The state of the American healthcare system has long been a subject of debate due to considerable health disparities witnessed in the country. Despite the US having one of the world’s most developed social, economic, and political systems, its citizens continue to struggle to cope with high healthcare costs making healthcare inaccessible to most Americans. As a result, the American healthcare system remains poor despite the government’s considerable investment, the highest global healthcare investment of approximately $3 trillion annually, representing 18% of the American GDP (Tikkanen and Abrams). However, the US has the worst health outcomes with the lowest life expectancy globally, as corroborated by the ravaging impact of the Coronavirus pandemic on the American healthcare system. With such alarming statistics for a developed country, authors such as Sell and Williams, Owens, and Villarosa have sought to establish the cause of healthcare inequalities in America. The authors have discovered that inequalities in the American healthcare system are caused by systemic racism and other power and control systems, limiting proper healthcare delivery for marginalized communities.
One cause of healthcare inequalities in the American healthcare system is systemic racism which involves discrimination of patients based on racial orientation. For a long time, racism has been a significant issue in America, with minority communities encountering prejudice and disenfranchisement. Even after the slavery abolishment and the declaration of the Civil Rights Act, minority communities have encountered discrimination, especially in healthcare. Systemic racism as a cause of healthcare discrimination begins with the undesirable history of medical experimentation on African Americans, where black Americans have continually been subjected to unethical medical experimentation. For example, enslaved women were used for gynecological experiments that led to modern gynecology systems (Owens). Moreover, hundreds of low-income Black men were lured to be used in the Tuskegee syphilis experiment in exchange for free meals and meager handouts. The unethical use of black Americans without their informed consent depicts that the American healthcare system views black bodies as expendable and less valuable than white bodies (Herman). As a result, African Americans have increasingly lacked trust in the American healthcare system, thus impacting the healthcare outcomes among the group.
Another cause of inequalities in the American healthcare system is the existing health policies and practices perpetuating discrimination against minority communities. For a long time, the current policies and procedures have not favored the minority communities in America regarding employment in healthcare and service delivery to patients. Fundamentally, the American healthcare system lacks proper diversity in the workforce, with structural policies providing limited opportunities for people of color to work in the health sector. As a result, fewer providers can understand and relate to the cultural values of minority patients. Therefore, it leads to implicit bias among healthcare providers caused by unconscious attitudes and beliefs about patients belonging to racial and ethnic minorities. These biases significantly affected how healthcare providers offer services to patients from marginalized communities, with studies showing that minority patients are likely to be undertreated compared to their white counterparts. For instance, black mothers and babies are at significant risk of dying due to poor maternal care they receive from healthcare providers (Villarosa). As a result, there have been increasingly disproportionate chronic disease and maternal mortality rates among black American communities.
In addition, other power and control systems, such as capitalistic economic systems, also contribute to inequalities in the American healthcare system. The health sector constitutes a significant component of the American economy which is primarily based on a capitalist system where private organizations own a considerable proportion of the factors of production, seeking to generate profits without significant government intervention. Therefore, the American healthcare system is equally founded on capitalism, where healthcare organizations prioritize the profiteering interests of corporates over the health and well-being of American citizens. As a result, certain areas may remain underserved due to their perceived lack of profitability, especially those inhabited by the marginalized and low-income population. According to Sell and Williams, the American healthcare system is driven by players who aim only to make money with little concern for health outcomes (16). Therefore, the profit-motivated healthcare system is characterized by high medical costs, which often make access to primary care challenging for most American citizens, especially the marginalized and low-income communities. With the high costs of medical care, those with limited access to healthcare due to economic constraints often end up developing chronic health problems.
Furthermore, the inequalities in the American healthcare system are also caused by significant disparities in the socioeconomic status among American citizens. Fundamentally, unequal socioeconomic status creates a substantial barrier for lower-status people to access healthcare. For example, individuals of the lower class find themselves unable to afford the high costs of medical care leading to untreated illnesses and poor health outcomes. The socioeconomic wealth gap between Americans living below the poverty level and wealthy citizens is so vast that only a few people can afford proper medical care in the country (McMaughan et al.). Also, low socioeconomic status often forces individuals to live in places with poor environmental conditions and lack access to healthy food, exposing them to undesirable health issues. Further, the socioeconomic disparity is largely skewed on racial and ethnic structures, with higher poverty rates among communities of color. As a result, the disproportionate poverty rates among marginalized social groups and communities imply that the minority have limited access to good healthcare. Thus, the intersection of race and socioeconomic status in the American social structure influences individuals’ access to healthcare leading to inequalities in the American health system.
In conclusion, disparities in healthcare provision are a significant problem in the US that is influenced by multiple intersecting factors. They include systemic racism within the healthcare system, unfavorable health policies and practices, capitalistic economic systems, and disparities in socioeconomic status among American citizens. These longstanding factors plaguing the healthcare system have led to the US having one of the worst healthcare systems yet one of the most expensive in the world. Furthermore, these disparities in healthcare in the US are more widespread in some American communities than others, leading to unaffordable services for most of the population. Essentially, the American healthcare system is very complicated, with its interlinked relationship to systemic racism and other systems of power and control contributing significantly to the longstanding inequalities in the system. Ideally, these factors constitute the social determinants of health that largely influence health inequities. Bridging these disparities calls for a concerted effort from all stakeholders to disintegrate the interconnected oppressive systems in the health sector. As a result, the country can gradually develop an equitable healthcare system that serves everyone regardless of their social identity.
Works Cited
Herman, Jonnea. “Racism, Inequality, and Health Care for African Americans.” The Century Foundation, Web.
McMaughan, Darcy Jones, et al. “Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging.” Frontiers in Public Health, vol. 8, 2020, p. 231, Web.
Owens, Deirdre C. “Medical Bondage: Race, Gender and the Origins of American Gynecology.” YouTube, uploaded by Othering & Belonging Institute, Web.
Sell, Susan K., and Owain D. Williams. “Health under Capitalism: A Global Political Economy of Structural Pathogenesis.” Review of International Political Economy, vol. 27, no. 1, 2020, pp. 1–25, Web.
Tikkanen, Roosa, and Melinda K. Abrams. US Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes? Commonwealth Fund, 2020, Web.
Villarosa, Linda. “Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis.” The New York Times, Web.
