Lack of National Health Insurance in the United States Prior to the Affordable Care Act

Seminar Paper 2018 10 Pages

Medicine - Public Health


Table of Contents


Health Insurance Coverage in the United States
U.S Population without Health Insurance Coverage

Access to Healthcare by the Uninsured

Consequences of Lack of Insurance




The United States seems to be experiencing enormous challenges in public healthcare despite the numerous healthcare reforms, which have been enforced to enhance healthcare sustainability. For instance, the current burden of disease caused by obesity and its related health conditions appear to have become a potential healthcare problem because; the U.S Government has been spending colossal amounts of revenue to the healthcare sector to mitigate the issue. Recent healthcare reports indicate that, obesity consumes the highest percentage of healthcare expenditure and, this probably so because; obesity and its related health conditions such as cardiovascular disease, the heart disease and diabetes have been ranked among the top-five leading causes of mortality, in the U.S (Henslin, 2012). In addition, other Non-communicable diseases such as cancer and arthritis are also exerting intense pressure on the U.S healthcare system. Secondly, the lack of national health insurance has emerged to be another significant challenge to the U.S healthcare, leading to the unprecedented surge of healthcare cost and inaccessibility to healthcare services. Healthpac (2013) states, “75% of all health care dollars are spent on patients with one or more chronic conditions, many of which can be prevented, including diabetes, obesity, heart disease, lung disease, high blood pressure, and cancer” (par. 2).

Currently, there are about 48 million uninsured people, in the United States, which translates to 16.3% of the total U.S population (DeNavas-Walt et.al. 2012). It is surprising that the U.S is one of the wealthy industrialized nations in the world but, it does not have a universal healthcare system, which involves national health insurance and, this has led numerous healthcare consequences (Healthpac, 2013). Therefore, this research will give an overview on the lack of national health insurance, in the United States.

Health Insurance Coverage in the United States

In 2010, insurance coverage was found to be 83.7 percent at the national scope, although the U.S Government-funded insurance schemes; Medicare, Medicaid and Children’s Health Insurance Program (CHIP) accounted for only 31.0%. The remaining coverage percentage was provided employment-based and direct-purchase insurance, in which they accounted for 55.3% and 9.8% respectively (Healthpac, 2013). However, healthcare reports indicate that there was a significant decrease of the insured people among the U.S population, in 2011.

In 2011, the total number of the uninsured population was found to have decreased to 48.6 million and, this was equivalent to 15.7 percent. From an analytical perspective, there was a remarkable progress in insurance coverage, in 2010 compared to 2010 in which the total number of the uninsured was 50 million. Consequently, these changes in insurance coverage were reflected on the total number of the insured population, in which it increased from 256.6 million, in 2010 to 260.2 million, in 2011 (DeNavas-Walt et.al. 2012).

Ordinarily, there are different health insurance providers, in the United States, although these insurance providers can be categorized into two broad groups; the U.S Government-funded health insurance and private health insurance. Government-funded health insurance comprises of Medicaid, Medicare, the veteran and children’s health insurance programs and, it provides insurance cover to about 99.5 million people among the insured population (DeNavas-Walt et.al. 2012). On the other hand, private insurance provides insurance cover to the largest number of the insured population, and it has been the leading health insurance provider over past three decades.

In 2011, the number of people who were insured under private health insurance was 197.3 million but, this number seems to have remained constant for the last three years, owing to the introduction of healthcare reforms, which have enhanced enrollment of the public into the Government-funded health insurance programs. As a result, the total number of insured people under the government insurance schemes increased from 31.2%, in 2010 to 32.2% by the end of 2011, and this percentage is believed to have increased further, in 2012 (DeNavas-Walt et.al. 2012).

In regard to the distribution of insurance coverage, the number of the insured people under employment-based health insurance was 170.1 million, in 2011 and, this was equivalent to 55.1 percent of the total percentage of the insured people in the United States. Private health insurance coverage was 63.9%, whereas direct-purchase health insurance accounted for 9.8% by 2011 (DeNavas-Walt et.al. 2012).

On the other hand, government-funded health insurance accounted for 32.2%, in which Medicaid and medicare accounted for 16.5% and 15.2% respectively, whereas military health care insurance program accounted for 4.4% (DeNavas-Walt et.al. 2012).

Abbildung in dieser Leseprobe nicht enthalten

Insurance Coverage in 2011 by Percentage (DeNavas-Walt et.al. 2012)

U.S Population without Health Insurance Coverage

From an epidemiological perspective, the uninsured U.S population can be grouped in different categories with regard to demographic characteristics. Some of the most significant characteristics include family status, age, nativity, residence, economic and disability status.

In regard to family status, the percentage of uninsured families, in 2011, was 14.6%, whereas unrelated subfamilies and unrelated individuals accounted for 28.5% and 20.8% respectively. On races, the total number of uninsured whites was 14.9%, blacks accounted for 19.5% whereas people of Hispanic origin accounted for 30.0%. Whites of non-Hispanic origin alone accounted for 11.1% and, Asians constituted 16.8 percent (DeNavas-Walt et.al. 2012).

On the other hand, classification of the uninsured population in regard to age showed diverse distribution trends. In general, the percentage uninsured population under the age of 65 years, in 2011, was found to be 17.9%, whereas those aged 65 years and above accounted for 1.7% of the total number of the uninsured population. Demographic statistics showed that, individuals belonging to 19-25 and 26-34 age-groups constituted the highest percentage of the uninsured population, accounting for 27.7% and 27.5% respectively. Individuals in the age of 45 to 64 years uninsured population recorded to account for 16.3%, whereas the population aged less than 19 years accounted for 9.7% (DeNavas-Walt et.al. 2012).

In regard to the disability status, the uninsured people with no disability were found to be 21.7%, whereas the disabled people accounted for 16.6%, especially with respect to the age-groups beyond 18 years of age. Consequently, Native Americans accounted for 13.2%, individuals with neutralized citizenship and non-citizens accounted for 19.1% and 44.2% respectively, whereas people who were born in foreign countries living in the U.S accounted for 33.0%, with regard to nativity.



ISBN (eBook)
File size
525 KB
Catalog Number
Institution / College
Egerton University
lack national health insurance united states prior affordable care




Title: Lack of National Health Insurance in the United States Prior to the Affordable Care Act