The U.S. Department of Health and Human Services (HHS) stated that "The health of the individual is almost inseparable from the health of the larger community and that the health of every community in every state and territory determines the overall health status of the nation." It has now become clear that our economy in terms of healthcare insurance is not healthy; the healthcare system in the United States spends 1 cent of every healthcare dollar in the prevention of diseases and 99 cents on the cure. Our healthcare system is the most expensive and yet arguably among the least cost effective in the developed world. Despite the highest per person health care spending among the Organization for Economic Cooperation and Development (OECD) nations, the United States still ranks below many along a variety of health indicators (Aguirre, 55). In a complicated health care system where the rules are many and economic forces drive both structure and function, the needs of vulnerable populations in terms of quality and access to care inevitably suffer due to economic incentive and rationalized care.
The U.S. health care financing system is based on the premise that most workingage Americans (and their dependents) receive health insurance through their employment. A large proportion of citizens who are not covered through their employment are only partially covered by charity care, municipal health care facilities, or governmentsponsored programs such as Medicaid and Medicare. Both of these assumptions break down in the case of the uninsured or the "working poor", approximately 45 million Americans or 15.6 % of the population that tends to be clustered in jobs that are low paying, less stable, more hazardous, and less likely to have fringe benefits such as health care coverage. This lack of coverage is a serious problem for all, resulting in reduced access to medical services, restricted access to primary and preventive care, and
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