Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Health Economics


Thomas Colletti, DHSc, PA-C


The United States healthcare system is the most expensive in the world. It is also the only developed nation to not have universal healthcare for its citizens. Not having insurance has been correlated with poor health outcomes and financial consequences. Despite the increased coverage after the implementation of the Patient Protection and Affordable Care Act of 2010, there is still 8.8% of the population, or 28.3 million people, in the U.S. without health insurance in 2018. The uninsured are typically households with a full-time worker, making less than 400% of the federal poverty level, 26-34 years old with less education, some of whom may qualify for tax credits but need to purchase insurance, and they are saying it is too expensive. The high cost of healthcare is inextricably linked to the inability of some Americans to afford health insurance. While some causes of increased expenditure are unavoidable, healthcare reform has the potential to decrease costs which would decrease the barrier to universal coverage.


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