UIC ED 135

1. Child and Adolescent
Health
ED 135
Session 21

2. General Discussion
Healthcare policy is more relevant than ever right now.
• In what ways has the COVID-19 (Coronavirus) outbreak
influenced your thoughts on healthcare policy?
• In what ways have you seen recent healthcare debates (e.g.,
Medicare for All vs. Insurance) play out?
• Has healthcare influenced your decisions during the
outbreak?
• What are your general thoughts?
• How are you?

3. Think about this throughout class:
Access to Healthcare
• Availability: Does the service exist?
• Cultural acceptability: Is there a fit between the cultural belief systems
and languages of the client and the provider?
• Convenience: Does the client have transportation to the service, and
can the client access the service at a convenient time?
• Affordability: Can the client pay for the service, or does the client have
private or public insurance to cover the cost?
How do you think access may vary for different groups of people?
In different contexts?

4. Healthcare in the U.S.
• No universal coverage
• Privatized
• Fragmented
• Expensive
• Insurance***
• In 2017, nationally, 5% of kids under 18 are uninsured
while in IL we have 3% uninsured. (kff.org)
• The ACA attempted to curtail some of these issues

5. Insurance is not the same
as healthcare
Health insurance is a system of profit; ultimately
insurers’ goal is to make money, not to care for sick
people

6. Affordable Care Act
• What do you know about the ACA?
• Our most recent health care policy; President Obama’s signature policy
• Sought to address some issues with insurance
• Prior to the ACA, 1 in 7 Americans were uninsured
• Originally intended to include a public option but this did not pass
• ACA supports a competitive marketplace
• Expanded coverage, including pre-existing conditions
• Uninsured rates, premium growth, and overall spending decreased
• As we saw from Kimmick et al., youth in certain Latinx heritage groups were less likely to be
covered even after ACA implementation—disproportionate coverage

7. The Basics of the American System

8. How does the current system relate to:
Availability
Cultural acceptability
Affordability
Convenience

9. Free Market Capitalism and Health
Insurance
• Our health insurance system is meant to be a free market
 Focuses on health as individual rather than community good
• Several reasons why this is not possible:
 People needing care often can’t make informed decisions—not the same as choosing
bread at the store
 People are often desperate
 Paperwork is confusing
 People (and doctors) may not know the costs up front
 Not everyone pays their health costs
 Some employers do, meaning not everyone would think to price shop
 Emergency rooms can’t turn people away
 Someone ends up paying for “free” services, meaning prices increase
 It is difficult to establish new hospitals to compete in marketplace
 Or even to become a doctor

10. Capitalism and COVID-19

11. Barriers to Access—Insurance Gaps
and Medical Deserts

12. What are some of the issues the videos
present?
Think about…
Availability
Cultural acceptability
Affordability
Convenience

13. A Remedy? Medicare for All
• What do you know about Medicare for All?
• One of Bernie Sanders’ key policy initiatives
• Single, national health program covering everyone in the U.S.
• Healthcare is not only individual good but also public good
• No more marketplace; government sets rates
• No more insurance
• Taxes would increase but individuals would no longer pay premiums or co-pays
• Similar to other countries’ systems
• Sees healthcare as a right—no longer tied to job or income
• Universal coverage is meant to provide healthcare rather than disaster care
Interesting: Go to BernieTax.com to see how much Medicare for All would cost for you.

14. Increasing Access to Healthcare for
Youth
• Access to healthcare is a protective factor
• A way to pay for care
• Eliminating non-financial barriers
• Organize services to coordinate more effectively
• Access to care interrupts chain of risk
• Having a usual source of care/medical home increases likelihood of receiving care
• Delivery models that make care accessible
 School-based
 Convenient hours
 Support services
 Confidentiality
 Cultural competence

15. Increasing Access to Care—School-
based Care

16. Let’s Discuss
How does a free market health insurance system relate to
access to healthcare?
How does a single-payer system relate to access?
Outside of large-scale policies, how else could we increase
access to healthcare for youth?
Access:
Availability
Cultural acceptability
Affordability
Convenience