We know there are many problems with the American healthcare system. Which elements should our system retain? Which elements should it replace? Taking a critical look at the way healthcare works in other countries could give us a wealth of ideas to improve our own system.


Access to health insurance provides protection for Americans across the country.  Health insurance not only minimizes the sudden impacts of a major injury or illness but also promotes preventative care and treatment for injuries and illnesses fostering healthier communities throughout America. The uninsured are often one serious illness or accident away from financial crisis.  When communities are healthy the local economy benefits as well.  


We must work to ensure that we focus on programs, practices, and policies that maximize opportunities to increase access to healthcare.  We must find solutions and address other social determinants of health, such as housing, education, or workforce. We must implement policies and programs at all levels of government that increase community health as well as financial well-being.


One of the most important protections a family or individual can have when facing a medical emergency or the treatment of a chronic illness and expenses that might otherwise require a family to spend long-term savings, sell assets or go into debt. One public program that directly provides assurance that low-income families have insurance is Medicaid. 


All states can elect to expand Medicaid coverage. Expanding income eligibility for Medicaid extends coverage to millions of currently uninsured adults eligible for the program. Thirty-two states and the District of Columbia have already expanded Medicaid eligibility to those with incomes at or below 138% of the federal poverty level.


This can be done on Florida as well.


Over 60 percent of voters in Florida support expansion of medicaid.


States receive credit for expanding Medicaid if coverage eligibility is extended to adults with earnings up to 138% of the federal poverty level (FPL). States may elect to extend coverage even further, lifting the 138% FPL threshold to encompass more low- and moderate-income adults.


  • "The Centers for Medicare and Medicaid Services approved the demonstration project for Orange, Osceola, Seminole, Brevard, Pasco and Pinellas counties. The money will cover mental health and substance abuse treatment for people who are eligible for Medicaid and who have been repeatedly homeless or spent longer than a year living on the streets."

This program, fully supported by the Florida Legislature, is an excellent example of the great work we can do in our communities when we find common ground.




Health starts in our homes, schools, workplaces, neighborhoods, and communities. We know that taking care of ourselves by eating well and staying active, not smoking, getting the recommended immunizations and screening tests, and seeing a doctor when we are sick all influence our health. Our health is also determined in part by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships. The conditions in which we live explain in part why some Americans are healthier than others and why Americans more generally are not as healthy as they could be.

By working to establish policies that positively influence social and economic conditions and those that support changes in individual behavior, we can improve health for large numbers of people in ways that can be sustained over time. Improving the conditions in which we live, learn, work, and play and the quality of our relationships will create a healthier population, society, and workforce.


The Social Determinants of Health topic area within Healthy People 2020 is designed to identify ways to create social and physical environments that promote good health for all. All Americans deserve an equal opportunity to make the choices that lead to good health. But to ensure that all Americans have that opportunity, advances are needed not only in health care but also in fields such as education, childcare, housing, business, law, media, community planning, transportation, and agriculture.


Making these advances involves working together to:


  • Explore how programs, practices, and policies in these areas affect the health of individuals, families, and communities.

  • Establish common goals, complementary roles, and ongoing constructive relationships between the health sector and these areas.

  • Maximize opportunities for collaboration among Federal-, state-, and local-level partners related to social determinants of health.


  • Social norms and attitudes (e.g., discrimination, racism, and distrust of government)

  • Exposure to crime, violence, and social disorder (e.g., presence of trash and lack of cooperation in a community)

  • Socioeconomic conditions (e.g., concentrated poverty and the stressful conditions that accompany it)

  • Residential segregation

  • Language/Literacy

  • Access to mass media and emerging technologies (e.g., cell phones, the Internet, and social media)

  • Culture

  • Availability of resources to meet daily needs (e.g., safe housing and local food markets)

  • Access to educational, economic, and job opportunities

  • Access to health care services

  • Quality of education and job training

  • Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities

  • Transportation options

  • Public safety

  • Social support


  • Natural environment, such as green space (e.g., trees and grass) or weather (e.g., climate change)

  • Built environment, such as buildings, sidewalks, bike lanes, and roads

  • Worksites, schools, and recreational settings

  • Housing and community design

  • Exposure to toxic substances and other physical hazards

  • Physical barriers, especially for people with disabilities

  • Aesthetic elements (e.g., good lighting, trees, and benches)


  • Economic Stability

  • Education

  • Social and Community Context

  • Health and Health Care

  • Neighborhood and Built Environment


Health insurance provides important protection for a household’s assets by reducing expenses incurred from a medical emergency or the treatment of a chronic illness that might otherwise require a family to spend down long-term savings, sell off assets or go into debt. In addition, because health insurance coverage encourages people to seek preventative care and treatment for injuries and illnesses, it minimizes the impact a major injury or illness would otherwise have on an individual’s ability to earn income. The uninsured are often one serious illness or accident away from financial crisis.


While the Affordable Care Act (ACA) significantly reduced the uninsured rate, millions of Americans still lack coverage, including the low-income individuals who fall into the coverage gap as a result of some states' decisions not to expand Medicaid under ACA. Further, the repeal of the ACA's individual mandate - and the Congress' attempts to repeal the ACA outright - have sown the seeds of a rise in uninsured rates in every state.


15.9% of people in Florida are uninsured.