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America is faced with many persistent issues, many of which are due to the growing divide between our two leading parties. One issue that profoundly stands out is income inequality and poverty. Income is a major determinant of health and well-being. Some of the most significant aspects of an individual’s life are determined by income level or socioeconomic status. Income plays a significant role in education and employment opportunities, and most notably housing status. Outside of occupational disparities those with a lower income status are also subject to more health concerns, a trend that has worsened in recent years due to the COVID 19 pandemic. According to the National library of Public Medicine, data from Medicare revealed that older adults with a low income are more likely to be diagnosed and hospitalized with COVID 19.
The COVID 19 pandemic was followed by more concerning trends past the pandemic’s initial stages. According to the National Library of Public Medicine, the wealthy fared well during the pandemic and by august of 2021, estimates suggest that the collective wealth of U.S billionaires increased by over a trillion dollars. Meanwhile, millions still live at or below the poverty line. Data from the U.S census bureau revealed that 37 million people lived in poverty, 15 million of which are children. Considering the impact income has on health and longevity, this is a concerning figure affecting predominantly marginalized communities. For decades, we have seen the effects wealth disparity has on health factors, yet this problem persists. The National Library of Public Medicine found that today 50% of household income goes to the top 10% of income earners in America, while only 13 % of household income goes to the bottom 50% of income earners. This dispairty also coincides with survival rate, as income determines the quality of housing, education, and healthcare. Without the ability to afford necessities, low-income individuals are subject to a more hazardous lifestyle meaning that health factors as well as crime and violence are more likely to occur for those affected by the wealth disparity. For long before the start of the COVID 19 pandemic, wealth inequality was a major problem that created more disparities for those affected. For decades we have seen the impacts this issue has on health and well-being. Like many Americans one can only hope our government intervenes and, at the very least, reduces the severe impacts that arise from wealth inequality.
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Since the beginning of the 21st century accessing mental health care has been needlessly difficult, particularly for marginalized communities. Many providers have limited what kind of insurance they will accept, putting people in need in a disadvantageous position forcing them to pay out of pocket for treatment. The COVID 19 pandemic further highlighted the various barriers to accessing mental health care and historically marginalized communities experienced the greatest barriers to accessing health care. According to a study conducted by the National Library of Public Medicine, the odds of having health insurance were 40 % lower for people with serious psychological distress than for those without. This is particularly concerning when considering the cost of treatment. According to a study by the American Center for Progress the average cost of a psychiatric diagnostic evaluation in Minnesota is $241 and the total cost for 12 sessions of psychotherapy is $1,920. Considering the broad scope of mental illnesses in contemporary society, psychotherapy providers could recommend more intensive treatment leading to a higher cost for clients in need who are paying out of pocket. This is where we see a clash between insurers and care providers. In some states, insurance companies have the authority to deem what is and what is not a medical necessity. The main problem that arises with this is that it limits the level of autonomy for those attempting to access mental health resources. The interference from insurance companies makes it difficult for care providers to ethically carry out their duties. The term “medical necessity” is also ambiguous and hard to define and clinicians who often deal with insurance companies believe that it is a way for insurance companies to undermine the client’s autonomy and access to treatment. For far too long insurance companies have made accessing necessary care needlessly difficult and it is apparent that having insurance companies active in the process only hinders the progress of those seeking care.
References Director, S. Nadeau Associate, Nadeau, S., Director, A., President, J. Cusick Vice, Cusick, J., President, V., Director, M. Shepherd Senior, Shepherd, M., Director, S., Rapfogel, N., Altiraifi, A., Sozan, M., Correa-Buntley, T., Ombres, D., Ballard, D., & Bedekovics, G. (2020, March 23). The Behavioral Health Care Affordability Problem. Center for American Progress. https://www.americanprogress.org/article/the-behavioral-health-care-affordability-problem/ Rowan, K., McAlpine, D. D., & Blewett, L. A. (2013). Access and cost barriers to mental health care, by insurance status, 1999-2010. Health affairs (Project Hope), 32(10), 1723–1730. https://doi.org/10.1377/hlthaff.2013.0133 |
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