There is great diversity in people who can be members of vulnerable populations. Elderly people, low-income people, non-white people, women, and LGBT folks are a few examples of vulnerable populations, and the reasons they may not be able to access care are as numerous as they are. Many years ago, cultural competence in health care became a major topic in health care research. Today, we have seen cultural competence evolve into population-based health care, whose approach is a bit more comprehensive. However, this approach has also been criticized as potentially harmful, in that it could obscure the individual needs of members of these populations (Kelley, 2012). Today, lack of access to insurance is a concern for many vulnerable populations, which only compounds the problems patients face when interacting with care providers who lack a basic understanding of cultural competence.

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A study conducted in 2014 found that, for many patients seeking primary care providers and appointments, their insurance status was the biggest factor in determining their ability to schedule an appointment on both sides of the reception desk (Rhodes et al., 2014). Further, many new technologies are being tested in population-based health care, many of which focus on patients with complex physical and cultural needs (West 2016)

Any effective policy that could potentially support competitive approaches would have to employ measures to ensure that, no matter the price point charged by the care provider, the insurer would be required to pay all the charges aside from a set copay to be paid by the insured. This copay needs to be either income-based, or at a set level for all people. This way, no patient would be affected by price fluctuations in health care, placing burden on the providers and insurance companies. An incentive program would also help hold providers and insurers accountable.

  • Kelley, T. (May 2012). ‘Population-Based,’ Meet ‘Patient-Centered.’ Retrieved from
  • Rhodes, K.V.; Kenney G.M.; Friedman, A.B.; Saloner, B.; Lawson, C.C.; Chearo, D.; Wissoker D.; and Polsky, D.. (2014) Primary care access for new patients on the eve of health care reform. JAMA Internal Medicine, 174(6):861-9. doi: 10.1001/jamainternmed.2014.20.
  • West, J. (2016 July). Population-Based Accountable Care in the National Health Service. Retrieved from