For many Americans, health insurance is a medical necessity and without it, many Americans would be left with medical bills that are too expensive to pay. Most people would agree that without some form of health insurance, purchasing prescription drugs would not be possible. Many Americans, such as those with diabetes cannot survive without certain prescription medications.

The upper middle and upper class citizens are generally able to afford health care, often times without needing health insurance and lower class Americans are able to obtain health care through organizations such as Medicaid, which usually pay for over-all incurred medical expenses.

So who did we leave out of this mix of American society? The lower middle class Americans who fall between the cracks of obtaining the quality health care they need.

Why cant many lower middle class Americans afford quality health care? To provide an adequate answer to this question, we first need to define the American class system in terms of socioeconomics and its relationship to health insurance and the general health care system.

The working class or middle class is defined as a group of people who make up about 33% (the majority) of the population and bring home an average yearly income of $30K to $50K per year. The upper middle class also averages $55K to about $155K annually. Compare those figures to the upper class, which make up only 2% of the population and contribute $155K to billions per year. (Source: http://www.alamedasoc-tripod.com/handouts/soc2/Slides_Pt_2_Soc2.doc). One can clearly see that there is a large economic gap between the classes and that income in part plays a significant role as to why many lower middle class Americans cannot afford quality health insurance or health care.

Another contributing factor as to why many working class Americans cannot afford health care is due to the continued rising costs of over-all health care. Total health care costs, including insurance premiums have gone up drastically since 2001 and many employers are sticking the additional associated health insurance costs to their employees.

While many working class Americans are presented with health insurance opportunities, (usually through employment) many cannot afford the high monthly and sometimes yearly premiums associated with a health insurance plan. Other working class citizens are able to afford the insurance premiums, but are unable to take advantage of a health care plan because such a large percentage of their monthly or yearly income is set aside to pay for health insurance. This leaves many Americans left with the dilemma of making a choice between basic necessities such as paying for a monthly mortgage note, groceries or health insurance.

In essence, American society has created and contributed to a highly flawed health care system that caters to the rich, cares for the poor, yet excludes the largest percentage of its population. As a society, we need to develop new ways of coping with the changes and rising costs in our health care system and develop a method that allows the lower middle class to receive the quality health care they deserve without going penniless.

This may require a change in the American healthcare system itself or quite possibly, a change within government medical aid. Either way, one thing is certain: Without the basic necessities of life, including quality healthcare, the working class over time is sure to crumble.