On The Future of Health Care

The future state of health care in this country, including the scope of such coverage, the cost of coverage and, more importantly, whether or not such coverage is even available, is perhaps the most highly debated social issue of our time. With the advent of what many have termed “ObamaCare”, it seems that widespread, affordable coverage is finally available to all except the most extremely impoverished. Still, others assert that such programs are unconstitutional or socialistic, and that democratic societies such as what comprise the United States should employ better solutions in solving the health care dilemma. Healthcare has never been indicative of widespread equitable coverage, rather providing excellent care to some while withholding care entirely from others. Still, in understanding the current debate, it is important to understand the history associated with healthcare reform, as well as the effects that poverty, class, and socioeconomic status have on one’s level of coverage.

Healthcare, like so many other social issues that preceded it, was slow in its progression through the process of gaining national recognition. As noted in the text, most social issues have four distinct stages of development, during which such issues go from being relatively unrecognized to becoming fully publicized matters of society (Leon-Guerrero, 2013, p. 12). The four stages of development of social issues include transformation, legitimization, conflict, and finally, breaking the boundaries that confine the dilemma.

In the United States, the first step in this process known as the transformation process began in the mid 1800’s. It was during this time that Americans began to express a desire for a comprehensive health care coverage. The second stage, or the legitimization process, is generally defined as having begun sometime in the years from 1900-1940, with groups such as the American Association of Labor Legislation and even the American Medical Association initiating the process of institutionalizing healthcare coverage. Many would argue that stage three, the conflict stage, defined by Leon-Guerrero as a time when the efforts associated with the legitimization process are unable to effectively address the problem, began as early as the 1970’s when those with life-threatening health concerns had difficulties attaining the necessary medical treatment from health care providers (2013, p. 12). This third stage has effectively dictated the ensuing decades’ progress on healthcare reform, focusing on whether the industry’s sole priority is best as one of regulation or as one of competition (Moran, 2005, p. 1415). Finally, the fourth stage in the creation of social issues is what happens when advocates feel that they can no longer operate within the bounds of their current society, and they therefore seek alternate routes via which to solve the problem. Here, an argument might be made which asserts that the recent legislation surrounding “ObamaCare” represents the epitome of this fourth stage for national healthcare, as it completely redefines the scope of coverage and ultimately identifies regulation as the better of the aforementioned priorities.

Still, it is important to understand that the widespread concern surrounding adequate healthcare coverage for every American is largely contingent on levels of poverty. If America consisted only of the middle and upper classes, it is unlikely that any debate as to the efficacy of healthcare would ever surface in mainstream media. However, because the United States is home to both rich and poor alike, the importance of affordable healthcare coverage cannot be overlooked. As noted in the text, Leon-Guerrero reports that in 2008, the government counted nearly 40 million Americans as living in poverty (Leon-Guerrero, 2013, p. 42). Characterized as a function of income with respect to dependents, it is no wonder how a family of four, two parents and two children, earning less than $22,000 per year would struggle to secure for themselves the necessary health coverage. Moreover, the staggering percentage of the American population identified as impoverished is a statistic that further sheds light on the weight given to this social issue’s resolution.

Tangential to understanding the impacts of poverty is an understanding of the social classes that characterize society and how such social structures affect one’s ability to attain the necessary levels of healthcare coverage. Author Anna Leon-Guerrero states that those who occupy lower levels on the socioeconomic ladder possess proportionally lower levels of health than those above them (2013, p. 264), citing studies conducted all over the world confirming this link between social status and health. Sociologists have suggested that this disparity often stems from the kind of work available to those on lower rungs of the socioeconomic ladder—positions that are inherently more hazardous or which characterize exposure to conditions detrimental to one’s well-being—citing that health issues might directly correlate with such individual’s occupations (2013, p. 265). Also worth mentioning is the fact that because such individuals often have access to only the lowest paying jobs, they often work disproportionally longer hours than those in better paying occupations, and as such rarely have the time to engage in physically beneficial activities such as resistance exercise or even recreational sports. Strangely, it is this group of individuals, who comprise lower socioeconomic levels, who experience greater difficulties in the healthcare arena than those whose need is far less dire. One study from Gorey et al. investigated the relief provided to lower socioeconomically classed women diagnosed with breast cancer and found that, in America, the healthcare system is disastrously biased towards those who are more financially well-off (2013, p. 13). The fact that healthcare coverage may elude those suffering from medical ailments as life threatening as cancer is appalling in and of itself, but compounding such calamities is the notion that, if so diagnosed, the chances of survival increase proportionally to one’s annual income. Financial security should in no way dictate the terms of treatment for those suffering from medical afflictions, and a simple examination of the functionalist perspective should illustrate the fallacies of such policies.

In examining the issue of healthcare from a functionalist perspective, there are a number of considerations that necessitate further analysis. Foremost among the implications of such sociological perspectives is the notion that there are some who, more so than others, deserve to experience the prosperity and success that has always characterized the opportunity in America. By extension, then, functionalist theorists assert that a country’s impoverished have only themselves to blame for their current predicament and would likely contend that those who cannot foot the bill themselves for medical coverage need only elevate themselves to a higher level on the functionalist’s societal ladder. By procuring a higher position on the social ladder, thus increasing the value of one’s contributions to society, functionalists contend that society would reward such an individual with higher compensation for more valued services, thus affording such individuals the opportunity to provide healthcare coverage both for themselves as well as for their family (Leon-Guerrero, 2013, p. 47). Unfortunately, this take on society is not very useful as it fails to take into consideration certain of the dynamics associated with individuals falling into poverty. Namely, in suggesting that individuals merely elevate themselves on the social ladder, proponents fail to recognize the necessary education often requisite for such graduations to occur. However, if individuals have neither the financial wherewithal nor the time to pursue higher levels of education, than climbing the rungs of the social ladder often represents an infeasible solution. Moreover, the black-and-white, take it or leave mentality of the functionalist perspective represents a dated, less compassionate regard for society than what has come to prevail in the 21st century. Taken in the aggregate, it seems clear that a functionalist perspective yields little in the way of useful contributions towards more comprehensive healthcare coverage.

While a functionalist perspective may not hold a solution to the ongoing dilemma in healthcare, the fix that eventually sets aright the preceding decades’ mishaps will likely comprise more than the mere adoption of a singular sociological paradigm. Solving the disparity in healthcare coverage among the financially secure and the impoverished entails a number of reformations across a multitude of sectors. Perhaps most important in the fight to equitably reshape healthcare coverage is to introduce legislative reforms that not only stipulate mandatory coverage for insurance providers but which also promote better employment and educational opportunities.

Because those lower on the socioeconomic ladder are often too financially burdened to pursue higher education, their health, and the health of their extended family often suffers. For this reason, more comprehensive legislation bolstering the educational opportunities provided to those in lower tier income brackets represents a pivotal step towards ameliorating the socioeconomic divide between those with money and those without. Because higher paying jobs are often correlated with higher education, improving the accessibility of higher education is a logical extension in the approach to remedy the current healthcare deficit plaguing those in lower income brackets. By promoting the availability of higher education to those with less income, the health care dilemma undergoes an attack of it’s root cause by giving individuals the opportunity to better their education, thus providing the potential to attain better paying jobs and, by extension, increasing the chances that such individuals can provide more comprehensive health coverage for themselves and their families. Unfortunately, while a solution of this magnitude might hold the potential for bettering the healthcare coverage of those lower on the socioeconomic ladder, such a solution is still predicated on the ideology that healthcare coverage will remain expensive and that, absent a significant financial foundation on which to stand, such coverage will remain outside the realm of possibility.

A better approach to solving the healthcare dilemma in this country should focus on reducing the costs of healthcare while still promoting an atmosphere conducive to free market competition. While the recommendations from Kellis, Rumberger and Bartells advocating a nationwide standard level of coverage are great in terms of equalizing the extent to which families are provided care irrespective of their socioeconomic status, such solutions are inadequate with regards to preserving the free market competition of economies like the United States’ (2010, p. 292). Conversely, while those who suggest that the health care market remain unchanged are clearly in support of keeping the sector competitive, such propositions cannot in any way improve the current inequality in healthcare. In consideration of the effects of unaltered competition, claims asserting that marketplace competition in the healthcare sector empowers consumers and contributes to the accessibility of healthcare are difficult to take seriously (Hyman, 2007, p. 73). Such conclusions seem particularly disconcerting when one considers that the recent healthcare legislation termed “ObamaCare” actually arose as a result of the need for affordable healthcare not available in a market full of competitive insurance companies. Until legislation arises that effectively addresses the need for affordable health coverage while maintaining the competitive nature of American markets, it is likely that such disparities in coverage are likely to persist among the financially secure and the financially destitute.

The current state of healthcare in the United States is without question one of the most widely disputed social issues of the 21st century. While those higher up the socioeconomic ladder enjoy comprehensive coverage, those whose income is at or near the poverty level often live with little or no coverage for themselves or their family. The notion that one’s income should in any way correlate to his or her ability to provide health insurance for loved ones is an absurd notion to be sure, and may even indicate discrimination on behalf of large, conglomerate healthcare providers. Nonetheless, healthcare reformation must incorporate the needs of society as well as cater to the free market economy that made countries like America great.

References

Gorey, K. M., Luginaah, I. N., Holowaty, E. J., Guangyong, Z., Hamm, C., & Balagurusamy, M. K. (2013). Mediation of the effects of living in extremely poor neighborhoods by health insurance: breast cancer care and survival in California, 1996 to 2011. International Journal For Equity In Health, 12(1), 6-20. doi:10.1186/1475-9276-12-6

Hyman, D. (2007). Improving Healthcare: A Dose of Competition (Vol. 9). Springer.

Kellis, D. S., Rumberger, J. S., & Bartels, B. (2010). Healthcare Reform and the Hospital Industry: What Can We Expect?. Journal Of Healthcare Management, 55(4), 283-297.

Leon-Guerrero, A. (2013). Social Problems: Community, Policy, Social Action. (4th ed.). Sage Publications, Los Angeles, CA

Moran, D. W. (2005). Whence And Whither Health Insurance? A Revisionist History. Health Affairs, 24(6), 1415-1425. doi:10.1377/hlthaff.24.6.1415