Health Care Inequality

The Sociological Imagination and Health Care “Whether or not you are healthy, or can be healthy, depends on a lot of factors beyond your control…In other words, your health depends on where you fit into the larger society…[and the] global, economic scheme” (Dollars and Sense 2001:2) Access to nutritious food and health care Ability to minimize stress level Living in a non-hazardous area

Health Care Woes How many advanced industrialized nations do not have a nationalized (“socialized”) health care system? What are some of the main problems associated with the American Health Care System? Do you have positive or negative experiences?

Problems in American Health Care Inadequate Health Insurance Coverage The High Cost of Health Care U.S. World Rankings Unequal access to health care The politics of Health Reform and influence of Private Industry

Inadequate Health Insurance Coverage 2010: 50 Million Americans Uninsured 700,000 bankruptcies a year due to medical bills How many bankruptcies occur per year due to med bills in France? Germany? Japan? Britain? Why do many individuals, both single individuals in their 20’s and entire families with working adults, not get health insurance coverage?

The High Costs of Health Care In 2009, Americans spent $2.5 trillion on health care. 17.3% of the GDP This is more than any other modern nation. Why is this the case?

The High Costs of Health Care System is driven by profit. System is inefficient. Many physicians practice defensive medicine. Overuse of Specialists Prescription Drug Costs Unregulated drug costs

U.S World Rankings The U.S. ranks 47th in average life expectancy. While the U.S. spends 50% more per capita on health care than any other country: The U.S. ranks 47th in average life expectancy. The U.S. ranks last among 23 wealthy countries in its infant mortality rate. The U.S. ranks 54th out of 191 countries in terms of the fairness of its health care system. The World Health Organization ranked the U.S. 37th out of 191 countries in Overall Health Care (From Eitzen and Baca, Social Problems (2012))

Unequal Access to Health Care Social Class The poor are more likely to suffer from certain types of diseases and illnesses. The poor are more likely to receive inferior medical service. The poor are less likely to use preventive medicine. Medicaid helps, yet it is often the working poor and their families who do not qualify

Unequal Access to Health Care Race Life expectancy Infant mortality Maternal mortality Prenatal care Low birth weight Cancer and other diseases From Eitzen and Baca, Social Problems (2012)

Unequal Access to Health Care Gender Women have significant health advantages over men. For what reasons do women live longer than men? …Yet women have been left out of medical research. Research has traditionally excluded women Women are less likely to have health insurance than men. The feminization of poverty Pink collar jobs Negative effects of divorce From Eitzen and Baca, Social Problems (2012)

U.S. Health Care Reform The U.S. is the only country in the industrialized world that does not guarantee health care to its citizens. Health care is rationed in United States on the ability to pay In all other industrialized nations there is a mechanism for guaranteeing health care to all citizens. Many industrialized nations provide national health care, or Universal health care, which is also known as socialized medicine

Reforming the Health Care System In 1912, Theodore Roosevelt proposed a national health insurance plan, and since then, many presidential administrations have sought health care for all citizens In 2009, the majority (61%) of U.S. adults was in favor of the government guaranteeing health coverage to all citizens, even if it meant higher taxes.

Application: Canada’s Health Care System Federal proposal-The National Health Insurance Act-Expand Medicare to every U.S. resident (2009) Creates a single payer health care system-a tax financed public insurance program that replaces private insurance companies National health insurance card for all citizens-covers all medical services with no co- payments or deductibles and would see doctor of choice.

What are the primary barriers to reforming the system?

Barriers to Reform The Insurance Industry is in great opposition to reform Interest groups have spent hundreds of millions on televisions ads, lobbying, and campaign contributions to combat against reforms. (1.5 million recently went to the chairman of the Senate Finance Committee) In 2009 there were 3,098 health-sector lobbyists. Reconstruction of the social problem using misinformation and the media-Critical Constructionism

Barriers to Reform The Politics of Health Reform-Partisan issues Government should be involved in the health care system (Democrats). The marketplace should dictate the health care system (Republicans).

Reforming the Health Care System The Obama Plan Everyone must have insurance. Government will subsidize those with low income. Individuals may keep their current plan. Private plans will compete for business. Individuals cannot be denied for a preexisting medical condition. Millions uninsured will become insured.

Problems with Obamacare Anti-Injunction act: Tax or penalty? People want to sue government for imposing tax that they see as improper/or penalty because they opt not to buy product Individual mandate Opponents argue that congress cannot force someone to enter a marketplace or require him or her to buy a product Expansion of Medicaid to individuals over the poverty line States required to pay in and some are not happy

Reforming the Health Care System Obamacare is not socialism. A public option was not included; health care is a mostly private system. Although not perfect, it is a historic achievement. How might a critical constructionist view the Obama Reforms and the way ObamaCare was created? Should public anger over problems with reform be directed at President Obama?