I Pledge Allegiance to the Healthcare of the United States of America

Being an American, one gets to experience the melting pot of cultures prevalent in almost every city.  We also get freedoms and human rights just for being born on US soil.  One of these rights is that of health care, but America falls victim to dramatic health disparities seen between upper and middle-class Americans, and everyone else.


I understand that health is influenced by many complex factors like genetics, but the best predictor of population health is the outcomes of our lower socioeconomic citizens. When examining the determinants of premature death, be it smoking, environmental exposures, and other social circumstances or assessing health outcomes by measuring amenable mortality, which is “deaths that should not occur in the presence of timely and effective health care,”[1] America should do better.


The United States is the only industrialized country without a comprehensive national health system to cover our residents, yet we spend the most on healthcare – roughly double the average per capita than Western European countries, but do not see better health outcomes as the return for our investment.


Don’t get me wrong; by in large our citizens have one of the longest life expectancies, but compared to France, Germany, and the United Kingdom, there is room for improvement in our health care system. In 2010 a survey was administered that asked adults “how confidant they were in their ability to afford health care if they became seriously ill?  US adults were the most negative about affordability.”[1]  So where to begin?  Well, healthcare reform for universal healthcare that includes: vision, dental, and prescriptions, increases access to primary care, minimizes insurance claim wait times, and ensures equity across all points of access.


I give kudos to the government for Medicare, which has been around since 1966, and is the closest thing to universal access to healthcare for persons 65 and older and younger people with disabilities.  What about everyone else? 


America is in the grips of what will be a glorious, much needed health reform that initiates universal health coverage for ALL Americans and for the first time addresses “health disparities resulting from differences in socioeconomic status.”2 If participants can successfully sign up, we can expect to see improved access to primary care through affordable, preventative measures, and better outcomes for population health.


Long and short, we have to do better, and we will; our Affordable Care Act is a step in the right direction, but we still have a long way to go…starting with fixing the website.



1. C. Schoen, R. Osborn, D. Squires, M. Doty, R. Pierson, S. Applebaum.  (2010) “How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries” Health Affairs, 29.

2. S. Schroeder.  (2007) “we Can Do Better – Improving the Health of the American People” New England Journal of Medicine, 357 


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