Healthcare Challenges: Health Insurance, Homelessness, Innovation

This report analyzes three key challenges in the healthcare sector: health insurance, homelessness, and innovation. The first section examines health insurance in the USA, highlighting the percentage of insured and uninsured individuals, the types of coverage, and the impact of policies like the ACA. The second section focuses on homelessness in metropolitan cities, particularly in the US, discussing the causes, affected populations, and government initiatives. The final section explores healthcare innovation at a global level, emphasizing the role of technology, advancements in medical treatments, and the impact on life expectancy and disease management. The report uses data and statistics to illustrate the current state of these challenges and their potential future implications, drawing on various sources and studies.

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Future Challenges

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Healthcare
Choice 1: Health Insurance (USA)
According to Soete, Gonzalez, Dahlin & Dewulf (2017), health insurance is a product
that covers the surgical and medical expenses of an insured individual. In accordance with
the Current Population Survey Annual Social and Economic Supplement, 27.5 million or
8.5 percent of people in the US did not have health insurance in 2018 and 91.5 percent of
people have health insurance coverage (Cicala, Lieber & Marone,2019). Further, as
compared to 2017, the rate of uninsured people in the US increased from 7.9 percent to 8.5
percent and in between that, people in the US with insurance overage decreased by 0.4
percent (Census,2018). It can be seen from figure 1 that uninsured people increased and the
number of insured people in the US decreased. On the other side from the insured person,
most of the people in the US depend on private plans such as employment-based health
insurance, direct purchase of health insurance and TRICARE. In the US 66.1% of insured
people have an employment-based plan and only 34 % of people depend on public health
insurance plans (Hamming, Henry & Davis,2019).
Figure 1: Type of coverage and change between 2018 and 2019
Source: (Census, 2019)
In the US, most people who are uninsured are under the age of 19. In total 5.5 % of
children below 10 are uninsured in 2018 and from its 7.8% of Children are from below

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poverty, from that 4.6% of children from Asian and Black origin and 18.3% of them are non-
citizen (Niles,2019). It is also highlighted that most uninsured people are from the South
region and from the west region (Figure 2). Moreover, health insurance in the US is a
mandatory thing under the ACA that is “Obamacare”, Americans require to have health
coverage for their families and for themselves. Americans who failed to get insured have to
face a tax penalty. But from effect to 2019, elimination of penalty may lead to a decrease in
the number of health insured or 4 million Americans choose not to have health insurance in
2020 (Niles, 2019). According to WHO, at the global level, 56% of the population has health
insurance and remaining have not insured yet. Hence, the US has a good rate and the
percentage of people who are insured (Seshadri, Strane, Matone & Rubin,2019).
Figure 2: Percentage of Uninsured Children aged below 19
Source: (Seshadri, Strane, Matone & Rubin,2019)

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Choice 2: Homelessness (Metropolitan cities)
Homelessness is a big problem in America and President Trump continued to
dwell on this problem. Mainly these issues are seen in metropolitan cities such as San
Francisco and Los Angeles (Kim & Garcia,2019). In these cities, the situation is terrible as
most of the people are living in highways, streets, and entrances to buildings. According to
the report by the US Department of Urban and Housing development, it is found that nearly
553,000 people on a single night were homeless in the US in 2018 (Henwood &
Padgett,2019) There are top 5 metropolitan cities in the US containing the largest number of
homeless people in 2018 that are; Santa Clara, San Diego, Seattle, Los Angeles, and New
York. The number of people experiencing homelessness in these cities in 2018 was 156,573
people (McCarthy,2020).
Figure 3: Homeless people in Metropolitan cities in the US
Source: (McCarthy,2020).
In 2019, there was a 3 % increase in the one night estimates of people
experiencing homelessness (Henwood & Padgett,2019). This is because of a number of
increase in homeless people in California that was by 21,306 people or by 16.4%. California
has the highest number of homeless people or nine times as other states in the country.
Despite many initiatives taken by the government in America, half a million people still

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shelterless and only 63% of the population of America lives in-home (Henwood &
Padgett,2019)
According to CoC (Continuums of Care) data, considering both unsheltered and
sheltered individuals, New York is a metropolitan area with a high number of homeless
people that is 78,604 (Figure 4). The main causes of homelessness in America are lack of
affordable housing, mental illness, substance abuse, unemployment and poverty (Lee, 2019).
Figure 4: New York has the highest number of homeless people amongst all metropolitan
cities
Source: (Henwood & Padgett,2019)
According to HUD’s reports, Americans with mental illness, domestic violence
survivors and veterans experiencing a higher rate of homelessness. It was found that higher
rent and higher homeless rates are correlated and due to the higher cost of living and less
affordable homes America is facing homelessness as a bigger issue. However, long term
subsidies by the government to empower people to buy their own place on the private market
make a difference and with that as compare to 2010 homeless people decrease in America
(Donaldson & Yentel,2019).
Choice 3: Innovation Healthcare (Global level)
Health care is a sector that requires attention to the global platform because of the
increasing number of diseases and its impact on the population and growth of the world

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economy. The technology is the main reason behind any innovation; some of the innovations
in the healthcare industry are pocket-size ultrasound machines, use of artificial intelligence,
virtual reality in rehabilitation centres and use of robots in heart treatments and surgeries
(Wass, Vimarlund & Ros,2019).
According to Wirtz (2019), innovations in healthcare increase the chances of saving
the lives of most people. Innovation in healthcare changed the way this industry operates.
This improved the quality, accuracy, and efficiency of the healthcare services. The US
government spend $26 billion in healthcare R&D as this helped people to get access to
healthcare services at a lower cost and with best practices. The spending at the global in
innovations in healthcare increased at an annual rate of 5.4% and due to that life expectancy
of people improved from 73.5 % in 2018 to 74.4 percent in 2019 (Weintraub &
McKee,2019). The use of the e-health platform by people helps to bring awareness about
communicable and non-communicable diseases at the global platform, and result in a drop in
a number of AIDS patients, cancer patients, and diabetes. Internet users in the different
regions increased and this also helps to develop the healthcare sector at the global platform.
At last, artificial intelligence transforms health care units as the use of virtual reality is
expected to increase by 20 percent and will become a million-dollar industry in the upcoming
years (Hollick, Black, Reid & McKee,2019).
Figure 5: Healthcare Innovation technology trend at the global platform
Source: (Weintraub & McKee,2019)

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References
Census, US Bureau,2018. Uninsured rate by state: 2008 to 2018. Retrieved From:
https://www.census.gov/library/publications/2019/demo/p60-267.html
Cicala, S., Lieber, E. M., & Marone, V. (2019). Regulating Markups in US Health
Insurance. American Economic Journal: Applied Economics, 11(4), 71-104.
De Soete, W., Jiménez-González, C., Dahlin, P., & Dewulf, J. (2017). Challenges and
recommendations for environmental sustainability assessments of pharmaceutical
products in the healthcare sector. Green Chemistry, 19(15), 3493-3509.
Donaldson, L. P., & Yentel, D. (2019). Affordable Housing and Housing Policy Responses to
Homelessness. In Homelessness Prevention and Intervention in Social Work (pp. 103-
122). Springer, Cham.
Henwood, B. F., & Padgett, D. K. (2019). Homelessness in Los Angeles and New York City:
A Tale of Two Cities. In Homelessness Prevention and Intervention in Social
Work (pp. 171-183). Springer, Cham.
Hollick, R. J., Black, A. J., Reid, D. M., & McKee, L. (2019). Shaping innovation and
coordination of healthcare delivery across boundaries and borders. Journal of Health
Organization and Management.
Lee, D. (2019). Is need enough? The determinants of intergovernmental grants to local
homeless programs. Journal of Urban Affairs, 1-15.
McCarthy, N.,2020. The American cities with the highest homeless populations in 2019.
Retrieved From: https://www.forbes.com/sites/niallmccarthy/2020/01/14/the-
american-cities-with-the-highest-homeless-populations-in-2019-infographic/
Niles, N. J. (2019). Basics of the US health care system. Jones & Bartlett Learning.
Seshadri, R., Strane, D., Matone, M., Ruedisueli, K., & Rubin, D. M. (2019). Families With
TRICARE Report Lower Health Care Quality And Access Compared To Other
Insured And Uninsured Families. Health Affairs, 38(8), 1377-1385.
Wass, S., Vimarlund, V., & Ros, A. (2019). Exploring patients’ perceptions of accessing
electronic health records: Innovation in healthcare. Health informatics journal, 25(1),
203-215.

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Weintraub, P., & McKee, M. (2019). Leadership for innovation in healthcare: an
exploration. International journal of health policy and management, 8(3), 138.
Wirtz, J. (2019). Cost-effective service excellence in healthcare. AMS Review, 9(1-2), 98-104.