Relation between Gender, Class and Health Care System - Essay Example

Relation between Gender, Class and Health Care System Name: ____________ Dated: _____________________ Introduction The Health system is such an institution which divides the society on the basis of gender, class, and ethnicity by setting out the boundaries of human performance. The social foundation of health and illness is stark and conspicuous when the issue of how incidents of serious diseases and early death affect the working class, poor and excluded. Therefore, inequalities in society (in terms of wealth, power, prestige and social inclusion/exclusion) are far more important factors in the maintenance of good health and the creation of disease than those that emerge from biology. Moreover, these social disparities are replicated globally, with the health of the poorer nations far worse, and life expectancy far lower, than in richer parts of the world. Relationship between Nursing, Gender and Class Geographic origin, historic events, cohort position, class and gender create significant individual differences within health care system of any culture. However it varies in accordance with the age, gender and class. As age becomes more diverse and heterogeneous we are constantly challenged to understand their needs and assist them to appropriate resources. Competent role enactment requires a bio-psycho-socio-political-spiritual-cultural perspective. The increasing specificity and accumulation of knowledge on any of these topics lead to health care commitment to persons of various cultures, cohorts, and social strata. Gender: If we analyse the relationship which gender enjoys in health care, we would come up with two ideas. Firstly gender as a ‘patient’ and secondly gender as a ‘practitioner’. Gender, as an entity is discriminated on the basis of men and women where women are not given as intense or immediate health care as men. This relationship upholds personal and cultural meaning of biologic differences, which is fundamental to personal identity and is the primary way in which experiences are organised. Older women with various disorders are expected to be treated less energetically than men. More women than men die of heart attacks each year in Australia. Among several possible reasons the one which goes with Nursing is the notion that Nurses are more engaged and comfortable with men than women. However women must be more subjected towards health protection than men. For example, the risk of death for women who have coronary artery angioplasty is 5 times that of men of the same age with similar medical histories, and they are 2 to 3 times less likely to survive coronary artery bypass. A study of ‘clot-busting’ drugs found that the drugs worked just as well with both men and women except that 1 month later 13% of the women, compared to 5% of the men, died. It was thought that this occurred because the women in the study were at least 10 years older than the males of the sample and had more cardiac risks factors such as high blood pressure and diabetes, yet they were not able to completely explain the gender differences in death. (Lumby & Picone, 2000, p. 56) Plea for appropriate funding and distribution of services for appropriate pain control has fallen on deaf political and administrative ears as it has been demonstrated that poorly managed pain has economic and social costs society cannot afford. There are ethico-legal implications for nurses and other clinicians for the recognition and treatment of pain. The code of ethics for nurses in Australia, developed in 1993 under the auspices of the Australian Nursing Council (ANC), includes the following explanatory note under its first value statement: ‘Respect for individual needs, beliefs and values includes culturally sensitive care, and the provision of as much comfort, dignity, privacy and alleviation of pain and anxiety as possible’ (ANC 1993). In order to meet ethical standards of nursing care in relation to pain, nurses need to know and understand all of the possibilities now available for its management. The recent publication of guidelines for practice highlights accountability for pain management and that it becomes a liability issue. Health care professionals’ attitudes towards pain should be subjected to critical examination in the light of new research and clinical realities. It is only as our concept of pain approximates the daily complexity of community and hospital life that we can comprehend pain and suffering sufficiently to control and relieve it. (Lumby & Picone, 2000, p. 15) Class: Class differences are present in different health care systems to a greater or lesser degree. Therefore it is obvious that quality health care is only available to high class citizens. Social Health care workers argue strongly in favour of the concept of equal access and justified need and therefore argue against allowing individuals to buy higher-quality services over and above that provided by a publicly-funded system. The argument is that inequities in access to health care services are unacceptable due to the special nature of health. Dougherty argues: “there is something more repugnant about unequal treatment in matters as intimate as life, death, and the quality of life as in the general arena of consumer goods and services.” (Flood, 2000, p. 31) The unregulated operation of a health insurance market will perversely result in those who are most in need of health care services being priced out of or directly excluded from the market. Due to the importance of health to every individual’s existence and dignity, an egalitarian theory of distributive justice seems to require governments to intervene to ensure a fairer distribution of resources. Justice cannot be discounted as a goal for a health allocation system and if ignored will result in costs to the system in any event. For example, the uninsured in Australia may receive care if doctors feel unable to ignore their plight and the costs of this care will be borne to some degree by insured individuals. So either explicitly or implicitly a system has to absorb the costs of justice goals. Thus, the crucial task is not to design an efficient health allocation system per se but to design and implement a system that results in the optimal allocation of resources to the health sector and efficiently achieves the goal of satisfying justice concerns using these resources. Justice, however, only seems to require of a government that it intervenes to ensure health care services for those people who cannot otherwise afford them. However, once having accepted the need to ensure access for people to services they would otherwise not be able to afford then the system itself takes on its own internal logic. It becomes possible to then justify a nationalised health insurance system covering all citizens or at least a majority of citizens for a comprehensive range of health care services on a mixture of justice, political, and economic reasons: 1) to ensure that the quality of health care services supplied to those covered by the public system does not fall; 2) to sustain continued political support for the public health system by capturing the middle-class and wealthy who are likely to have a greater influence on politicians; 3) because the particular society in question rejects treating individuals in need (particularly of life-saving services) differently depending on their ability to pay (this is not, however, a conviction held by all societies); 4) to avoid free-riding on a safety-net designed for the poor; that is, relatively wealthy people not buying insurance coverage in the expectation they will be able to play the system to receive coverage should it eventuate they do need health care services; 5) to minimize opportunities for cost-shifting so that providers are not subsidising the costs of care for people without health insurance from the prices charged to those with health insurance; 6) to ensure comprehensiveness so as to minimize the ability or incentive of insurers and/or providers to shift costs to each other or on to society; 7) To increase bargaining power on the demand side in order to deal with the problems of information asymmetry, moral hazard and monopoly supply. Conclusion To tackle disease and premature death effectively, inequalities have to be addressed, which may demand major ‘cultural’ changes in the way in which people conduct their lives, the internal structure of society, and the relations between class and health care system. Therein lies the problem. Although ostensibly there is at times the political will by governments to grapple with inequality nationally and internationally, little would seem to have been achieved. Moreover, in Britain the National Health Service (NHS), set up in 1946 with the explicit mandate of harmonising the health status of people at the lower end of the social scale with that found among people at the top, has not been successful. Overall, the health of all groups in society has improved, but nearly sixty years of medical (and nursing) interventions within the framework of the NHS appears to have had the paradoxical effect of making people further down the social hierarchy comparatively more sick. (Morrall, 2001, p. 120) References/ Bibliography ANC (1993) Code of Ethics for Nurses in Australia, Canberra: Australian Nursing Council. Flood M. Colleen, (2000) International Health Care Reform: A Legal, Economic, and Political Analysis: Routledge: London. Lumby Judy & Picone Debbie, (2000) Clinical Challenges: Focus on Nursing: Allen & Unwin: St. Leonards, N.S.W. Morrall Peter, (2001) Sociology and Nursing: Routledge: London. Read More