Recently, an article stated that people in rural areas are underserved when it comes to having sufficient doctors and hospitals to meet their needs. Hospitals and physicians need to meet expenses and show a healthy financial income to permit them to function, and many rural areas have insufficient populations to support their presence. But that doesn't tell the whole story about underserved populations. There are many groups who lack affordable access to health care in both cities and rural areas, and in most cases, that lack of access has nothing to do with whether there are enough doctors and hospitals in the area.
One of the primary determiners of underserved populations is affordability. In these days where COVID-19 has caused vast unemployment, people normally served by an employer's health plan no longer have that coverage. Congress passed the Consolidated Omnibus Budget Reconciliation Act (COBRA) to give workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. However, for most people, that coverage isn't affordable because laid-off employees usually have to pay the entire premium for coverage, including the amount they'd paid as employees plus the amount their employer had contributed up to 102% of the cost to the plan. COBRA is also only available to employees of companies having 20 employees or more, which leaves out many people who had worked for small businesses but were laid off due to loss of business from COVID-19 shutting many small businesses down either for some months or permanently.
Part-time workers are often not eligible for employer-sponsored health coverage, which includes people who had their working hours reduced when businesses were partially closed. This group includes many workers in the hospitality industry – restaurants, hotels, amusement parks, and other tourist attractions. It also includes "gig" workers, musicians and actors who are dependent on theaters, clubs, and restaurants remaining open and as short-term workers are ineligible for employer-sponsored health care.
Contract workers, such as many construction employees are hired for a specific project but are not treated as employees of the construction company but as independent contractors.
The underserved for health care includes all these groups as well as independent workers, such as writers and artists who work for themselves and rely on sales of their creative work for income.
Affordability and access are the two major factors that prevent many individuals and families from having adequate health care either long-term because the nature of their work makes them ineligible for affordable health care or relatively short-term (which may be measured in a year or more) for those who will be able to have employer-sponsored plans when businesses are again hiring.
What is needed for these groups is basic affordable health care for at least the immediate foreseeable future. One potential option for such coverage relies on the newer telehealth plans that allow for virtual doctor visits by phone or video-conference online. These plans don't serve every health need and do not provide coverage for hospital stays and major illnesses and injuries and lab tests, but for most common health needs a virtual visit to a physician can provide a diagnosis remotely without the patient having to go to a doctor's office or an emergency room for an expensive onsite visit. Telehealth combined with a good prescription discount plan can often mean the difference between a family having to go into debt that can't easily be paid and getting immediate care.
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