality of care. According to Dr. Ananya Mandal (2019), discrimination occurs when healthcare providers treat individuals from certain population groups differently to other population groups, whether this is done consciously or not. It is common for this to occur when providers have stereotyped impressions of specific racial or ethnic groups.
Gender can play a major role in healthcare disparities among women, specifically, in some of the developed countries. Researchers have reported that determinants of gender differences, like welfare indicators (e.g., education and income), behavioral factors (e.g., smoking and drinking), and social factors (e.g., social support and socioeconomic status) have direct correlations with some of the existing disparities (Hassanzadeh, et al, 2017). Afghanistan is a country that still has a high rate of gender disparities among women, even though some improvements have occurred. In this country, the biggest disparities that I feel still exist are between women in rural versus urban areas, and those with some education, as opposed to those women with none; showing that as education of women increases, so does their health and that of their children because of the education and resources that they have.
I think several economic policies have impacted these disparities and they include differences in income levels, education, and geographic location. A person’s annual income may have a direct effect on his or her ability to purchase or assist with the cost of health insurance coverage. However, it is not uncommon for lower income citizens to have lower education capacity than their middle and high-income level counterparts. Another common factor is, said individuals often reside in the poverty-stricken areas of various geographic locations. Residents of rural areas often face barriers to quality health care, like limited number of healthcare providers in those areas, driving longer distances to seek care, and limited job opportunities. Women in various developed countries are also plagued by the income and education economic policies. Therefore, these disparities and economic policies are directly related to each other and share some similarities. As stated by Dr. Ananya Mandal, “Disparities in the quality and availability of healthcare across different population groups is a major problem in many developing and developed nations, including the United States.”
The recommendations that I would make, related to each disparity, for an organization to plan for this to minimize the negative impact while still delivering quality care include the following:
· Continue promoting free healthcare services provided by local health departments; while creating at least one free-clinic site in every community for the uninsured or underinsured
· Healthcare services should be expanded to ensure access to all ethnic and racial groups (Mandal, 2019)
· Promote educational opportunities for young girls and women globally
 References
AHRQ. (2017). Understanding Quality Measurement. What is Quality? Retrieved from https://www.ahrq.gov/professionals/quality-patient-safety/qualityresources/tools/chtoolbx/understand/index.html
 Hassanzadeh, J., et al. (2017, October 19). The Correlation between Gender Inequalities and Their Health-Related Factors in World Countries: A Global Cross-Sectional Study. Epidemiology Research International. Retrieved from https://www.hindawi.com/journals/eri/2014/521569/
 Mandal, A. (2019, February 26). Disparities in Quality of Health Care. News Medical Life Sciences. Retrieved from https://www.news-medical.net/health/Disparities-in-Quality-ofHealth-Care.aspx
Pearlman, A. (2012, September 6). Afghan women largely lack healthcare, education. Global Post. Retrieved from https://www.pri.org/stories/2012-09-06/afghan-womenlargely-lack-healthcare-education
Orgera, K., Artiga, S. (2018, August 8). Disparities in Health and Health Care: Five Key Questions and Answers. KFF. Retrieved from https://www.kff.org/disparitiespolicy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answer

Post # 2
Farrah Garno 
            Health disparities are preventable differences in the burden of disease or opportunities to achieve optimal health by socially disadvantaged racial, ethnic, population, educational, or economic status (Centers for Disease Control and Prevention, n.d.).  Poverty and access to health services are two specific disparities that occur throughout the country.
            The prevalence of poverty in the United States affects approximately 43 million Americans.  Researchers state there is a strong relationship between poverty and health outcomes which include increased risk for disease and premature death (Poverty, n.d.) .  Low-income persons of all races reports worse health status than those of higher income (Artiga, Orgera, and Pham, 2020).  Many factors influence an individual’s risk or family’s risk of poverty.  Those factors include marital status, education, social class/status, income level, and geographical location.  In 2012, 17.7% of rural families lived in poverty compared to those living in an urban area where 14.5% were living in poverty.  Poverty-stricken individuals have more adverse health outcomes and at risk for heart disease, diabetes, and obesity (Poverty, n.d.).
            Economic policies that have helped decrease poverty and health outcomes due to poverty include the government economic security programs, Medicaid, and Children’s Health Insurance Program (Children’s Health Insurance Program (CHIP) n.d.).  Economic security programs include food assistance programs, housing subsidies, and working families tax credits.  These programs assist families with basic needs (Sherman and Mitchell, 2017).  Medicaid is a program jointly funded by the state and federal governments.  It provides insurance coverage to eligible low-income adults, children, pregnant women, the elderly, and people with disabilities.  CHIP is a health insurance program that provides insurance coverage for qualified children.  This program is jointly funded by the federal and state governments (Medicaid, n.d.).
            Access to health services is defined as “the timely use of personal health services to achieve the best possible health outcomes.”  Throughout the United States, many people face barriers that can limit or even prevent access to health services.  These limited accesses or prevention of access leads to an increased risk of poor health outcomes that can negatively affect an individual’s short-term and long-term health, such as diabetes, cancer, and cardiovascular disease.  The barriers that can affect such access include lack of health insurance, unreliable transportation, and limited resources.  Limited resources are barriers that include physician shortages, which can increase wait times and delay care.  Limited resources also include physicians who do not accept an individual’s health insurance, Medicaid, for example (Access to Health Services, n.d.).
            An economic policy that has aided in access to health services includes the Affordable Care Act. This has improved health coverage by expanding the Medicaid program, covering adults with a low income below 138% of the federal poverty level (Affordable Care Act (ACA), n.d.).  The Affordable Care Act developed Insurance Exchanges, a marketplace to purchase affordable health insurance for those who do not qualify for Medicaid (Access to Healthcare: Affordable Care Act, 2020).
            Medicaid expansion from the Affordable Care Act began in 2014, and as of 2018, 33 states and the District of Columbia had expanded their programs.  The expansion of Medicaid eligibility had reduced the number of uninsured in the United States.  By reducing the number of uninsured individuals, the law was expected to positively impact the hospital finances by reducing the number of charity cases and bad debt (Young, Flaherty, Zepeda, Singh, and Rosenbaum, 2019).  Recommendations for healthcare organizations to prevent this law to negatively impact, would be to monitor and control cost and maintain a balanced budget.  One area to assess would be the supply chain.  This area holds a large portion of the budget.  Maintaining appropriate amounts of stock without overstocking, maintain capital equipment and service contracts can help offset any negative impact from reimbursement to the organization.  Another way to prevent any negative impact would be to ensure that the physicians practicing at the facility have enrolled in the Medicare and Medicaid Programs.  This will ensure that the physician/ facility will obtain appropriate reimbursement without denial or delay.
References 
Access to Healthcare: Affordable Care Act. HHS.gov. (2020, November 30). https://www.hhs.gov/programs/topic-sites/lgbt/accesstohealthcare/affordablecareact/index.html.
Access to Health Services. Healthy People. (0AD). https://health.gov.
Affordable Care Act (ACA). HealthCare.gov. (0AD). https://www.healthcare.gov/.
Artiga, S., Orgera, K., & Pharm, O. (2020, March). Disparities in Health and Health Care: Five Key Questions and Answers. KFF. https://www.kff.org/.
Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/.
Children’s Health Insurance Program (CHIP). Medicaid. (0AD). https://www.medicaid.gov/chip/index.html.
Medicaid. Medicaid.gov: The official U.S. government site for Medicare. (0AD). https://www.medicaid.gov/.
Poverty. Healthy People. https://health.gov.
Sherman, A., & Mitchell, T. (2017, July 17). Economic Security Programs Help Low-Income Children Succeed Over Long Term, Many Studies Find. Center on Budget and Policy Priorities. https://www.cbpp.org/research/poverty-and-inequality/economic-security-programs-help-low-income-children-succeed-over.
Young, G. J., Flaherty, S., Zepeda, E. D., Singh, S., & Rosenbaum, S. (2019). Impact of ACA Medicaid Expansion on Hospitals’ Financial Status. Journal of Healthcare Management, 64(2), 91–102. https://doi.org/10.1097/jhm-d-17-00177