Avi Parshionikar

English 1201

Professor Kretzer

4/26/30

The Crisis of American Public Health

The United State’s Healthcare system has become increasingly scrutinized in recent

times, at first with the candidate Bernie Sanders bringing many of its flaws to light. Now, this

scrutiny has expanded to the United State public health system in general when under the strain

of the coronavirus and the massive influx of patients to hospitals all over the country. This leads

me to my current research question. How effective is the United States’ public health system?

After gathering many sources and reading through them, I started to notice many similar facts

and claims about the healthcare system, ultimately leading me to the conclusion that the United

States healthcare system is not very effective, as it doesn’t provide comprehensive or thorough

enough treatment for enough US citizens.

Many sources stated that the United States spends the most on healthcare compared to

many other countries in Europe and Asia. Many sources also discussed how the US doesn’t rely

on a centralized system which handles healthcare, and rather leaves the people on their own to

get healthcare from private providers. So why does the United States have such comparatively

high costs for healthcare? According to the Department of Professional Employees, one of the

factors is the fact that the United States is the money that goes into developing new technologies

and in testing new drugs and innovative health solutions. While this is a great initiative, many of

the demands for these new drugs and technologies are not cost effective. Another factor that
leads to healthcare’s high cost is thought to be the prevalence of chronic diseases like obesity and

heart disease. This is an example of how intangible things like the American lifestyle has

concrete repercussions on the economy and national spending.

The American Public Health Association stated that the Affordable Care Act was a good

way to reduce this unsustainable spending on healthcare. According to the American Public

Health Association, the Affordable Care Act aided 20 million people in gaining access to

healthcare, and it placed an emphasis on public funded healthcare, so that more money is spent

on preventing chronic diseases like heart disease and obesity rather than treating them, which

would ultimately reduce the total amount spent on healthcare. However, in 2017, most policies

which were encompassed by the Affordable Care Act was repealed by the Trump

Administration. According to Charley E. Willison in the National Institute of Health journal,

congressional republicans targeted the part of the affordable care act which guarantees essential

health benefits (EHBs). By preventing the guarantee of these EHBs, insurers would be able to

create less comprehensive, but cheaper plans which would ultimately reduce a part of the

national spending on healthcare. The current presidential administration has taken a different

approach to reducing the cost of healthcare, and repealing parts of the Affordable Care Act was

only the first step.

The action taken against policies instilled by Obama has led to a lot of misconceptions

about what’s good for the healthcare system and what isn’t. Trump’s administration passed a

new system in place of the Affordable Care Act called the Affordable Health Care Act, and

many republicans or people who support this decision are under the notion that this new act

remodels the whole healthcare system or destroys Obama’s “harmful” policies. In reality the

Affordable Health Care Act makes the provision of essential health benefits optional to states,
giving them the choice to refuse to provide them. Most states, however, still uphold most of what

was outlined in the Affordable Care Act, according to the Charley E. Willison.

Despite the fact that so much money goes into America’s healthcare system, some argue

that the standards set by global and American health organizations are too high, saying that it’s

unethical to raise spending to work towards goals that will never be achieved. According to Nir

Eyal in the American Journal for Public Health, a health report in 2010 called for the prevention

of all health and health care related issues. A movement for patient safety championed their goal

of reducing preventable hospital deaths to zero, and the American Public Health association

made it their goal to make the united states the “healthiest nation” in the world in only one

generation. These are undeniably unrealistic goals, yet Eyal argues that these unrealistic goals

are necessary to improving healthcare systems. Because there’s such a large disparity between

reality and what still needs to be accomplished, a sense of urgency and passion is developed

towards reaching those goals. I believe that the current mindset towards healthcare in the US

doesn’t uphold that same urgency or passion. Rather than providing adequate care for everyone

and anyone, current policies imply that legislators believe that, if you can’t afford healthcare,

you don’t deserve it. An example of which is seen in the Affordable Health Care Act’s attempts

to remove essential health benefits as a guarantee to all citizens. While the health care crisis

affects millions of people, it is only one of the many facets of American public health.

With the rise of unemployment due to COVID-19, homelessness now is even more of an

impending threat than ever before. According to a journal from the American Public Health

Association, the United Nations declared housing as a fundamental human right in 1991. While

America reduced the rate of homelessness by 13% from 2010 to 2018, people who have

extremely low income, classified as 50% of the median income in their area, pay over 50% of
their income towards housing. These conditions make it extremely difficult for people who have

disabling conditions. According to the journal, in 2016, a person with a disability and whose

main income source was Supplemental Security Income had no way to enter the housing market,

meaning they wouldn’t be able to afford a safe or clean rental unit. America is about being

inclusive to all types of people, and any great country should have provisions to allow for

everyone to be able to succeed. While I understand that an income which mainly came from a

government program like Supplemental Security Income won’t be able to afford a typical house,

I still think that people who rely on SSI deserve a clean and safe space to live and get a stable

footing so that they have an opportunity to get a job and increase their income.

Another issue with America’s public health system is its inability to stay prepared for

crises like the one we’re currently experiencing. According to the New York Times, US hospitals

lack resources like masks or gowns to protect their doctors and nurses, and they are running short

on hospital beds to accommodate patients. In addition to this, laboratories also do not have the

resources to test cases quickly, health departments are struggling to track the disease’s spread.

The New York Times states that in the 20th century, when faced with tuberculosis, yellow fever,

and other diseases took the country by storm, researchers and scientists were pushed to their

limits to make cures and find solutions. But the cure of these diseases wasn’t truly all the result

of scientists testing new vaccines, rather from a combination of leadership and policy change

from the united states government which allowed regulations to protect food, air, and water. The

leadership from multiple state governments also helped to reduce the spread of these diseases

and helped to contribute to an “epidemiological transition” as stated by the New York Times.

This transition emphasized change in government policy and promoted the understanding that

controlling these diseases was the responsibility of multiple organizations and people within the
government and within the healthcare system. As time went on and the life expectancy increased

with improving technology, this emphasis on the shared responsibility of public health declined.

According to the New York Times “‘It was like a great forgetting took place,’ Wendy Parmet, a

public health law scholar at Northeastern University, told me. ‘As the memory of epidemics

faded, individual rights became much more important than collective responsibility.’ And as

medicine grew more sophisticated, health began to be seen as purely a personal matter.”

Programs that are vital to a secure public health system experienced funding cuts. Programs that

provide vaccines, tests, and food and water testing were all victims of this. This attempt to save

money put the United States in an extremely vulnerable position when faced with new threats

like the coronavirus, and thousands of lives have undoubtably been lost due to this as well. While

on a public, nationwide scale, America’s public health system is extremely lacking, many argue

that the United States has some of the most specialized and technologically advanced treatments

when compared to other countries.

It's true that the United States is home to some of the most high-end, specialized care in

the world, but what people may not realize is that the money which funds this doesn’t go into

making it more accessible to every American citizen. While America pours in this funding for

new innovative solutions, they neglect spending money on basic systems like testing centers or

hospitals which are more relevant and useful for a larger majority of the American population.

This seems to be a common trend in the American healthcare system. Most of the specialized,

unique care that America funds is only affordable by the rich or economic elite. And the

American emphasis on public health as an individual responsibility rather than a shared one

reflects the lack of spending on the correct parts of america’s health system. In fact, according to

the Trust for America’s health, public health spending when compared to the total spending on
health has been decreasing since the Great Recession. Rapid policy change is needed to divert

funding into public systems and programs.

While it has some unique perks, the United States’ healthcare system has some very

apparent flaws, most notably the large number of people who are still uninsured in addition to

the prevalence of chronic diseases in America despite the fact that America spends the most

GDP on healthcare compared to any other country. While some policies like the Affordable Care

Act played to the notion that a small amount of spending from everyone would decrease the total

spending in the long run, many current policies have tried to repeal or reduce these effects from

previous administrations. In order to achieve change in the system, the public perspective

towards health needs to change rapidly. People should regard health as a necessity, not a luxury.

With social change comes political change, and by being able to find a balance between

innovation, accessibility and affordability, the public health system will be able achieve massive

improvement.
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