Functionalist Perspective- Health and Medicine – Good health and effective medical
care are essential for the smooth functioning of society. Illness is “dysfunctional”
because it reduces people’s ability to preform their roles in society. Society responds to
illness not only by providing medical care but by allowing people “sick role”
Sick Role – Patterns of behavior defined as appropriate for people who are ill. They
must “look the part”. Sick role releases people from everyday obligations such as going
to work.
Conflict Theory- Health and Medicine – Social inequality characterizes the quality of
health and the quality of health care. People from disadvantaged social backgrounds
are more likely to become ill and to receive inadequate health care. Partly to increase
their incomes, physicians have tried to control the practice of medicine and to define
social problems as medical problems.
Social Constructionist- Health and Medicine – Health and illness are social
constructions: Physical and mental conditions have little or no objective reality but
instead are considered healthy or ill conditions only if they are defined as such by a
society. Physicians “manage the situation” to display their authority and medical
knowledge.
Health – State of complete and physical, mental and social well-being.
Social Epidemiology – The study of how health and disease are distributed throughout
a society’s population. Examines both the origins and the spread of the disease.
Analyze how people’s health is tied to their physical and emotional environments.
Relationship Between Health and Social Class – Inequality is at the heart of the
differences in health among different segments of the population. All societies distribute
resources unequally. Overall, the rich have far better physical, mental, and emotional
health than do the poor.
Disease Model – Patients are first diagnosed and then treated for illness. critics argue
there is lack of emphasis on prevention- evidence that prevention of many illnesses is
possible but focus is on health rather than illness.
Socialized Medicine – The government owns and runs the entire healthcare system.
Pays for all healthcare services.
United States Costs of Medical Care – 18% of our gross domestic product, 3rd leading
industry in the U.S. we spend 2x per capita as the United kingdom or Sweden.
No National Program of Universal Healthcare (U.S.) – Most sectors of health care
system are for-profit businesses i.e. hospitals and pharmaceutical companies. Spending
on prescription drugs has increased from 40 billion (1990) to 326 billion.
Medicare – Provides health insurance to older americans
Medicaid – Provides health insurance to poor americans
Managed Care – a system of providing health care (as by an HMO or a PPO) that is
designed to control costs through managed programs in which the physician accepts
constraints on the amount charged for medical care and the patient is limited in the
choice of physician.
Direct Fee System – patients are responsible for paying the fees the health care
provider charges. insurance companies may cover part of or all expenses.
Health Maintenance Organization (HMO) – an organization that provides or arranges
comprehensive medical care to subscribers for a fixed fee
Defensive Medicine – refers to the practice of recommending a test or medical
treatment that is not necessarily the best option for the patient, but an option that mainly
serves the function to protect the physician against the patient as a potential plaintiff.
2010 Patient Protections and Affordable Care Act (critical features) – 1. Expansion of
availability of health care insurance to all Americans
- Insurance companies may not deny coverage to children (under age 19) because of
preexisting conditions - Elimination of lifetime coverage limits on insurance coverage
- Insurance plans must cover preventive care, such as mammograms and
colonoscopies, without charging deductibles and co-pas - Young adults are allowed to stay on parents’ plan until age 26
- Early retirees keep their employer-sponsored benefits until they are eligible for
Medicare
2010 Patient Protections and Affordable Care (assessment) – Helping minimize
number of uninsured people.
Critics argue that insurance costs will rise for companies
Inequality and Health – Health care institutions recreate structural inequality of society.
Medical options are not equally available to all Americans.
Unequal distribution of health care by social class, race, and gender – Health care is
more readily available to whites than to others