Healthcare Delayed Is Healthcare Denied

The U.S. healthcare system is fragmented and split between public and private insurance companies. Thus, health coverage for patients varies based on factors such as age, income, and employment status.

Because of a lack of organized communication between doctors and insurance providers, patients find themselves caught between referrals. According to research, 35% of Medicare beneficiaries saw 5 or more physicians for the same ailment.

Referrals to specialists are a common practice in medicine, as differing opinions help clarify a patient’s ailment. But the number of referrals we see now correlates to higher rates of medical errors reported, unnecessary hospitalizations, and longer wait times in between.

This inaccessibility of medical aid highlights one core problem: care delayed is care denied. In a developed country such as the U.S., this is concerning. Let’s discuss how we got here and where the future of medicine is headed. Today we’re talking about:

• The Factors Causing Delays In Healthcare
• Why Healthcare Delays Translate Into Inaccessibility
• Tackling Wait Times In Healthcare

Why Are Americans Delaying Their Healthcare Needs?

The U.S. is known for many advancements in the modern world, but healthcare is one field it lags in. Compared to other developed countries, the U.S. ranked poorly in almost every aspect, such as health equity, patient outcomes, and administrative efficiency.

But healthcare access ranked the worst. The U.S. has the lowest number of practicing physicians per 1000 people, with Americans barely visiting a doctor more than four times a year. We also lack hospital beds, with 2.8 hospital beds per 1000 people.

When a country lacks the resources to provide healthcare for its people, wait times between physician visits grow. Both affordability and availability of healthcare have faced significant hurdles here, even though our country generously funds the sector. Or funded it at any rate. It is estimated that the U.S. healthcare budget crossed $4.9 trillion in 2023, accounting for 17.6% of the national GDP.

And yet, the healthcare sector is underperforming. Despite a healthcare budget that could be the fifth-largest total GDP in the world, we have some of the worst patient outcomes in the world, with the highest maternal and infant mortality rates. Americans tend to have a lower life expectancy at birth and the highest number of individuals with multiple chronic illnesses. Even our general health is at a decline, with an obesity percentage twice that of the OECD average of 18%.

Most Americans don’t qualify for any public healthcare mandate. Instead, they rely on employer-provided insurance for their health coverage.

Around 26 million Americans are left entirely uninsured, which forces them to pay out of pocket for basic healthcare services such as doctor visits and medical tests. With how costly these services can be in the U.S., patients often have to wait and delay a hospital visit until they have the money to cover the expenses.

Even if they do save up enough to finally get an appointment, the wait times are enormous. Depending on the region and specialty they are referred to, 26% of surveyed patients state they had to wait for more than 2 months before they were matched to a healthcare provider in their area.

Sometimes, that day never comes. Patients can’t access healthcare when a medical issue arises because they simply don’t have the finances to do so. Hence, their healthcare is delayed and ultimately denied.

Inaccessible Healthcare: Who is at Fault?

There isn’t any one perpetrator we could point to as the reason patients are facing delays in accessing healthcare. But we can examine some issues at root.

Affordability is one of the biggest contributors to health inaccessibility in the U.S. The U.S. spends twice as much per person on healthcare compared to other OECD countries, but healthcare itself isn’t expanding at the same rate. Instead, that money is mostly used to curb the administrative costs of both insurance and providers rather than for the actual treatment options.

Administrative costs are an excessive expense that take up 30% of the budget allocated to healthcare. Meanwhile, prescription drugs and medical machinery combined only makeup 15%, sometimes even less than that.

When wages for healthcare providers are secondary to bureaucratic costs, doctors are left underpaid and overworked. This trend has left the medical fraternity reeling, which leads us to our next symptom: the physician shortage.

Physicians were already scarce in the U.S., with rural areas going through the worst of it. But this shortage has only gotten worse over time, with many states sounding the alarm on a looming primary healthcare crisis. It is estimated that the U.S. will be short of 86,000 physicians by 2036.

This, combined with fewer doctors entering the workforce everywhere, means the overall number of doctors per capita will decrease as time goes by, extending patient wait times. The overloaded system also decreases the quality of care received, with 64% of patients admitting they felt unheard by their healthcare providers and decided not to go for follow-up visits.

Sociological and environmental factors also hinder patients. Even if they can afford healthcare, many Americans don’t have the time or means to schedule a visit to their local general physician.

65 million people live in rural areas across America, often in zones that are considered healthcare deserts. To get to a healthcare or Medicare provider, they have to travel a great distance. Not only does scheduling conflict with their jobs and responsibilities, but traveling itself is the second biggest reason why patients delay visiting the doctor.

While medical innovation has made great strides, it has also increased the complexity of care and reimbursement processes. An aging population with greater medical needs finds it hard to keep up with a constantly evolving system, which leads to a higher risk of scheduling errors.

Reimbursement is a hassle because payments have decreased over time, which has caused an increase in the number of providers who refuse to take in Medicaid patients. Even if a patient does find a physician that accepts them, they have to wait for pre-approval from their providers before any medical aid can be given to them, therefore prolonging wait times even more.

Healthcare Access For All: Is It Possible?

The longer healthcare distribution is delayed, the longer a patient remains sick. And yet, the solution is fairly straightforward.

Like other countries in the OECD, the U.S. can greatly benefit from a single-payer healthcare system that covers its citizens universally. If the healthcare system could expand insurance coverage, such as the Affordable Care Act, it could help take care of those uninsured individuals who slip through the cracks and have to delay their medical needs.

Making healthcare affordable would also mean bringing down out-of-pocket costs. This could include slashing down the prices for prescription drugs and making sure drug prices are controlled across the board so they remain accessible for all.

Focusing on a healthcare system that is more value-based rather than quantity-based would help streamline patient processing times. This would not only lead to faster appointment scheduling but also improve medical aid in general.

We already saw the success of telemedicine during the Pandemic, as it allowed people in healthcare deserts to still access healthcare. A bigger push towards telemedicine becoming more mainstream would also help lessen wait times between patients.

Healthcare in the U.S. faces many blockades and these delays in accessing medical help are quickly becoming a permanent fixture for many Americans, which lowers the country’s overall health standards.

As a country that spearheaded some of the biggest medical innovations of the last century, our healthcare system needs a more streamlined approach so that everyone can get the level of care they require without delay.

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