Health Care for Marginalized Groups - Essay Example

Health Care for Marginalized Groups Task: Health Care for Marginalized Groups Healthcare for marginalized of the America’s society has created tension and debate over a considerable period. These marginalized persons include Hispanics, the homeless, migrants, the disabled, gays, Native Americans, and immigrants among others. However, this analytical paper is going to discuss the overall healthcare policies influencing the marginalized especially the immigrants. This will involve the investigation of whether appropriate services of healthcare have been offered to such persons by the government and look into the necessary government policies that protect this group among others (Fowler, 1998). Additionally, this analytical essay aims at weighing both the strengths and faultiness of such policies in terms of ensuring that immigrants are under a proper health care from the government. In this aspect, the paper intends to analyze the various techniques the government is using to serve such persons. For example, the use of appropriate language in addressing the immigrants i.e. by using translators, equality of service in all health care facilities to enhance both race relations and patriotism. Furthermore, these health care services should aim at upholding the respective culture of immigrants. The government should also seek the opinion of immigrants about the health care services they offer and respond timely to their feedbacks (Simich, 2009). In as much as the government is investing significantly in the health care system thus positively affecting the lives of its citizens, their efforts often end up unnoticed in certain groups within the country’s population, especially among the marginalized. Marginalization of health care for immigrants Marginalized groups consist of individuals who are underprivileged in the society such as African-Americans and immigrants. Marginalization, therefore, is the process of exclusion, prevention, or even ignoring certain persons from attaining equal education, finding a job, enjoying social services such as housing and health care privileges, and integrating as equal members of the society. This discrimination is always done on an economic or political perspective to render such persons powerless before the state (Barusch, 2008). On this aspect, marginalized groups are people affected by the marginalization situation, in terms services and unequal representation in the society. Thus, in our case, I have decided to critically, analyze immigrants, in America and the health care services they receive from the government. Several reasons lie behind the situation faced by immigrants. For instance, the existing health disparities in America in terms of providing equal health care services to all its citizens has always been alarming. In this aspect, health disparities are classified into two, the health and healthcare disparities. The former involves inequities and dissimilarities between two or more persons in their health results. Additionally, it further looks at the prevalence, the diagnosis, quality of treatment offered, mortality rate, screening, and life expectancy among others. This also involves the cost of healthcare by the immigrants. For example, the cost includes the involvement insurance, Medicare and Medicaid, access to health care and managed care among others. Alternatively, healthcare disparities entail the dissimilarities in among immigrants in terms healthcare coverage, access, quality of care, preventive measures and treatment services (Finkel, 2001). Various factors contribute to the existing marginalization in the United States (US). For instance, most of these immigrants such as the Hispanics work in deplorable conditions, which predispose them to poor health. In the effort to receive treatments, they seek medical intervention from substandard facilities where they receive poor medical care from health authorities because the lack insurance or money. In addition, sources confirm that new immigrants commonly use their health services in small portions. In addition to the aforementioned reasons, cultural, political, and administrative huddles also afflict the immigrant in their quest for better health care services. Moreover, America has an Act of 1996 (PRWORA), which limits privileges from the federal, state, and local service to new immigrants. This Act has affected women and children immigrants in offering them schooling services, welfare, and medical services (Simich, 2009). This marginalization has spread to the children of these immigrants despite the health coverage funded by the government. Additionally, PRWORA permits for the provision of emergency services and immunizations on discount for immigrant children. According to Evan Charney, in his book, children of immigrants and nonnative youths are three times vulnerable to poor health care services when compared to children and youth belonging to US parents. This is caused by the deficiency of health insurance coverage due to its expensive charges and the need for an employer cover. The author adds that, even for children with parents who have full time jobs and from immigrant families have less chances of being insured as compared with those born in US. In this aspect, according to various studies, Charney quotes the Hispanic children as the most exposed group of immigrant families to miss the health insurance. However, despite the setbacks facing immigrants, there is the Medicaid programme that decreases the risk of the uninsured among the immigrant children and youth. This programme provides coverage to one among four immigrant children obtaining their health care coverage. Additionally, the state provides storefront clinics and mobile vans, which offers health-screening, immunizations, and referrals of immigrants at risk of treatable diseases. Most of these immigrants are found in distant areas along the US-Mexico border. Alternatively, according to Lu Ann Day, in her book, the government is still not providing appropriate health care to new immigrants. The author points stringent requirement that is imposed upon new immigrants to give evidence of their citizenship or being a permanent resident in order to receive health care service. Therefore, due to this factor, new immigrants who are afraid of detection and eventual deportation refuse to ask for health care. In other cases, the author explicates that health care facilities offer inadequate or fail to provide accommodation to sick immigrants. Similarly, there is the lack of bilingual translators to help the heath care attendants in conducting effective communication with sick immigrants. Additionally, the writer mentions legislation such as Proposed 187 of California passed in 1994 that grants inadequate access to publicly funded health care services for new immigrants such as Medicaid (Weissman & Rosenburg, 2006).  Furthermore, with the passing of this legislation, there is control by the state to limit social services to the new immigrants. The congress is also trying to reduce the entitlement programs such Medicaid that caters for these vulnerable persons due to the rising cost. Policies developed about health care for immigrants There have been various policies created and executed by state about health care to assist immigrants attain adequate health care. For instance, the government has provided adult members of most immigrant families with dual-parent households and employment. Additionally, the state has improved the minimum wage to help these families to afford better health care services. Similarly, the government offers child-care subsidies and health care to advance the economic condition of the immigrants. Furthermore, there has been the expansion by the state of the Earned Income Tax Credit and TANF (temporary assistance for needy families) that aims at providing economic security for these marginalized persons. Apart from the child-care subsidies and employment, there is a reduction of restrictive policies in terms of eligibility conditions and call for all US citizens to respect one another. Policy makers in government have been enticing skilled and trained immigrants to enter the country to build the economy (Chen & Jackson, 2010). Furthermore, due to the need for trained and skillful personnel, the state now focuses on education and training policies especially for the offspring of non-natives. On the perspective of reforming the education system, the policy makers have invested in transforming English to a Second Language thus the introduction of programs such as the (ESL) programs, strategies such as bi-lingual education and early education programs such as Head Start. In addition to the above policies, many states also use Health Care Financing Administration (HCFA) waivers to enlarge Medicaid coverage to a vulnerable group such as immigrant (Agic, 2003). This state-supported program aims at ensuring the new immigrants especially women and children can access better medical services. Similarly, a majority of the immigrants are categorized as Limited English Proficient (LEP) thus given extra-assistance in receiving public services especially the ones that needs adequate communication. This, in extension, means that immigrants often face tremendous difficulties in reading, writing down, comprehending, or achieving excellent interaction at a social level. This has hence led to the requirement of bilingual or multilingual personnel who can understand the immigrants’ language or other methods of communications, when they seek for health care services. Furthermore, the state requires translated materials and the services of an interpreter in the facilitation of access to health care to immigrants with poor communication. Lack of such significant services can result to misdiagnosis, patient dissatisfaction, and miscommunication among others between the providers and the immigrants thus poor medical interventions. This, thus, may leave most immigrants unhealthy and in poor living condition. The government also has the power to institute Medicaid and Child Health Insurance Plan (CHIP) programs that grant benefits to a new immigrant for a 5-year period (Agic, 2003). Then there has been the HIPAA Act of 1996 that intends to offer an extensive therapeutic coverage for both the native and new immigrants, who find their way and settle in the US (Agic, 2003). This Act entails the granting of Medical Savings Accounts (MSA) that raises tax deductions concerned with health insurance premiums for the new working immigrants. Eventually, the savings will be used to provide immigrants with adequate healthcare with the assistance of insurance companies thus improving their basic health conditions. Strengths and Weaknesses of the Policies There are several strengths and flaws of the above-mentioned policies for new immigrants, depending on one’s perspective. In terms of strength, for instance, reforms in health policy have come with tremendous reforms in the direction of more transparent immigration policies at the federal stage to tackle the health care concerns of the new immigrants. The US senate has also made a proposal to new immigrants on legal ways of becoming a US citizen. This is through registration at an immigration office of the US, and paying fine for the offence of illegal entry into the country (Weissman & Rosenburg, 2006). Additionally, the new immigrant policies has a guarantee of securing employment to be able to afford better health care services by paying back taxes, and studying English-language classes to enhance their communication in the US. Consequently, this has helped immigrants in the US to receive excellent medical interventions thus improving their quality of life. Moreover, such policies help immigrants escape from unnecessary deaths caused by inadequate health care. Similarly, the implementation of labor and health laws under free trade such NAFTA and CAFTA by the state is aimed to decrease the number of uninsured immigrants. Alternatively, since 2000, the governments of US and Mexico have guided two initiatives that intend to address the pressing needs of new immigrants. These include the California-Mexico Health Initiative (CMHI) and the Mexico Health Initiative (MHI), which are institutions with the sole motive of improving the lives of immigrants. For example, in California, great strides are being made in the mobilization of the creation of transnational health-insurance products intended for public-private health plans. This is especially to the Mexican immigrants as such attempts can call upon the state and other stakeholders in the health sector to assist where necessary. Alternatively, there are also weaknesses to these developed policies, which affects the immigrants and the entire society as a whole. For Example, the increased costs of Medicaid program always offers health care cover to immigrants has become tough for new immigrants. The high funding of Medicaid programs has led states into deficit, which removes the prioritization of immigrants in the health care agenda. Additionally, despite the reforms on the legislation: Proposed 187 of California passed in 1994; children borne of parents of new immigrants have no guarantee to health insurance. This is made worse, if the immigrant has not been in the country for more than ten years (Simich, 2009) Therefore, there is still the factors barrier and discrimination from the Native Americans in blocking these vulnerable group from accessing health care services. A high cost of insurance rates affects mostly children in immigrant families in the US that exposes children to no health care cover. The causes of the high cost of insurance are high rate joblessness among immigrants, layoffs, or the employer does not offer it (Chen & Jackson, 2010). However, due to lack of education from most of these new immigrants, they lack the skills that can help them in securing jobs to afford services such as health care. Furthermore, children of immigrant families have limited visits by physician annually, as compared to those of non-immigrants. There is also the PRWORA Act of 1996 that interfered with Medicaid privileges of immigrants. This Act is from effective August 22, 1996 when it became law barring immigrant children of immigrants from Medicaid cover unless they are from refugee families. Conclusion In my opinion, there are several failures of the policies mentioned above that aim to make the life new immigrants better. For instance, there are anti-immigrant sentiments among born-Americans and policy in place that influences health care access and use by the marginalized group. Additionally, PRWORA Act of 1996 has set the bar high for new immigrants requiring them to be in the country for the last 5 years. It is only after meeting this requirement are they eligible for Medicaid programs. Another failure of these policies is to address issues such as Illegal Immigration Reform and Immigration Responsibility Act of 1996 and California Proposition of 187 (Fowler, 1998). These two Acts have vocal in barring immigrants and their children from receiving health care benefits. Alternatively, due to the limited education and proper communication skills from the immigrant families, most of them do go for applications of public health benefits. This is despite their entitlements to such benefits, and it mostly affects children. In addition, these policies have not discussed the challenges of immigrants such as socio economic status, culture, and race discrimination that bars immigrants from accessing social services such as health care (Fowler, 1998). Similarly, studies reveal that more physicians practice in upper class instead of low class neighborhoods where a majority of immigrants reside making it hard for them in accessing Medicaid care. Apart from limited access to doctors, the rising cost of health services and the inability to afford health insurance has become a hindrance for most America families but worse for immigrants (Barusch, 2008). There is also the issue of employment whereby full-time immigrant employees are more prone to low-wage jobs when compared to non-immigrants. In this case, the low-wage jobs lack the health insurance sponsorship that can help the worker in accessing health care. Finally, there is the issue of the language barrier. On this aspect, calls for policy makers and stakeholders to implement policies that would help new immigrants in communication have not succeeded. Therefore, language barrier continues to hinder many immigrants from accessing health care services leading most of them to stop seeking for those services. Additionally, the reforms in the education system have not been strong in implementing ESL despite the LEP weakness of the immigrants. References Agic, B. (2003). Health promotion programs on mental health/illness and addiction issues in ethno-racial/ cultural communities: A literature review. Centre for Addiction and Mental Health, 1-17. Barusch, S. (2008). Foundations of social policy: social justice in human perspective. Belmont, CA: Cengage Learning. Chen, A., Khanlou, N. & Jackson, B. (2010). Immigrant access to mental health services: Conceptual and research issues. Canadian issues. Public Health Agency of Canada. 1-118. Finkel, M. (2001). Public Health in the 21st Century, Volume 1. Santa Barbara, CA: ABC-CLIO. Fowler, N. (1998). Providing primary health care to immigrants and refugees: The North Hamilton experience. Canadian Medical Association. JAMC, 159 (4), 388-391. Simich, L. (2009). Health literacy and immigrant populations. Public Health Agency of Canada and Metropolis Canada, 1-18. Weissman, A. & Rosenburg, G. (2006). International social health care policy, programs, and studies. Binghamton, NY: Routledge. Read More