HEALTHCARE IN THE UNITED STATES

ACCESS ISSUES IN HEALTH CARE

unexpected healthcare bill, would they be able to pay the bill. Fifty-nine percent said they would be able to pay the bill at the time of service, whereas 34% said they would not and would need to use a credit card, borrow money, or not be able to pay it at all. The results of this 2017 poll is depicted in Figure 8.4.

Figure 8.4: About One-Third of Individuals with ESI say They Would Not be Able to Pay an Unexpected $500 Medical Bill

Source: Kaiser Family Foundation

Attribution: Kaiser Family Foundation

License: © Kaiser Family Foundation. Used with permission.

For those with public health insurance (Medicare or Medicaid), Medicaid does not pay hospitals or physicians the same rate as Medicare. Medicare does not pay the same as most private health insurance plans. Original Medicare does not provide the supplemental benefits that Medicare Advantage does. Medicare Part D has cost limits for medications. Therefore, one may have insurance, but the insurance may not be enough to obtain needed services or may not pay sufficiently to prevent exorbitant costs to the individual. Moreover, healthcare providers cannot depend on third parties to reliably provide any, or even some, form of payments (Elrod & Fortenberry, 2017).

8.5.3 Not Having a “Usual” Place to Obtain Healthcare

One of the questions on the 2018 National Health Interview Survey (NHIS) asked whether interviewees (249,456 individuals 18 years and older) had a usual place of healthcare (Cohen et al., 2019). Having a usual place of obtaining healthcare often involves having an easily accessible location with appropriate services provided and development of a rapport with caregivers. Interview results indicate that among adults aged 18 and over, 85% have a usual place of healthcare. The most often-cited place for healthcare was a doctor’s office or HMO (69.7%),

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