Universal Healthcare.
Universal Healthcare
Litrature Review
The United States of America has no universal health care system compared to other developed countries in the world. The health care system in the United States is highly decentralized leaving the delivery of health care services to many private and public institutions. It makes it difficult for the government of United States to maintain universal health care due to this devolution and privatization. According to Shi and Singh, the United state health care is hybrid composed of multi-player health care insurances system and health care system. In the year 2014, the highest amount of health care expense came from the private funding, which was 48%. The private business contributes 20% of this spending, and the household contributes 28% of healthcare this spending. The federal government accounts for twenty-eight percent of all the spending that in the health care in the United States while twenty percent come to the local government of the different state (5). The government finances most of the health care system, but they are privately managed and offer most of the services privately.
The cost of health care is very high in the United States compared to other industrialized countries in the world. The health insurances system in the United States has high inconsistency in various social set up. Although the United States of America has the highest expenditure in health care services in the world only a half of the expenditure is contributed by the by the government the rest is contributed by the private institutions and non- governmental organization. It poses a problem in the attainment of universal health care in the United States because the government cannot control most of the private institution. The increase in the private institution offering most of the health care services in the United States has caused a lot of disparities in the health care cost and uneven insurance distribution (Nash 212). Most of the private institutions are profit-oriented, so they provide services depending on the economic income of the citizen. Other sectors offering health services are non-profitable organization and the government. Most of these organizations are poorly managed and monitored hence providing substandard health care to the member of the public.
The high cost of primary health care in the United States has challenged the effort of achieving universal health care among various member of the society in the United States. Most of the Americans are unable to access primary health care services due to their low-income status. Also, Americans are living on the income that is below average income making them unable to meet all the health expense charged by the health institution in the United States. Shi and Singh reported that American who are earning salaries below ten dollars in a day they are unable to visit the physician for the medical checkups, unable to purchase pharmaceutical for treatment, and unable to follow up care. More than 60% of the health practitioners reported that most of the patients were unable to meet their health expenses. In the year 2013 more than thirty-one percent of the adult in the United States who was uninsured, they were unable to get prompt medical attention when they visited most of the health facilities in the United States (13).
The health insurance premium in the United States is increasing at a very alarming rate from the year 2000-2015. The quality of the insurances policy is deteriorating year after year due to many insurances companies gave tender by the government to ensure its citizens against any susceptible health risk. Most of the American citizens do not have enough money to cater for the escalating cost of insurance premium to cover their health. Only the tycoons and some of the wealthy government officials can pay the best insurance premium to cover them. The other member of the society usually opts for the cheap premium, which offers limited health coverage. Dzau, McClellan & McGinnis (711) highlights the major disparity in the insurances coverage in the United States. These disparities hinder attainment of universal health care in the United States. They state more than 33% of American were uninsured by the end of the year 2014. Secondly, the workers had insurance premium depending on their wages. Thirdly, women are charged costly than men for the same premium. Fourthly a large number of youths between 19-25 years were under insurance cover of their parent by the year 2015. Lastly, minor races and children are disproportionally uninsured.
Theoretical Approach to the Problem
Social disorganization theory was the theory developed in the Chicago school in the mid-1920. There are many theorists who have explained the theory but Shaw and Henry D. McKay made extraordinary explanation and research on the theory. The theory explains crime and delinquency in many disciplines of criminology study and sociological study (Bursik 520). In theory, an organization of the society is the one that determines the causes of crime and delinquency behavior. The disorganized society faces many crises such as education problem, poverty, poor health services, poor leadership, lack of social amenities and they mostly live on the outskirts of urban area in the congested and stuffy environment. The same case is experienced in the United States; although the United States is the most industrialized and urbanized country in the world, it also has some of the worst slums in the world. As social disorganization states, most of these slums found in the outskirt of the modern cities and the towns in the United States. A good example of the slams in the United States is Hidalgo County of Texas and Skid Row in Los Angeles. The two slums are mostly composed of the poor who live in congested houses with poor living condition with poor water and sanitation system as well as poor health services.
The central dimension of the theory state that community is divided into two distinctive groups with a distinct characteristic. It divides the community in two major group that is a disorganized social community and socially organized community. Most of the theorists who tries to explain this theory such as Shaw and McKay states there is much crime in the community that is socially disorganized compared to the community that is socially organized (Bursik 520). This element of social disorganization theory can explain the challenges faced by the United States in the fight of attaining universal health care among the entire citizen. The United States health care system is socially disorganized with very many stakeholders who are the overseer and implementers of health care system. It is very hard for the government and health care ministry to co-ordinate all these stakeholders in the same way so that they provide universal health care to all member of the society. Some of them tend to defy the regulation that is set by the authority and offer services in the way they think is the best. Most of the stakeholders in the health institution are corrupt due to the disorganization in the sector hence it becomes difficult in achieving universal health care in the United States.
Shaw and McKay states in the disorganized society with ethnic diversity, economic crises, high population density, family disruptions and residence instability has a higher rate of crime and delinquency. This illustration can well explain life in the United States characterized by social disorganization characteristics. The United States is a multi-ethnic country comprises of people of different cultures and races such as the white, blacks, and Hispanic. United States is the most populated country in the world with more than two hundred and thirty-four million people (Byrd and Clayton 24). The Economic crisis and family disruption are also very common in the United States where there are a high number of single parents, orphans, and street children. Social disorganization in many American states leads to difficulties in meeting universal health services to each and every citizen due to increasing cases of racial discrimination and oppression. Minority groups such as Hispanic and the blacks always gave last priority in health services. High population density makes the government unable to meet quality health care services to each citizen due to economic shortages. Family disruption leads to the breakup of the families leading to minors not receive adequate health insurance cover due to the separation of their parents. Moreover, family disruption in some cases lead to children opting to become street children, and the street has an adverse condition that endangers their health status.
Research Assumption
If the government does not reduce the cost of health care services and insurance premium, the universal will be unachievable.
Compared to other western nation U.S has the highest expenditure in the health services, yet the quality of the health services offered in the United States is far much behind the health services offered by other nation that spend very little on health services. The health services in U.S is affordable to many people been the society due to the high cost of treatments and health insurance premium. The federal government has expenditure had continued to increase since 1969 when the expenditure was 5% currently the federal government uses 28% of GDP to cater for the health expenses every year (Shi & Singh 7). These could be as a result of privatizations of most of the health sectors and services. In spite of expenditure by the government, the household is being taxed heavily to cater for the health services offered in the country. Employees of the various organization in the United States are deducted a lot of money from their wages to cater for the insurance premium every month. Every business and private organization must pay a lot of money to cater for the health services in the United States. Very many people especially those that earn fewer wages and unemployed are restricted from accessing some of the health services due to lack of appropriate insurances premium, which is costly. The increment of the health cost has influenced the greatly social organization of people in U.S. Most of the people spent a lot of money in health leading them to ravish in poverty. Most of them opt for slums, which have a lot of risk to the health of the dweller, hence increasing the problem to the achievement of universal health care.
If the government does not improve the living condition in slums dweller, the universal health care will not be achieved
All the health risks characterize Life in the slum to the dwellers. In slums, there is no clean water and good sanitations channels. In many slums, water-borne diseases such as typhoid, cholera, and amoebic dysentery infect people. In the slums there many ethnic groups that are living together hence there are high cases of criminal activities in the area. Criminal activities can risk the health of the dweller or the criminal himself whereby criminal may hurt themselves or hurt other in the process of the criminal activities. Hospitals and others health facilities are few and cannot cater for all the health problem of the residence. Moreover, there is no enough space for building the health facilities in the slum due to the limited space. Infant motility rate and morbidity are very high in slum environment due to the harsh condition and poverty that are in the in a slum. It is very difficult for the government to reach each slum dwellers due to insecurity and congestion. It is advisable to the government to improve the living condition of the slum to reduce exposure to various health risk.
Research Questioner
Question | R1 | R2 | R3 | R4 | R5 | R6 | R7 | R8 | R9 | R10 | Frequencies |
Do you frequently visit the hospital? | Yes I have chronic high blood pressure | No I have no insurance cover | No I don’t see any reason for wasting money for check up | No it is expensive | No I have personal Doctor | Yes I work in government Hospital everything is free | Yes I have a comprehensive medical cover | Yes To attend my grandfather suffering from prostate cancer | No I consider medicine men because they are cheap | Yes Because am pregnant, and I care the fate of my unborn child | Yes= 5 No = 5 |
Do you have insurances medical cover?
| Yes From Medicare | No Am not employed | No Am just 21 years | Yes I am casual worker and is mandatory | Yes In case of any emergency | No Union covers us | Yes I care about my health | Yes For my safety | Yes It is mandatory to every worker | No Am a housewife | Yes =6 No = 4 |
Were you able to pay all your hospital bill when you were hospitalized? | No My friend granted me a loan | No My parent catered for the bill | No I have never been hospitalized | No I have no money | Yes I have enough money to afford all my Medicare | Yes I was given overdraft of my salary | Yes My medical cover did that for me | No My family supports me | No I ignored some medical test | Yes Because my husband supported me | Yes =4 No =6 |
Do your insurance cover for all medical expenses?
| No I have not paid the premium as per my condition
| No I don’t have insurances cover | No I don’t have insurances cover | No It only cover for inpatient only | Yes in case my doctor is away | No I don’t have insurances cover | Yes My medical cover caters for everything | No Does not cover the outpatient and admission fee | No It only cover for inpatient only | No I don’t have insurances cover | Yes =2 No =8 |
Do you think medical cost is high? | Yes I have wasted a lot | Yes Compared to quality of services | Yes There are many to cater for medical bill | Yes Because I can’t afford check up | No Health is priority no matter the cost | No Compared to service delivered it is the best cost | No I care about my health | Yes my family has wasted a lot | Yes Medical tax are everywhere | Yes They charge even antenatal care | Yes =7 No =3 |
Do you access clean water frequently?
| No We use borehole water and is salty | No One time in a week | No We use river water | No It is very dirty | No There is no water in our area | Yes Am neighboring to water treatment plant | Yes Times in a week | No You may queue for a whole day to get one jerry can | Yes I distribute water in the area | Yes But only with cash. | Yes = 4 No = 6 |
Do your area has hospital or health facility near? | No It is very far | No Only in town | Yes There is a clinic nearby | Yes It is not very far | No It is not near | Yes Just a walking distance | No Nothing like that | Yes A dispensary is not far | No I have never seen one | No It is very far from here | Yes =4 No = 6 |
Do the government care for the health condition in your area? | No No garbage collection | No No water | No High taxation | Yes Situation is okay | No I think they don’t exist | No No water | No No free medical check up | No Poor road | No Poor sanitation | No No hospital | Yes = 1 No =9 |
Are you able to access latrine? | No We share with neighbor | Yes But not clean | Yes Public toilet | Yes We have pit latrine | No We use bucket | Yes We have one in our homestead | No It’s too far | Yes We have pit latrine | Yes Public toilet | Yes Plastic toilet from AMREF | Yes =7 No =3 |
Do you like the health care of your area? | No It is very poor | No Very few hospital | No Garbage are everywhere | Yes Nothing else we can get | No It is awful | No No hospitals | No Very few doctors | Yes I don’t see any problem with it | No Poor sanitation | No Industrial affluence drained into the river | Yes =2 No = 8 |
Findings and Conclusion
From the research, we found that the citizen of United States visited the hospital was almost equal to those who did not visit the hospital the research found that most of the respondent have the insurance cover, but the insurance cover does not cater for all of the cost of the health services of the respondents. The respondent gave the varying answers on the case that when they were hospitalized, they were unable to pay their hospital bills, but they concluded by indicating that the cost of the health services in the United States is high to an ordinary citizen. The condition of the health status in the slums was concluded to be unfit to most of the slum dwellers in the United States. Most of the respondent indicated that they were not able to access clean water and latrines hence the sanitation in most of the slums in the United States is not fit for the health of many respondents. The health facility and the government involvement in health are the biggest challenges among the slum dwellers in the United States. Most of them think that the government does not care about their health condition. Many respondents in the slum indicated that the health care was very far from their vicinity and most of the respondent among the slum dwellers did not appreciate the health conditions in their areas.
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Works Cited
Bursik, Robert J. “Social Disorganization and Theories of Crime and Delinquency: Problems and Prospects.” Criminology vol. 26, no. 4, 1988, 519-552. Print.
Byrd, W. Michael, and Linda A. Clayton. An American Health Dilemma: Race, Medicine, and Health Care in the United States 1900-2000. Vol. 2. Routledge, 2015. Print.
Dzau, Victor J., Mark McClellan, and J. Michael McGinnis. “Vital Directions for Health and Health Care: An Initiative of the National Academy of Medicine.” JAMA vol. 316, no. 7, 2016, 711-712. Print.
Nash, David B., et al. Population Health. Jones & Bartlett Publishers, 2015. Print.
Shi, Leiyu, and Douglas A. Singh. Essentials of the US health care system. Jones & Bartlett Publishers, 2015. Print.
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