One of the major topics of interest among voters is health care, according to Politco. The basis of a health care system is to keep people alive, and with the current system people have had the difficult decision of getting treatment for their health or paying their rent for a place to live. Health care is such a controversial issue because the United States spends $9,403 per capita, more than any other nation, and the United States life expectancy is 76 years for females and 81 years for males, according to the World Health Organization.

Some of the biggest challenges that patients face within the health care system are the costs of medication and even if a person has insurance, the price of the co-pay could still be too expensive to afford. Another challenge patients face is the access they have to health care services. This is why many people wait to get help until the last possible minute.

“Prices of medication have increased over time, and this causes a lot of my patients to not be able to afford the medicine they need,” said Jennifer Gilbert, a doctor who specializes in diabetes, endocrinology and metabolism at Nebraska Medicine.

“I would say the biggest problems with the health care system is that it is very expensive for the patient. I think the biggest challenges in our health care system are related to cost of medications, particularly insulin and diabetes medications, those prices have really increased over time, so they can have a lot of trouble affording them,” Gilbert said. “Also, a lot of people that have insurance coverage have co-pays, and deductibles that are still too high. So, even with insurance they have trouble affording the medications they need.”

Access to health care impacts one’s overall physical, social and mental health status and quality of life, according to the Office of Disease Prevention and Health Promotion. Under the current health care exchanges established by the Affordable Care Act, undocumented immigrants are not allowed to be covered by Medicaid or Medicare, according to the Center for Immigration Studies.

The cost of medication and access to health care services can come into play for many individuals especially if they are undocumented. In Marshalltown, Iowa, there are three main health care facilities; McFarland Clinic, Unity Point Medical Clinic and Primary Healthcare. Marshalltown has a very high population of undocumented immigrants. Of the three health care facilities in Marshalltown, Primary Healthcare will treat anyone regardless of documentation or insurance.

Marshalltown is just under an hour away from Ames; however, Ames also has a Primary Healthcare facility. Anyone can receive any of the services that Primary Healthcare provide. If undocumented patients need any of these specialty services, they would need to go on the Volunteer Physicians’ Network (VPN) located in Des Moines. This is where physicians do work for free, but only by the offerings of what they have available at the time. This can cause a lot of patients to spend years on the waiting list before they get access to care.

There’s a position at Primary Health Care called the health benefits specialist that is basically considered the financial adviser, said Susan Vititoe, director of the Marshalltown Primary Health Care Clinic.

“We have three health benefits specialists here in the clinic. When a patient comes in, if they’re homeless or they’re living out of their car, they would come in and provide any income information they have,” Vititoe said. “Based upon that we have a formula that is used and that determines how much it is going to cost for them. Homeless people generally have zero, payment for cost for any type of health care that we see here in the clinic.”