Abstract

For many people in the world today, access to health care is unattainable. In the developing (i.e., poor) countries, yearly public expenditure on public health and health care often amounts to less than $10 per person (Pogge 2008). In the U.S. before the Affordable Care Act (ACA) took effect in 2010, estimates placed the number of uninsured individuals at roughly 48 million, with another 60 million underinsured (Centers for Disease Control and Prevention 2013). The passage of the ACA promised to place access to health insurance within the reach of just about every citizen, but the weakening of that Act by the Supreme Court and the refusal on the part of many states to implement the expansion of Medicaid under the Act have left millions without access to affordable insurance. Indeed, roughly half of the uninsured in the U.S. reside in states whose political leaders have refused to extend Medicaid to them (Tavernise and Gebeloff 2013). The promise of universal access thus remains unfulfilled for the foreseeable future.