Hcl 531 - Healthcare Organizations and Delivery Systems - Vulnerable Population

Vulnerable Population

Healthcare Organizations and Delivery Systems HCS/531

Facilitator Rochelle Robinson

September 12, 2011

Vulnerable Population - Part I

The increase in the uninsured population puts a strain on the health care system as a whole. It is difficult to have a health care delivery system that meets the needs of the uninsured in a cost-effective manner. The characteristics of the uninsured are impacted by several factors such a race, income level, employment status, and geographical area. The employment rates in recent years have also caused an increase in the number uninsured population. The downward spiral of the economy has increased the number of people who do not have health care insurance. Many of the small and medium size businesses have either stopped offering health care insurance as a benefit to their employees or have decreased the cost share amount. This causes an increase in premiums for the employee who in these tough economic times has made it unfeasible for the employee to take advantage of the benefit.

Uninsured Demographics

A significant number of people that are uninsured fall into one geographic area. There are several factors that should be considered when looking at this information. Twenty percent of people residing in one of the following 12 states from 2007-2009 were uninsured: Texas, Florida, New Mexico, Nevada, Arkansas, California, Arizona, Mississippi, Oregon, North Carolina, Oklahoma, and Georgia. These states where more likely to have lower income rates, higher unemployment, as well as the higher concentration of non citizen groups that are less likely to be covered by health insurance (Frostin, 2010).

Based on the study conducted by Employee Benefit Research Institute, "One-quarter of men were uninsured in 2009, compared with 19.9 percent of women. This difference between men and women is observed at all age groups, especially below age 35" (Frostin, 2010, p. 21). The reason for this could be because the top employment for those that are uninsured is being self employed or blue collar jobs.

Ethnicity did yield significant difference in the uninsured population. White non elderly accounts for 62. 7 percent of the population and 46.8 percent are uninsured. While Hispanics account for 33.9 percent of the uninsured population, which is the highest population of insured per capita. This lends itself to the previous findings regarding the type of work and locations where the incidence of uninsured is highest (Frostin, 2010).

The study by Employee Benefit Research Institute also revealed that one in 10 children is uninsured. In 2009 that equated to 7.5 million children without insurance and the majority of those had family income of less than 200 percent of the federal poverty level. Of the families making less than 200 percent of the federal poverty level, 58% where employed full time (Frostin, 2010).

Population Vulnerability

The uninsured population is a vulnerable population because many of the people in this group are less educated and make less money than those that are insured (O'Neill & O'Neill, 2009). These factors will contribute to a lack of knowledge to make educated decisions that will assist in pushing to the necessary changes to assist. These factors will also contribute to poor health habits that will contribute to a greater need for the health coverage. Though there is consistent documentation that those who are uninsured receive less preventative care and due to this are diagnosed with advanced disease, and receive less therapeutic care once a diagnosis is made (Hadley and Holahan, 2004).

Challenges that make this Population Vulnerable

Based on studies previously discussed there are many factors that contribute to the uninsured population. Those factors include the types of jobs, the immigration status, and the education level. The current focus of healthcare reform is on a wellness models which is great for those that are currently being treated but doesn't really impact the uninsured population.

It is difficult to discern if the lack of health coverage or lifestyles are the issues surrounding the mortality differences between the insured and uninsured, though there is a disparity. It is important to remember that problems within the healthcare sector is not just financial cost though cost is a large portion of the issue.

When looking at the spend on health care for the uninsured, "the estimates indicate that on a per capita basis, the uninsured receive about 40 percent of the amount of health resources received by those with insurance" (O'Neill & O'Neill, 2009, p 33). However, of that 40 percent, it is probable that about half of that is used by involuntarily uninsured since many health care facilities and providers distribute resources for lower income individuals (O'Neill & O'Neill, 2009).

Impact on Health Care system

The financial impact on the healthcare system for the uninsured is significant. Nearly one third of the services rendered to the uninsured are not compensated. This accounted for 40.7 billion dollars in 2004 (Hadley and Holahan, 2004). This lack of compensation contributes to higher costs to insured consumers. It is similar to how a department store increases prices to their customers to offset the losses for stealing,