i did this ALL today
i've barely left my computer in 16 hours. 12 pages.
Daniel J. O'Neill
Class, Power, and Social Change
Sociology U210
12/13/03
Perspectives on Healthcare in the United States
In 2002, the United States census reported that 43.6 million people in the nation were without any form of healthcare, leaving 15.2% of Americans with no place to turn to for their medical issues (www.census.gov). Healthcare in the United States exists mostly in the hands of wealthy privately owned medical providers, with minimal government sponsored programs or regulations. In a free market capitalist economy, the primary concern is that the market is turning a profit, not that individuals in the society are provided for. Since no profit is made from insuring healthcare throughout the public, government administrations that support the capitalist tendencies of our economy have little interest in seeking to provide for those in our society who live without healthcare coverage. This is a pressing issue on the hands of every politician and citizen given that the United States is the only westernized nation without some form of a national healthcare system. The degree of government provisions in these other industrialized nations varies, but comparatively to our nation's policy that leaves the issue in the hands of the private sector, the rates of people without coverage here is astonishing to most of these foreign nations. Clearly the blame cannot be placed on a lack of resources, given the size and wealth of the medical industry in the US, but the solution to the issue of how to disperse these resources, or whether these resources universally accessible is an issue at all, is widely disputed.
One of the few ways in which the Unites States government has provided any kind of support to those in need of healthcare coverage is through a program known as Medicare, in which citizens age 65 and older receive some financial benefits on costly drugs and medical procedures. The elderly are often the group most affected by a society's healthcare policy, because health problems are inherent part of aging and therefore more care is needed to ensure longevity for these people. This is in direct conflict with the fact that as one ages, it becomes more and more difficult to earn an independent income to support one's health expenses, and this is why some forms of social safety provisions have been made by our government. However, nowadays we are finding these provisions under attack, as the right wing Bush Administration pushes an agenda that tries to avoid interfering with the potential profits of healthcare maintenance organizations, or HMO's, who tend to reap the benefit of the industry at the expense of the elderly.
This agenda has recently been summed up in a 678-page bill that the Republicans are endorsing. The controversy that the bill presents has been debated in the media and in congress since its conception, and although the bill has passed, the issue is still unfolding. An article entitled "Medicare Prepares to Cut the Cards: U.S. Issues Rules for Drug Discounts," recently appeared in one of the nation's most prominent newspapers, The Washington Post. The article was published on December 11, 2003, and described the bill as "a two-year process to deliver broader prescription coverage to 41 million Medicare recipients." It was predicted that under the conditions of the bill, "many businesses will begin reaping financial benefits within a few months," including $1.3 in higher payments to HMO's. The ultimate goal of this plan is to keep HMO's invested in Medicare by increasing their profits, so that private support can mandate the program instead of money from the government via the pockets of taxpaying Americans. It is then mentioned that the profits made are predicted to go to higher income for physicians working under these HMO's, and could potentially be invested in new medical technology. The alleged benefits included in the bill for Medicare recipients would come from purchasing a card which would subsequently provide discounts on prescription drugs, based on the assumption that while the HMO's are turning a high profit, they have the financial leverage to lower drug costs.
Both sides to the argument for and against the bill were expressed to some degree in the article in the form of quotes from Democrats criticizing it, and Republicans supporting it. Beyond these two mainstream political viewpoints exist a number of social paradigms in our country that do not fit within the standard Democrat versus Republican ideology. There are multiple ways to look at an issue like this, and the following is an analysis of the article and its content based on the social and political ideology of five important theoretical hermeneutics whose perspectives are not always publicized on such a grand scale as the viewpoints in the article.
One of these perspectives is that of the Libertarian Party, who are characterized by their emphasis on individual responsibility and loathing for any form of intervention in the free market. To them, any government regulation of a private industry is inherently detrimental to the nature of the economy and society as a whole. Libertarians view healthcare provisions from anyone but a private company as harmful, and would argue that anything but the complete privatization of the industry only perpetuates laziness and dependency. In regards to the Medicare revision bill at hand, libertarians would be pleased with the predicted outcome of more market competition and profits, but opposed to the policies in the bill itself that extend provisions to Medicare beneficiaries because to them, the Medicare program shouldn't exist in the first place. The Official Libertarian Party Website summarizes this position by saying, "America can help lower healthcare costs and expand healthcare access by taking immediate steps to deregulate the healthcare industry, including elimination of mandated benefits...the federal government should begin to restructure the system to give Medicare recipients more flexibility to purchase private health insurance" (www.lp.org). The fact that the Medicare reform bill plans to use the government as a medium to provide affordable healthcare is a limitation on the freedom of the medical industry. Even if the expected outcome of this is the further privatization of healthcare, the way in which they are attempting to enact this is in conflict with a libertarian's far right-wing stance on economic issues.
Libertarians would not be concerned with how "fairly" this article was written because accountability with private organizations like The Washington Post for their publications should be in the hands of the individual and his or her ability to reason, not determined by a political group. Their viewpoint doesn't take potential media manipulation or the consumer's vulnerability into account, it does the opposite and places responsibility in the hands of the individual to use their judgment and power as a consumer to make the best decisions on issues without being swayed by biased viewpoints that could be in media publications.
Another way of looking at this issue is from the perspective of a communitarian, who would tend to be a lot less concerned with the individual, and wholly concerned with the functionality of society as a whole. The underlying nature of the problem with healthcare in our nation according to this group of people is that giving too many benefits to individuals could pose a threat to the market, and therefore to the stability of the society as a whole. No matter what steps the government has to take, even if this means tax breaks for the companies so that they stay invested at the expense of direct government provided health benefits for the individual, the primary concern of a communitarian is that things remain intact and functional. To a communitarian, every type of person in society plays an essential role, and they should be kept healthy enough to ensure that they can still fill this responsibility, but this can never come at the risk of destabilizing a wider social system. If the elderly are posing such an expense to Medicare that private companies (who are in theory essential to the functionality of society) no longer want to stay invested in the government-sponsored program, it is perfectly acceptable to take measures to keep them around at the potential expense of the healthcare of the elderly.
This is the position that the Bush Administration has taken up, and that is why communitarians would support this bill. Functionalist communitarian theory is not fundamentally opposed to more or less government regulation on any issue, they just support a government run by specialists that can determine what policies are necessary under the given circumstance to keep society intact, no matter what the cost. They would view this article as a fair portrayal of the issue considering that it highlights and emphasizes the opinion that it is a necessity for HMO's to stay invested in Medicare to ensure social stability above all other concerns and potential side effects of the proposed bill, such as lack of adequate care for every individual.
Social contract theorists seem to have less universality in their beliefs than libertarians and communitarians, but nonetheless they would probably have a relatively refined opinion on healthcare in the United States, and more specifically the issue presented in the article. They stress the importance of laws and social safety nets in society that provide a balance between protecting individual rights and ensuring market stability. The theme of "balance" is consistent in all reasoning as a social contract theorist, and if reform is needed in the healthcare system, they would argue that the nature of the issue is that there has not been enough balance established between the recipient and provider in the industry. Social contract theorists would support government provisions within programs like Medicare, and healthcare as a whole, as long as these provisions do not greatly inhibit profit in the private sector of the market, nor the rights of the recipient.
A social contract theorist would not support the proposed Medicare reform bill described in the article because it poses too great a risk to Medicare recipients by favoring the private companies too greatly. Instead, they would propose that laws would be put in place through which any individual could use the court system to seek retribution for any wrong they may have had done to them by a corporation in the medical industry. This way, patient's rights can achieve some balance with the power of those who run the industry. In his book In Defense of Tort Law, author and social contract theorist Thomas Koenig says, "Tort remedies create a necessary deterrent in the managed care environment, where there are tempting financial incentives to trade patient welfare for profits" (Koenig, 169). The phrase 'tort remedies' refers to a patient's ability to sue if they are receiving harmful or substandard care from their private provider, and through these laws it becomes more profitable for companies to provide adequate care than to be sued for large sums of money, ensuring a standard of care for all patients without infringing too greatly on company profits. It seems that a social contract theorist would view the article as a bit unfair in that it doesn't focus on the Medicare recipients and the negative ways they could be affected by this bill enough.
The social paradigm of elite theory provides us with a more radical way of looking at class, power, and social change than was presented to us by the libertarians, communitarians, or social contract theorists. According an elite theorist, all of society's power lies within the hands of an elite group of people that run the military, the government, and the economy. Power within these groups and hierarchy between them is interchangeable, but the domination they impose on the rest of society is cemented, and it insures that the only true beneficiaries of the policies they impose are those within the elite group itself. They would argue that the only time the United States' healthcare system works to the advantage of the rest of society is when conflicting interests within that dominant elite group create a balanced solution that happens to benefit the rest of the public only by happenstance, not because their interests were in mind. Within this relatively cynical mode of thinking, there is not a whole lot any individual can do to enact social change.
Given that premise, an elite theorist would be opposed to the Bush Administration's Medicare reform plan because they view it as only beneficial to those in power. They believe that the government is looking to perhaps keep the under privileged subservient and thus secure their power in society, and that the private companies are only looking to make a profit, paying little regard to legitimate health concerns of the public. The positive side to the proposal as seen by an elite theorist, is that the interests of the government and the interests of the market and private HMO corporations could conflict, resulting in a policy that could inadvertently help people in need of affordable healthcare. Furthermore, elite theorists' main grievance with society is that the rationalization that bureaucracies within capitalism have created pin us into monotonous routines that hinder human creativity and potential. The bill would potentially further the privatization of the healthcare industry, and that would only perpetuate a society dominated by these bureaucracies. The Washington Post article regarding the issue of Medicare itself would be seen by elite theorists as a biased attempt to push the agenda of big business as well as the government.
Finally is the Marxist perspective, which is more related to elite theory than any of the other paradigms, and therefore also provides us with a drastically different way of viewing society than the first three. Based on the teachings of social theorist/economist Karl Marx, this viewpoint focuses entirely on the evil and destructive nature of capitalism. Marxists believe that power in society lies in the hands of the government, the military, and the economy, but contrary to the power pyramid presented in elite theory in which the three powers are interchangeable, it is the economy that always prevails and dominates the other two in the Marxist model. Using the United States' system of healthcare as an example, a Marxist would argue that the even the minimal government provisions that do exist are not in place to help the public but to turn a profit for HMO's. In the bill at hand specifically, this argument is demonstrated well because its main function is to keep HMO's invested in Medicare by increasing their profits. The government's role in this situation is merely as a puppet of the businesses and wealthy people in society, a Marxist would argue, adding that they are fundamentally only interested in how they can exploit those below them because such is the nature of capitalism: to exploit and profit. Marxist theory would push for not only increased, but full government intervention and regulation over the healthcare industry to ensure the well being of everyone in society, not just those with the money and therefore power. None of the other paradigm's solutions offer sufficient enough action to satisfy a Marxist because the only thing they see fit is the complete eradication of capitalism and the oppression it causes. The Bush Administration's plans for Medicare reform would be foreseen as greatly detrimental to the supposed beneficiaries, because there is no way the opening up the market is going to solve anything, they argue. This all encompassing theory of power in the hands of the wealthy in society surpasses the elite theorists' definition of power as domination, and explains power as systemic and structural, existing within all aspects of society. This systemic power structure is perpetuated and solidified by propaganda from the media, businesses, and the government, and this ideology is disseminated throughout all of society. A Marxist solution to the issue of healthcare would be to implement a system similar to those that exist in other industrialized countries in which coverage is universal and unbiased, despite this being an infringement on free market capitalism.
A Marxists' opinion of the article that provides this information itself is an interesting example of their frame of mind, too. Everything about the article in the Washington Post would be viewed as media propaganda to further anesthetize the public and see to it that government policies that help big business are not criticized in the mainstream media. If an organization were to challenge this power structure, there would be a backlash against them, and their opinion would be discredited. This article in particular would be seen as a ploy to promote a government policy that favors business, and furthers economic stratification in our society.
After taking each one of these social paradigms into legitimate consideration, I have found that the only one I tend to agree with is the Marxist viewpoint. Private healthcare companies in this country have made it such that even the most basic coverage is well beyond the price range of many poor American families. The libertarians claim that there is a possibility for social mobility between all classes of people within our society, yet this hardly seems possible when such a high percentage of the population is left to their own devices or face outrageous medical bills whenever they become sick or injured. The healthcare system in the United States creates a perpetual cycle of poverty in which poor people are denied basic services while the rich are graced with the privilege of high paid doctors and medical technology. People often speak of our nation's vast and groundbreaking medical industry, but there is no validity in boasting advanced medical technology when it is only reserved for those who can afford it. If true class mobility is to exist here, everyone needs to have affordable options for coverage of prescription drugs, or any type of necessary medical procedure. Before one can concentrate on hard work and education, the things that in our society allow for personal advancement, one needs to be healthy. In Jeffrey Reiman's book, The Rich Get Richer And the Poor Get Prison, he points out that "Less money means less nutritious food, less heat in winter…less knowledge about illness or medicine…and above all else, less first-quality medical attention when all these other deprivations take their toll and a poor person finds himself seriously ill" (Reiman, pg. 75). All of these conditions hinder one's ability to do much of anything, making the promise of wealth and stature in society for the lower class seem like a fallacy.
The health insurance industry in this country is a business like any other. Even those people with a moderate amount of money and basic healthcare coverage are often manipulated by their HMO's. Prescription drugs and all types of medical consultations require a co-payment from the patient, which is still tough to afford for many. Bush's proposal to further the privatization of the industry seems like a plan that will only harm the United States' Medicare recipients. Much like the Marxist, I believe the only way to enact sufficient social change is to have full government intervention, at least in an industry as crucial to the public's well being as the medical industry.
Bibliography
1. Health Insurance Coverage - 2002 -Highlights (http://www.census.gov/hhes/hlthins/hlthin02/hlth02asc.html). U.S. Census Bureau.
2. The Libertarian Party's Legislative Program: Health Care & Health Costs
(http://www.lp.org/issues/program/health.html). Libertarian Party.
3. Koenig, Thomas. In Defense of Tort Law (New York: New York University Press, 2001), pg. 169.
4. Reiman, Jeffrey. The Rich Get Richer And the Poor Get Prison (New York: MacMillan Publishing Company, 1990), pg. 75.
Daniel J. O'Neill
Class, Power, and Social Change
Sociology U210
12/13/03
Perspectives on Healthcare in the United States
In 2002, the United States census reported that 43.6 million people in the nation were without any form of healthcare, leaving 15.2% of Americans with no place to turn to for their medical issues (www.census.gov). Healthcare in the United States exists mostly in the hands of wealthy privately owned medical providers, with minimal government sponsored programs or regulations. In a free market capitalist economy, the primary concern is that the market is turning a profit, not that individuals in the society are provided for. Since no profit is made from insuring healthcare throughout the public, government administrations that support the capitalist tendencies of our economy have little interest in seeking to provide for those in our society who live without healthcare coverage. This is a pressing issue on the hands of every politician and citizen given that the United States is the only westernized nation without some form of a national healthcare system. The degree of government provisions in these other industrialized nations varies, but comparatively to our nation's policy that leaves the issue in the hands of the private sector, the rates of people without coverage here is astonishing to most of these foreign nations. Clearly the blame cannot be placed on a lack of resources, given the size and wealth of the medical industry in the US, but the solution to the issue of how to disperse these resources, or whether these resources universally accessible is an issue at all, is widely disputed.
One of the few ways in which the Unites States government has provided any kind of support to those in need of healthcare coverage is through a program known as Medicare, in which citizens age 65 and older receive some financial benefits on costly drugs and medical procedures. The elderly are often the group most affected by a society's healthcare policy, because health problems are inherent part of aging and therefore more care is needed to ensure longevity for these people. This is in direct conflict with the fact that as one ages, it becomes more and more difficult to earn an independent income to support one's health expenses, and this is why some forms of social safety provisions have been made by our government. However, nowadays we are finding these provisions under attack, as the right wing Bush Administration pushes an agenda that tries to avoid interfering with the potential profits of healthcare maintenance organizations, or HMO's, who tend to reap the benefit of the industry at the expense of the elderly.
This agenda has recently been summed up in a 678-page bill that the Republicans are endorsing. The controversy that the bill presents has been debated in the media and in congress since its conception, and although the bill has passed, the issue is still unfolding. An article entitled "Medicare Prepares to Cut the Cards: U.S. Issues Rules for Drug Discounts," recently appeared in one of the nation's most prominent newspapers, The Washington Post. The article was published on December 11, 2003, and described the bill as "a two-year process to deliver broader prescription coverage to 41 million Medicare recipients." It was predicted that under the conditions of the bill, "many businesses will begin reaping financial benefits within a few months," including $1.3 in higher payments to HMO's. The ultimate goal of this plan is to keep HMO's invested in Medicare by increasing their profits, so that private support can mandate the program instead of money from the government via the pockets of taxpaying Americans. It is then mentioned that the profits made are predicted to go to higher income for physicians working under these HMO's, and could potentially be invested in new medical technology. The alleged benefits included in the bill for Medicare recipients would come from purchasing a card which would subsequently provide discounts on prescription drugs, based on the assumption that while the HMO's are turning a high profit, they have the financial leverage to lower drug costs.
Both sides to the argument for and against the bill were expressed to some degree in the article in the form of quotes from Democrats criticizing it, and Republicans supporting it. Beyond these two mainstream political viewpoints exist a number of social paradigms in our country that do not fit within the standard Democrat versus Republican ideology. There are multiple ways to look at an issue like this, and the following is an analysis of the article and its content based on the social and political ideology of five important theoretical hermeneutics whose perspectives are not always publicized on such a grand scale as the viewpoints in the article.
One of these perspectives is that of the Libertarian Party, who are characterized by their emphasis on individual responsibility and loathing for any form of intervention in the free market. To them, any government regulation of a private industry is inherently detrimental to the nature of the economy and society as a whole. Libertarians view healthcare provisions from anyone but a private company as harmful, and would argue that anything but the complete privatization of the industry only perpetuates laziness and dependency. In regards to the Medicare revision bill at hand, libertarians would be pleased with the predicted outcome of more market competition and profits, but opposed to the policies in the bill itself that extend provisions to Medicare beneficiaries because to them, the Medicare program shouldn't exist in the first place. The Official Libertarian Party Website summarizes this position by saying, "America can help lower healthcare costs and expand healthcare access by taking immediate steps to deregulate the healthcare industry, including elimination of mandated benefits...the federal government should begin to restructure the system to give Medicare recipients more flexibility to purchase private health insurance" (www.lp.org). The fact that the Medicare reform bill plans to use the government as a medium to provide affordable healthcare is a limitation on the freedom of the medical industry. Even if the expected outcome of this is the further privatization of healthcare, the way in which they are attempting to enact this is in conflict with a libertarian's far right-wing stance on economic issues.
Libertarians would not be concerned with how "fairly" this article was written because accountability with private organizations like The Washington Post for their publications should be in the hands of the individual and his or her ability to reason, not determined by a political group. Their viewpoint doesn't take potential media manipulation or the consumer's vulnerability into account, it does the opposite and places responsibility in the hands of the individual to use their judgment and power as a consumer to make the best decisions on issues without being swayed by biased viewpoints that could be in media publications.
Another way of looking at this issue is from the perspective of a communitarian, who would tend to be a lot less concerned with the individual, and wholly concerned with the functionality of society as a whole. The underlying nature of the problem with healthcare in our nation according to this group of people is that giving too many benefits to individuals could pose a threat to the market, and therefore to the stability of the society as a whole. No matter what steps the government has to take, even if this means tax breaks for the companies so that they stay invested at the expense of direct government provided health benefits for the individual, the primary concern of a communitarian is that things remain intact and functional. To a communitarian, every type of person in society plays an essential role, and they should be kept healthy enough to ensure that they can still fill this responsibility, but this can never come at the risk of destabilizing a wider social system. If the elderly are posing such an expense to Medicare that private companies (who are in theory essential to the functionality of society) no longer want to stay invested in the government-sponsored program, it is perfectly acceptable to take measures to keep them around at the potential expense of the healthcare of the elderly.
This is the position that the Bush Administration has taken up, and that is why communitarians would support this bill. Functionalist communitarian theory is not fundamentally opposed to more or less government regulation on any issue, they just support a government run by specialists that can determine what policies are necessary under the given circumstance to keep society intact, no matter what the cost. They would view this article as a fair portrayal of the issue considering that it highlights and emphasizes the opinion that it is a necessity for HMO's to stay invested in Medicare to ensure social stability above all other concerns and potential side effects of the proposed bill, such as lack of adequate care for every individual.
Social contract theorists seem to have less universality in their beliefs than libertarians and communitarians, but nonetheless they would probably have a relatively refined opinion on healthcare in the United States, and more specifically the issue presented in the article. They stress the importance of laws and social safety nets in society that provide a balance between protecting individual rights and ensuring market stability. The theme of "balance" is consistent in all reasoning as a social contract theorist, and if reform is needed in the healthcare system, they would argue that the nature of the issue is that there has not been enough balance established between the recipient and provider in the industry. Social contract theorists would support government provisions within programs like Medicare, and healthcare as a whole, as long as these provisions do not greatly inhibit profit in the private sector of the market, nor the rights of the recipient.
A social contract theorist would not support the proposed Medicare reform bill described in the article because it poses too great a risk to Medicare recipients by favoring the private companies too greatly. Instead, they would propose that laws would be put in place through which any individual could use the court system to seek retribution for any wrong they may have had done to them by a corporation in the medical industry. This way, patient's rights can achieve some balance with the power of those who run the industry. In his book In Defense of Tort Law, author and social contract theorist Thomas Koenig says, "Tort remedies create a necessary deterrent in the managed care environment, where there are tempting financial incentives to trade patient welfare for profits" (Koenig, 169). The phrase 'tort remedies' refers to a patient's ability to sue if they are receiving harmful or substandard care from their private provider, and through these laws it becomes more profitable for companies to provide adequate care than to be sued for large sums of money, ensuring a standard of care for all patients without infringing too greatly on company profits. It seems that a social contract theorist would view the article as a bit unfair in that it doesn't focus on the Medicare recipients and the negative ways they could be affected by this bill enough.
The social paradigm of elite theory provides us with a more radical way of looking at class, power, and social change than was presented to us by the libertarians, communitarians, or social contract theorists. According an elite theorist, all of society's power lies within the hands of an elite group of people that run the military, the government, and the economy. Power within these groups and hierarchy between them is interchangeable, but the domination they impose on the rest of society is cemented, and it insures that the only true beneficiaries of the policies they impose are those within the elite group itself. They would argue that the only time the United States' healthcare system works to the advantage of the rest of society is when conflicting interests within that dominant elite group create a balanced solution that happens to benefit the rest of the public only by happenstance, not because their interests were in mind. Within this relatively cynical mode of thinking, there is not a whole lot any individual can do to enact social change.
Given that premise, an elite theorist would be opposed to the Bush Administration's Medicare reform plan because they view it as only beneficial to those in power. They believe that the government is looking to perhaps keep the under privileged subservient and thus secure their power in society, and that the private companies are only looking to make a profit, paying little regard to legitimate health concerns of the public. The positive side to the proposal as seen by an elite theorist, is that the interests of the government and the interests of the market and private HMO corporations could conflict, resulting in a policy that could inadvertently help people in need of affordable healthcare. Furthermore, elite theorists' main grievance with society is that the rationalization that bureaucracies within capitalism have created pin us into monotonous routines that hinder human creativity and potential. The bill would potentially further the privatization of the healthcare industry, and that would only perpetuate a society dominated by these bureaucracies. The Washington Post article regarding the issue of Medicare itself would be seen by elite theorists as a biased attempt to push the agenda of big business as well as the government.
Finally is the Marxist perspective, which is more related to elite theory than any of the other paradigms, and therefore also provides us with a drastically different way of viewing society than the first three. Based on the teachings of social theorist/economist Karl Marx, this viewpoint focuses entirely on the evil and destructive nature of capitalism. Marxists believe that power in society lies in the hands of the government, the military, and the economy, but contrary to the power pyramid presented in elite theory in which the three powers are interchangeable, it is the economy that always prevails and dominates the other two in the Marxist model. Using the United States' system of healthcare as an example, a Marxist would argue that the even the minimal government provisions that do exist are not in place to help the public but to turn a profit for HMO's. In the bill at hand specifically, this argument is demonstrated well because its main function is to keep HMO's invested in Medicare by increasing their profits. The government's role in this situation is merely as a puppet of the businesses and wealthy people in society, a Marxist would argue, adding that they are fundamentally only interested in how they can exploit those below them because such is the nature of capitalism: to exploit and profit. Marxist theory would push for not only increased, but full government intervention and regulation over the healthcare industry to ensure the well being of everyone in society, not just those with the money and therefore power. None of the other paradigm's solutions offer sufficient enough action to satisfy a Marxist because the only thing they see fit is the complete eradication of capitalism and the oppression it causes. The Bush Administration's plans for Medicare reform would be foreseen as greatly detrimental to the supposed beneficiaries, because there is no way the opening up the market is going to solve anything, they argue. This all encompassing theory of power in the hands of the wealthy in society surpasses the elite theorists' definition of power as domination, and explains power as systemic and structural, existing within all aspects of society. This systemic power structure is perpetuated and solidified by propaganda from the media, businesses, and the government, and this ideology is disseminated throughout all of society. A Marxist solution to the issue of healthcare would be to implement a system similar to those that exist in other industrialized countries in which coverage is universal and unbiased, despite this being an infringement on free market capitalism.
A Marxists' opinion of the article that provides this information itself is an interesting example of their frame of mind, too. Everything about the article in the Washington Post would be viewed as media propaganda to further anesthetize the public and see to it that government policies that help big business are not criticized in the mainstream media. If an organization were to challenge this power structure, there would be a backlash against them, and their opinion would be discredited. This article in particular would be seen as a ploy to promote a government policy that favors business, and furthers economic stratification in our society.
After taking each one of these social paradigms into legitimate consideration, I have found that the only one I tend to agree with is the Marxist viewpoint. Private healthcare companies in this country have made it such that even the most basic coverage is well beyond the price range of many poor American families. The libertarians claim that there is a possibility for social mobility between all classes of people within our society, yet this hardly seems possible when such a high percentage of the population is left to their own devices or face outrageous medical bills whenever they become sick or injured. The healthcare system in the United States creates a perpetual cycle of poverty in which poor people are denied basic services while the rich are graced with the privilege of high paid doctors and medical technology. People often speak of our nation's vast and groundbreaking medical industry, but there is no validity in boasting advanced medical technology when it is only reserved for those who can afford it. If true class mobility is to exist here, everyone needs to have affordable options for coverage of prescription drugs, or any type of necessary medical procedure. Before one can concentrate on hard work and education, the things that in our society allow for personal advancement, one needs to be healthy. In Jeffrey Reiman's book, The Rich Get Richer And the Poor Get Prison, he points out that "Less money means less nutritious food, less heat in winter…less knowledge about illness or medicine…and above all else, less first-quality medical attention when all these other deprivations take their toll and a poor person finds himself seriously ill" (Reiman, pg. 75). All of these conditions hinder one's ability to do much of anything, making the promise of wealth and stature in society for the lower class seem like a fallacy.
The health insurance industry in this country is a business like any other. Even those people with a moderate amount of money and basic healthcare coverage are often manipulated by their HMO's. Prescription drugs and all types of medical consultations require a co-payment from the patient, which is still tough to afford for many. Bush's proposal to further the privatization of the industry seems like a plan that will only harm the United States' Medicare recipients. Much like the Marxist, I believe the only way to enact sufficient social change is to have full government intervention, at least in an industry as crucial to the public's well being as the medical industry.
Bibliography
1. Health Insurance Coverage - 2002 -Highlights (http://www.census.gov/hhes/hlthins/hlthin02/hlth02asc.html). U.S. Census Bureau.
2. The Libertarian Party's Legislative Program: Health Care & Health Costs
(http://www.lp.org/issues/program/health.html). Libertarian Party.
3. Koenig, Thomas. In Defense of Tort Law (New York: New York University Press, 2001), pg. 169.
4. Reiman, Jeffrey. The Rich Get Richer And the Poor Get Prison (New York: MacMillan Publishing Company, 1990), pg. 75.