The US Healthcare Issues - Essay Example

Healthcare Barack Obama, the first African-American President in the history of the United s, was ushered in on a wave of promise and a desire to enact thorough changes to the United States in a variety of economic, social and political realms. Inheriting an economic crisis with international ramifications, a seemingly never ending war in Iraq and a healthcare system desperately in need of reform, President’s Obama’s attempts at completely overhauling healthcare in the United States have recently landed his administration in hot water. Accordingly, his attempts at healthcare reform have arguably been the most controversial aspects of his early presidency. As a result of the controversy surrounding the changes currently being proposed by the President of the United States, the issue of healthcare in America is particularly timely and relevant. Seeking to understand healthcare from an issue-based perspective and attempting a holistic analysis, this essay will compare and contrast the medical model of healthcare with the social model of health. Following this we will debate which model is the most important to health today giving examples as to why this might be. Theories of Healthcare In the United States, health insurance coverage ensures that basic healthcare can be accessed by all. Individual comprehensive health insurance plans depend on an one’s age, employment status, residency, and race/ethnicity. Medicare is a federal government funded insurance program for disabled young adults, persons above the age of 65, and those with permanent disabilities who become eligible for Social Security. A racial difference in coverage among Medicare beneficiaries has also been found to influence difference in supplemental care. Most individuals rely on private healthcare plans for the coverage that they need and the Obama administration is seeking to implement a single payer government system of healthcare as part of his reform package as opposed to market-based reform. Decried by detractors as “socialism”, Obama’s plan proposes that the government become more actively involved in healthcare provision and argues that the reform will cost a total of $1 trillion USD. Seeking to address the issues at stake, the following will provide a concise overview of theories of healthcare in America, as well as around the world, today (Smedley et al. 2003; Reuters, 2009). There are two important theoretical models of healthcare which will be discussed in this analysis. The first is the medical model of healthcare and it represents the traditional model of healthcare and health provision. Generally-speaking, the medical model includes a problem, diagnosis and treatment for an ailment. The medical model is practiced in the United States and throughout the Western world and represents pathology and the study of disease. Through the medical model of healthcare, a disease is diagnosed by a physician, treatment is prescribed and hopefully the ailment disappears. The physical presence of symptoms is an important component of the medical model of healthcare since it allows for a diagnosis replete with a proposed treatment. Alternatively, the social model of health explores both individuals and the social population in determining our conception of health. According to this theoretical paradigm, improved health can be improved by looking at the key environmental and social aspects of what constitutes positive health. This is a theoretical model which has recently gained credence due to its emphasis on social determinants of health. Seeking to explore the health status of African-Americans using the social model of health, this essay will argue that the latter theoretical paradigm is the most relevant in a modern context because it gives us a holistic vantage point through which we can witness health and demographic challenges (Smedley et al, 2003). The Social Health Model in Context Today, one in three Americans identify themselves as Hispanic, Native American, Asian American, African- American or Pacific Islander. Accordingly, it is predicted that by 2050, more than half of the American population will be self-identified minorities. Over the last 50 years, the United States has made efforts to ensure the improvement of healthcare access for all Americans. In the early 1960s, the United States established policies aimed at expanding the access to healthcare for all citizens. These programs did result in expanding access to healthcare for low-income families, people with disabilities and the poor through Medicare, Medicaid and the 1964 Civil Rights Act. Despite these positive changes, disparities in healthcare continue to exist for minority populations in the United States. For a country which came into existence based on the premise of universal equality, the United States has, from a health-perspective, ignored some of the very principals under which it was founded (Gans, 1995). More than 20 years ago in 1985, the United States Department of Health and Human Services released a milestone report on racial health disparities in the United States entitled, “Secretary’s Task Force Report on Black and Minority Health.” Revealing significant gaps in the health status among Americans of diverse racial and ethnic groups, this report was the first of its kind. This was also the first national report to document the health disparities of racial populations in the United States. Despite attempts at addressing these issues, health issues among minority populations continue to persist (DHSS Report of the Secretarys Task Force on Black and Minority Health, 1986). Today, a number of studies have shown that minority populations have higher death rates and rates of diseases such as cancer, HIV/AIDS, and cardiovascular disorders. These studies represent the social model of health and data collected from independent studies over the years have concluded that African-Americans have the worst health outcomes when compared to other minority populations in America. For example, African-Americans have the higher cancer rates and the survival rate for African-American women with breast cancer is half that of white females. Such disparities are generally ignored by the U.S. healthcare system because the system does not fully address the environmental causal factors which result in health inewualities. Not addressing the factors which lead to health disparities furthers the bridge between the minority and the majority population in relation to health statuses (Fiscella and Williams, 2004). There has been increasing interest in racial and ethnic disparities and the use of preventive health services to counteract these disparities. Since the Healthy People 2010 Initiative, there have been many attempts to develop interventions that decrease health inequities. Some of these interventions include cultural competency programs, community-based outreach for minority populations, and advance targeted screenings. In an important study conducted by the Kaiser Family Foundation in 1999 entitled Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences, researchers assessed people’s perceptions about racial biases in the US healthcare system. Accordingly, this was the first national research study to study these trend. The aim of this studies was an attempt to understand the differences that occur in the health system by virtue of race (Kaiser Family Foundation, 1999; (Gans, 1995). The Federal Healthy People 2010 Initiative, led by the U.S. Department of Health and Human Services, has set important health improvement goals for the United States. These include goals to eliminate health disparities among ethnic minority populations. The Healthy People 2010 Initiative has been very instrumental in increasing awareness about health inequities across the country. As a reult, various attempts have been made to develop interventions that have been designed to decrease the occurrence of health inequalities in healthcare. These interventions include cultural competency initiatives, health literacy programs aimed at enhancing patient-provider communications, and group-specific outreach activities (Fiscella, et al., 2004). Concluding Remarks The United States has the most advanced medical care in the world. However, medical care in the U.S. is very expensive and unevenly distributed. African-Americans in the United States continue to face a variety of health-related challenges including high rates of general mortality, infant mortality, cancer, hypertension and HIV and AIDS, among others. While personal bias and racism can influence health inequities, research has shown that societal and institutional racism has also accounted for some of these disparities (Maynard et al., 1986). Without the social model of health, one would not be able to understand the particular health challenges facing specific groups such as African-Americans. While the medical model of health remains relevant, in the 21st century the social model of health remains the most important in today’s world. References Fiscella, Kevin and Williams, David R. 2004. Health Disparities Based on Socioeconomic Inequities: Implications for Urban Health Care. Academic Medicine 79(12):1139-1147. Gans, Herbert. 1995. The War Against the Poor: The Underclass and Poverty Policy. New York: BasicBooks. Kaiser Family Foundation. 1999. Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences. Menlo Park, CA: The Henry J. Kaiser Family Foundation. Kaiser Family Foundation. 2007. Key Facts: Race, Ethnicity and Medical Care, Update. Menlo Park, CA: The Henry J. Kaiser Family Foundation. Obama vows to pass healthcare reform. 2009. Reuters. Wed Aug 5, 2009. Last Accessed August 23 2009 http://www.reuters.com/article/topNews/idUSTRE56M0HE20090805 Smedley, Brian D., Adrienne Y. Stith, and Alan R. Nelson (editors). 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: The National Academies Press. U.S. Department of Health and Human Services. 2000. Healthy People 2000. Washington, DC. U.S. Department of Health and Human Services. 2010. Healthy People 2010. Washington, DC. U.S. Department of Health and Human Services. 1986. Report of the Secretarys Task Force on Black and Minority Health. Washington, DC: U.S. Department of Health and Human Services (1):63-86. References Health Insurance Reform. (2009). The White House. Last Accessed August 14 2009 http://www.whitehouse.gov/realitycheck/ Smedley, B. D., A. Y. Stith, & A. R. Nelson (editors). 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: The National Academies Press. Read More