Question

Focus is on NYC health care system. Describe two challenges that NYC faces in providing equitable health care to all its citizens. Include data indicating the scope of the problem. For one of these challenges, analyze how a specific policy in the Affordable Care Act will help to meet this challenge. Please include references.

Answer 1

New Yorkers face many obstacles to obtaining affordable, quality health care. About 1 million adult New Yorkers are uninsured, another 500,000 have inconsistent coverage, and even more lack a regular provider. Each of these factors places New Yorkers at risk for not receiving regular, needed care and preventive services. In particular, Hispanics, men, and low-income residents are less likely to be insured or have a regular provider, and may, therefore, postpone or forgo services. Even among the insured, variations in covered services can prevent individuals from obtaining appropriate, timely prevention services and treatment.

Regardless of insurance, non-whites, as well as those without a regular provider, obtain care at the emergency department more commonly. This may be a product of several factors, including:

• The geographic distribution of health care facilities and their hours of operation
• The types of payment accepted by health care facilities
• Knowledge of how to access alternative sites
• Cultural preferences
• An individual’s health status Given the difficulty of receiving continuous care and preventive treatments through an emergency department,

this utilization pattern may reinforce existing health disparities.Many of the health conditions facing New Yorkers today, such as hypertension, diabetes, and obesity, are influenced by nutrition, exercise, and other lifestyle factors. Community and health care system characteristics, such as a lack of safe park space or low availability of primary care doctors, may compound these problems. These are usually not remedied by a single medical visit or intervention. Instead, these conditions improve with an ongoing relationship with a provider who can monitor health over time and tailor suggestions and treatment plans to individual circumstances. Regular providers can help ensure quality care with continuous communication and an emphasis on preventive care.Improving health care access for all New Yorkers will require the coordinated efforts of individuals, providers, health plans, policy makers, and community organizations.

so two important challenges in NYC health care sector is

One million adult New Yorkers, about 1 in 6, are presently uninsured. More than 1.2 million adults, or 1 in 5, lack a regular care provider.

• Certain groups of New Yorkers are more likely to be uninsured. Hispanics have the highest rates of being uninsured; 1 in 4 currently lack coverage. Men are more likely to be uninsured than women (21% vs. 13%), and non-whites are more likely to lack coverage than whites.

Unemployed adults are more likely than employed adults to be uninsured (26% vs. 18%), but about two thirds of uninsured New Yorkers are employed (approximately 708,000 of the 1 million uninsured).

• Health care coverage is frequently tied to employment. Unemployed adults have a higher rate of being uninsured than employed persons (26% vs. 18%). However, more than two thirds (68%) of all uninsured adults are employed

The Patient Protection and Affordable Care Act, also the Affordable Care Act (ACA) or colloquially known as ObamaCare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. The Act did not create a U.S. health service, such as the United Kingdom's National Health Service.

The law caused a significant reduction in the number and percentage of people without health insurance. The CDC reported that the percentage of people without health insurance fell from 16.0% in 2010 to 8.9% from January to June 2016. The uninsured rate dropped in every congressional district in the U.S. from 2013 to 2015. The Congressional Budget Office reported in March 2016 that approximately 12 million people were covered by the exchanges (10 million of whom received subsidies to help pay for insurance) and 11 million added to Medicaid. An additional 1 million were covered by PPACA's "Basic Health Program", for a total of 24 million. CBO estimated that PPACA would reduce the net number of uninsured by 22 million in 2016, using a slightly different computation for the above figures totaling PPACA coverage of 26 million, less 4 million for reductions in "employment-based coverage" and "non-group and other coverage.The U.S. Department of Health and Human Services (HHS) estimated that 20.0 million adults (aged 18–64) gained healthcare coverage via PPACA as of February 2016.The Affordable Care Act reduced the percent of Americans between 18 and 64 who were uninsured from 22.3 percent in 2010 to 12.4 percent in 2016. About 21 million more people have coverage ten years after the enactment of the ACA.Ten years after its enactment studies showed that the ACA also had a positive effect on health and caused a reduction in mortality