1. Social and economic inequality- Poor healthcare
Look at these two logos. What do you think each of them are? What do they represent?
Clue: they are linked to health.

2. Today we will… Success Criteria
Identify groups who face health inequalities in the USA.
Examine why some groups are more likely to suffer health related inequalities than others
Success Criteria
I will be able to explain the health inequalities that exist in the USA.
I will be able to describe what Medicaid and Medicare are.
I will be able to identify Obama’s planned reform.

3. What health issues exist in the USA?
Health Insurance
The USA is a capitalist country where the Government is less likely to interfere in healthcare. The USA does not have a Government paid healthcare system like the NHS in the UK.
In the USA people have to take out private health insurance for themselves or their families.
Private health insurance companies (or HMOs- Health Maintenance Organisations) such as Blue Cross Blue Shield, Cigna, Humana and Kaiser Permanente, provide healthcare and run it as a business – for profit.
What health issues exist in the USA?

4. Why are there Inequalities?
In the first half of 2017 (Jan-June) it was estimated that 9% of the population – 28.8 million people – were still uninsured.
It is estimated that 26.9% of people earning less than $25,000 a year were uninsured.
Many people may be unemployed and therefore do not get cover from an employer. Not all employers provide insurance.

5. Percentage of adults aged 18–64 who were uninsured
2010 – June 2017
Although there have been clear improvements in the number of people getting health insurance in the past 7 years it is clear that inequality still exists in healthcare regarding race: Hispanics and African Americans are still more likely to be uninsured.

6. Task
Make a mind map:
Individually, write down the consequences of not having health insurance. List as many as possible
Answer:
Lack of routine care – health problems may not be detected before they become serious.
Reluctance to use medical services – not getting medical care until things become serious.
People with no insurance are more likely to die before seeking medical help than an insured person.
Less access to new technology which could save your life.
Debt which can lead to poverty.

7. Think-Pair-Share Thinking about what you have learned so far:
Individually come up with as many reasons how inequality in other areas of life may make Black and Hispanic Americans more likely to face health inequalities? – 1 min
Now share with your shoulder partner – 1 min
Now share with the rest of your group – 1 min
You might want to run through some answers on the board for this.

8. Obesity: 30% of Blacks and 25% of Hispanics are obese.
Blacks and Hispanics are 3 times more likely to have no medical insurance cover.
Black and Hispanic children are less likely to visit the doctor. 7.3 million children without insurance
African American women are more likely to die in child-birth than other groups.
Black and Hispanics face greater health problems. There is also a very high infant mortality rate.
Health Problems Facing Black and Hispanic Americans.
Drug and gang related problems mean Blacks and Hispanics are more likely to die from guns and drugs.
Linked to drug abuse is the incidence of AIDS. This is on the increase.
Obesity: 30% of Blacks and 25% of Hispanics are obese.

9. Health inequalities
List some possible reasons as to why ethnic minorities are more likely to suffer from health inequalities?

10. Government Healthcare Schemes
Medicare
Medicaid
provides health cover for:
people age 65 or older,
people under 65 with certain disabilities.
In 2010, Medicare covered about 48 million Americans. One in five is a member of an ethnic minority group.
Most people will have paid monthly contributions throughout their working lives to cover the scheme.
3 main parts:
Hospital insurance
Medical insurance (GP, Physio,etc.)
Prescription drug coverage.
Provides healthcare for low-income adults.
Children receive health coverage through Medicaid and the state Children’s Health Insurance Program (CHIP).
More than 58 million Americans rely on Medicaid services.
These people could not afford adequate healthcare without Medicaid.

11. Government Healthcare Schemes
Neither of these programmes will cover the cost of ALL treatments
There are some free hospitals which rely on voluntary donations from churches and other charities as well as getting some funding from the government. They treat the people that nobody else will, but are often poorly staffed and short of high quality resources.
Those who are in full-time, long-term work are more likely to have better access to health care than those who are unemployed or in part-time work. Again, ethnic minorities are less likely to be in full time employment than whites so are at greater risk.

12. The Affordable Care Act
In 2010, President Obama and Congress signed the Affordable Care Act into law. Opponents nicknamed the act ‘Obamacare’.
We will now watch a clip about the Affordable Care Act.
You should answer the following questions as you watch:
Under the act, what four ways can people be covered?
What benefits might people see?
What happens if people don’t buy insurance?
Where does the money come from to fund the scheme?
This is another good clip to watch.

13. Obamacare Major features of the new law include:
young adults will be covered by their family's insurance plan until they turn 26.
more help for people who can't afford insurance.
insurance companies cannot deny coverage to people with pre-existing conditions.
People not covered by insurance by 2014 were required to get it or pay a fine. In 2014, uninsured people faced a fine of $95 or 1% of their income.

14. Why might these people oppose the Affordable
Opposition
Those who opposed the bill
challenged it in the Supreme Court
claiming it was ‘unconstitutional’.
In June 2012, the Supreme Court
ruled that the Affordable Care
Act was constitutional.
In 2013, people who make more than $200,000 have to pay an additional 0.9 % tax for the Medicare Hospital Insurance.
In 2014, businesses with more than 50 employees will have to insure their workers or pay a $2,000 fine per uninsured worker.
Why might these people oppose the Affordable
Care Act?

15. I can I can explain the health inequalities that exist in the USA.
I can describe what Medicaid and Medicare are.
I can identify Obama’s planned reform.