Unit 7: Science and Technology

THE U.S. HEALTH CARE SYSTEM “The health care system and the United States as a society stand as proxy for each other” Rosemary Stevens (Health Care in the 1960s) What can we learn about the U.S. Society from the Health Care System?

HEALTH CARE IN AMERICA 1.COST 2.EQUITY 3.DISTRIBUTION THE UNINSURED –(16% of the population) –Access THE UNDERINSURED THE INSURED –(Problems with the U.S. Health Insurance system)

1. COST RISING COST –$ 1,072/person spent on health care in 1980 –$7,498/person spent on health care by 2007 –$12,782/person estimated for 2016 –$247.3 million spent on health care needs in 1980 –$1,092.4 billion spent on health care needs in 1997 –$2.4 trillion spent in 2009 (estimates) –$4.1 trillion estimated for 2016 Consumer Price Index –(i)Hospital and related services, (ii) Outpatient hospital services, and (iii) Prescription drugs.

2. EQUITY NOT EVERYONE HAS EQUAL ACCESS TO QUALITY MEDICAL SERVICES. THE UNINSURED TWO-TRACK SYSTEM PROBLEMS WITH THE PUBLIC TRACK SYSTEM

Apart from whatever esthetic differences such a pattern might imply, the fact remains that the poor- and to an even greater extent, the near-poor, who lack even the limited access to private physicians Medicaid provides-have no continuing relationship with individual physicians. This means that access to other services resides in the hands of bureaucratic strangers. The poor and near-poor are more likely to be admitted to hospitals through emergency rooms than a scheduled doctor’s appointment, and more likely to be more sicker when they are admitted. They are more likely to be treated by a foreign medical graduate or resident physician still in training (or both) than a fully trained American graduate. Their drug prescription are written by physicians with little personal knowledge and understanding of the patients’ characteristics and problems, and they are likely to be seen on a follow-up visit by a physician other than the one who treated them originally.

3. DISTRIBUTION OF SERVICES 1.Health care services are not evenly distributed geographically 2.Primary Physicians care or Family Doctors underrepresented among physicians. Close proximity to cultural, educational, and recreational facilities. Proximity to extensive technological resources in the form of well-equipped hospitals, clinics, and laboratories staffed with well-trained personnel. More financially rewarding medical practices are those in large cities.

MALDISTRIBUTION OF PHYSICIANS IN THE U.S. PREDOMINANTLY RURAL VS URBAN STATES –1 out of 20 counties does not have a single doctor –More than half of all counties do not have a pediatrician URBAN LOCALITIES –Private doctors seldom found in poor nonwhite neighborhoods –Areas with low levels of education and income have fewer doctors. OVERSPECIALIZATION (e.g. Family Physicians) –In 1959 there were 95, 980 –In 1980 there were 60, 049 –In 1997 there were 78, 258 –In 2009 there were 100,000

DOCTORS’ STARTING SALARIES (2007 Averages) Radiology: $350,000 Anesthesiology: $275,000 General surgery: $220,000 Otolaryngology: $220,000 Emergency: $178,000 Neurology: $177,500 Psychiatry: $160,000 Internal medicine: $135,000 Family medicine: $130,000 Pediatrics: $125,000 Source: The Journal of the American Medical Association

CONTRADICTION IN THE U.S. HEALTH CARE SYSTEM 1.Advancements in evidence-based medicine and medical technology vs problems of inadequate and inaccessible medical care Shift from acute to chronic diseases (leading causes of death) 2.The two Americas: Young, affluent, middle class Poor, socially invisible, city dwellers 3.Social Inequality in medicine Patterns of stratification and segregation by class and race Of all the forms of inequality, injustice in health care is the most shocking and humane.”- Martin Luther King, Jr. 4.Emphasis on cure rather than prevention (most over- medicated country in the world)

Sociology, 13 h Edition by John Macionis Copyright © 2010 Pearson Education, Inc. All rights reserved. Leading Causes of Death in the United States, 1900 and 2006

HEALTH CARE REFORM SENATE BILL –Includes a government-run public health insurance option. –Requires individuals to buy health insurance, with a penalty for noncompliance. –Prevents insurance companies from denying coverage for pre-existing conditions. –Will cover 94% of the uninsured population –More security and stability for the insured Puts limits on out of pocket expenses, mandates routine checkup and preventive care

THE U.S. HEALTH CARE SYSTEM “The health care system and the United States as a society stand as proxy for each other” Rosemary Stevens (Health Care in the 1960s) What can we learn about the U.S. Society from the Health Care System? –Land of opportunity where many live in abject poverty and deprivation –Advances is medicine and technology vs disease, hunger, drudgery, unemployment –The two Americas (the haves vs the have nots) 1.Is distance learning equal opportunity for the global community? 2.Have technological and medical advances could bring an end to hunger, disease, drudgery and unemployment in the U.S.?