Examining Health Care Organizations from a Sociological Perspective

Social problems continuously arise from social interaction or social structure. The connection between “social problems and social solutions” will enable people to understand the problems that other segments of the population face (Leon-Guerrero, 2013, p. 23). Upon thorough examination of the privatized health care system, people in a more secure economic position will be less apprehensive to pay into a system that grants health care to less privileged individuals. To address this social problem, organizations have been developed to implement policies and programs to help combat this ongoing challenge.

Managed Care Organizations (MCOs) consist of companies and other entities that provide Medicaid benefits for those who qualify for the program. The managed care system is under contract with the designated state, which allows people the opportunity to voluntarily enroll in Medicaid. According to the National Library of Medicine, MCO’s “reduce unnecessary health care costs through a variety of mechanism including economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases” (NCBI, 1990, p. 1). By 2010, MCOs were responsible for providing Medicaid benefits for approximately 53% of beneficiaries in 35 states in addition to the DC and Puerto Rico (Leon-Guerrero, 2013, p. 1). The Medicaid program provides health care coverage to millions of pregnant women, families, and children thereby allowing them to receive medical services, prescription medication, and preventative care (Managed Care, 2013, p. 1). Families who would otherwise not be able to afford medical care will receive vaccinations and quality health care.

The feminist perspective underlying health care as a social problem is based on two types of programs including masculine programs and feminine programs. Medicaid is categorized as a feminine program lead by the MCOs that grant women and children access to medical services that they would not have been able to afford otherwise thereby promoting health and well-being (Leon-Guerrero, 2013, p. 51). From a functionalist perspective, the lack of adequate health care seems to be beneficial for at least one segment of the population otherwise it would not exist (Leon-Guerrero, 2013, p. 13). Health care issues involving the uninsured and underinsured and the lack of adequate health care services have emerged from the sociological perspective of an interactionist. Since social problems typically emerge from definitions, health care challenges become a social problem due to how the issue is defined and labeled (Leon-Guerrero, 2013, p. 16). Minority groups often seek assistance from organizations that support Medicaid programs. People who qualify for Medicaid must meet certain criteria, one of which is based on social class, which is directly linked to racial and ethnic differences. This accounts for approximately 43% of non-Hispanic Whites and African Americans comprising minority groups with the lowest socioeconomic status (Leon-Guerrero, 2013, p. 35). As a result, lower socioeconomic status is significant for a lower life expectancy and diminished health and well-being.

A few organizations provide a platform for developing and maintaining the health and well-being of millions of people within our nation, while other organizations assist with the provision of health care on an international level. Multilateral international health care organizations receive funding from various governmental and non-governmental sources, which allocate funds to cover the cost of health care in developing countries (IMVA, 2010, p. 3). The premier multilateral international health care organization is the World Health Organization (WHO) and the organizations’ goal entails “the attainment by all peoples of the highest possible level of health” (IMVA, 2010, p. 3). WHO addresses the social problem regarding the inadequate administration of proper health care in developing countries by coordinating international health-related activities and providing technical assistance to different countries. WHO “disseminates health information, promotes research, provides training in international health, collects and analyzes epidemiologic data, and develops systems for monitoring and evaluating health programs” (IMVA, 2010, p.3). Hence, WHO uses its resources to create and maintain a new set of health care standards that will soon become the norm in developing countries. As a result, people will not only have access to health care but will be provided a higher quality of health care in different countries.

Conflict theorists strongly believe that health patterns are correlated with inequalities due to ethnic and racial disparities, gender and varying views on interests, power, and values that apply to international health care organizations (Leon-Guerrero, 2013, p. 260). The inequality within the health care sector in less developed countries highlight a higher incidence of disease, illness, and other medical conditions. From a functionalist perspective, doctors and other health care professionals play a quintessential role in diagnosing and managing illnesses. It is therefore imperative for organizations in different countries, such as WHO to offer medical services including all available treatment options. A functionalist viewpoint helps to exemplify the outcome associated with societal structure as it correlates to the development and maintenance of a certain level of social order (Leon-Guerrero, 2013, p. 260). People in less developed countries have a lower social order due to economic disparities. The relationship between a lower socioeconomic status and incidence of disease is directly linked to education. Research studies have revealed that higher education levels help people practice a healthier lifestyle and make better choices regarding their health (Leon-Guerrero, 2013, p. 266). However, since people in developing counties often lack a proper education their health status reflects inequality.

References

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

Managed care. (2013). Centers for Medicare and Medicaid Services. Retrieved from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Delivery-systems/Managed-Care/Managed-Care.html

Managed care programs. (1990). National Center for Biotechnology Information (NCBI). Retrieved from http://www.ncbi.nlm.nih.gov/mesh?term=managed%20care

The major international health organizations. (2010). IMVA. Retrieved from http://www.imva. org/Pages/orgfrm.htm