This module is about education, the theoretical perspectives on the purpose of schooling and how we learn. Educational inequality and reform are discussed in detail. The aim of this module is to hig

Health Care in the United States

1. American citizens are healthy compared to the rest of the world. However within

the U.S. there are differences in life expectancy, general health, and access to

health care along race, ethnicity, class, and gender classifications.

A. Health and Illness - The U.S. healthcare system is among the most advanced in the

world, but there are still serious problems.

1. There is unequal access to the healthcare based on social class.

2. We have a very narrow and medicalized understanding of healthcare.

3. There is a lack of prevention.

a. Obesity is a major cause of health issues.

b. Environmental factors are not often taken seriously.

B. The Social Organization of Healthcare

1. The United States is one of the few industrialized nations without universal health

care.

a. The 2010 Affordable Care Act will address this.

b. Medicare and Medicaid are treated as political issues.

2. Affordable Care Act

a. Consumer protection for health insurance

b. More affordable insurance for all Americans

c. Better access to care

d. Stronger Medicare program

e. Critics claim it will increase costs.

VII. Health and Inequality

1. Prominent problem areas for U.S. health care

a. Unequal distribution by race, class and gender

b. Unequal distribution of health care by region

c. Inadequate health education of inner-city and rural parents

A. Race and Health Care

1. Non-whites face much worse health outcomes.

2. The health care system in our increasingly diverse society is challenged by the

need to respond to different cultural, racial, and ethnic group orientations, beliefs

and values when delivering health care.

B. Social Class and Health Care

1. Social class affects health and the availability of health services. This is shown in

the different rates of infant mortality (death) rates and disease (morbidity) rates

for different racial and ethnic groups.

2. Social circumstances and environment also affect health in worse ways for the

poor.

C. Gender and Health Care

1. Women live longer than men; older women are more likely than older men to

suffer from stress, obesity, hypertension, and chronic illness.

2. Other health differences reflect environmental and life style differences.

D. Health and Disability

1. The disability rights movement has defined disabled people as a social group with

rights similar to other minority groups in society.

2. The disabled often face a stigma.

3. The Americans with Disabilities Act (ADA) was passed in 1990.

E. Age and Health Care

a. As people age, their healthcare needs change.

b. Medicare is a federal program in place to meet the healthcare needs of the

elderly.

VIII. Theoretical Perspectives of Health Care

A. Functionalist Theory - The health care system has both positive and negative

functions.

1. Positive Function: The system operates to prevent and treat disease;

2. Negative Function: It contributes to disharmony and societal instability.

B. Conflict Theory - Conflict theory stresses the importance of social structural

inequality in society and therefore focuses on restricted access to medical care and the

bureaucratization of the health care system.

C. Symbolic Interaction Theory - Symbolic interactionists focus on how illness,

wellness, and health care are socially constructed.

1. This perspective highlights problems in the health care system, such as the

patronizing and infantilizing of patients, particularly of minorities in emergency

rooms and the failure of male gynecologists to appreciate the discomfort of their

female patients.

IX. Health Care Reform

A. The Cost of Health Care

1. A central element in the U.S. health care system is the fee-for-service principle,

whether in the form of direct payment by the individual or indirect payment by

third parties such as private insurers and government programs (Medicare and

Medicaid).

2. The greatest contributors to skyrocketing health care costs are:

a. the rising costs of hospital care due to the availability of technology,

b. pharmaceutical costs,

c. the rise in fees for the services of physicians, and

d. third-party payments, such as the Medicare program which provides medical

insurance covering primarily hospital costs for persons 65 and older and

Medicaid which provides health insurance for the poor, welfare recipients,

and the disabled.

B. Health Care for All?

1. Antigovernment attitudes, weak labor unions, and racial politics have contributed

to lack of universal health care access in the United States.