“[The US healthcare system is] a system in which the government pays directly or indirectly for more than half of the nation’s health care, but [where] the actual delivery both of insurance and of care is undertaken by a crazy quilt of private insurers, for-profit hospitals, and other players who add cost without adding value” – Robin Wells and Paul Krugman (Wexler)
Today, the US healthcare system has made healthcare a privilege when it should be a right. In addition, California’s uneven Covid-19 vaccine distribution is only the most recent manifestation of the injustice in US healthcare. Overall, change is needed to create a more equitable healthcare system for low income minority groups in need.
Privatization of US Healthcare: Past to Present
Inequality in US healthcare first began with the establishment of an insurance funded healthcare model. Privatized healthcare is naturally profit oriented which “increases costs,… jeopardize[s] quality,… [and] aggravate[s] the system’s inequity” (Wexler). During the 1930s and 1940s, calls for federal healthcare reform led to cooperation between the American Medical Association (AMA), composed of physicians, and the Health Insurance Association of America (HIAA), composed of insurance companies (Chapin). The AMA and HIAA established the insurance based healthcare model used today, and defeated President Truman’s plans to create a universal, federally managed healthcare system. Conflict over the insurance funded healthcare model continued until 1965 with the creation of Medicare, a program to provide health insurance for elderly Americans. Medicare was a turning point for legislators, who began to focus on improving the existing healthcare model (Chapin).
(Source: eHealth and ASPE)
Since 1965, Medicaid and the Affordable Care Act, the most important and pertinent healthcare reforms, have been passed. Medicaid, passed in 1965, provided health coverage to low-income families and individuals, while the Affordable Care Act, passed in 2010, expanded Medicaid’s eligibility. However, inequality in US healthcare still exists, especially in states that didn’t expand their Medicaid programs. In these states, people above 41% and below 100% of the federal poverty line receive no help from the government (Garfield). In addition in 2019, 9.5% of Americans were still without health insurance showing there are still improvements to be made to the US’s healthcare system (CDC).
Visual Representation of Coverage Gap (Source: KFF)
The Problem Today: California’s Uneven Vaccine Distribution
California’s Covid-19 vaccine distribution began in December 2020 with eligibility open to the 6.2 million people over 65 (Ostrov). While opening vaccine eligibility to the elderly may not seem like a problem, it doesn’t prioritize the low income minority communities that need the vaccine the most. According to vaccine working group experts, only 20% of the vaccine doses actually go to these communities (Ostrov). Part of the reason is due to the barriers marginalized groups face, primarily “technology, transportation, and time” (Ostrov). To sign up for the vaccine, one needs a device with the Internet, a method to get to vaccination clinics, and time to sign up for the vaccine. As Anthony Wright, the executive director of the advocacy group Health Access, stated, “The issues of equity are as much, or even more, about the logistical ‘last-mile’ issues that individuals face as they are about prioritization” (Ostrov).
“Technology, Transportation, and Time” (Source: Pinclipart)
As the Covid-19 vaccine was given out, the early numbers made it apparent that California’s vaccine equity was a major issue. For example, early numbers on February 5, 2021 showed that in “Walnut Creek, an affluent, largely White city, 21% of the population” had received one dose; while in “Oakley and Richmond, both lower-income cities with large Latinx populations, a little more than 7% of residents” had received one dose (Kendall and Kelliher). The most recent report released on March 17, 2021 by the Center for Disease Control found that California ranked 44th compared to other states in providing vaccines to high vulnerability counties, and that less than 1⁄3 of the vaccines in California were going to high vulnerability counties (CDC).
For Now: What Can Be Done on a Macro and Micro Level?
As an individual, one can take important action steps which include:
- Volunteering: Volunteer work can come in the form of either helping with vaccine distribution or spreading awareness, and both are important in getting vaccines to low income communities and minority groups in need. To sign up for volunteer work in California, go to the MyTurn Volunteer Website.
- Donations: Donating to organizations is also important as the more money these organizations get, the more people they can help. Some organizations could be:
- Political Activism: Pushing for political change is another way an individual can help with vaccine distribution, and this can range from protesting to even just voting for programs aimed to create more equity in healthcare.
Volunteers helping with vaccine distribution at one of El Sol Neighborhood Educational Center’s pop-up events (Source: Almendrala)
On a macro level, there are steps California can take by following what other places in the US have done. In Washington D.C. for example, residents of lower income communities were able to schedule a vaccine appointment 24 hours earlier than anyone else (Ndugga et al.). Another example is Texas where vaccine clinics have been placed in low income communities to provide them easy access to the vaccine (Ndugga et al.). Texas’s actions can also serve as a model for the US healthcare system as a whole because access to healthcare is one of the biggest problems for low income communities. For my part, I will try to be active in the political atmosphere of the US through voting and refute any false information about vaccine safety I encounter. Hopefully, the problems in California’s vaccine distribution will serve as a catalyst for change in reforming the US healthcare system so that in the future, marginalized communities won’t have to bear the brunt of the suffering.
In the comments below let me know what you think about the following questions:
- Do you think the current US healthcare system is redeemable or do you think the model needs to be changed into something like universal healthcare?
- What action steps have you taken or will you take to help solve the problem?
- What information have you found surprising after going through my website?
Thanks for reading through my webpage, and I hope you have learned something from my research.