Health care in the United States always places a set of principles that enables the development of a fair and equitable health policy. However, there are a number of setbacks that exists in the society that prevents the achievement of such an ideal concept. A fair and equitable health policy must look to see beyond crime and see illness, and beyond moral weakness and see addiction thus moving from viewing sin and sinners and instead concentrate on the provision of health care for the citizens of the United States (Morone, 2005).
There are different core concepts that promoted a fair and equitable health policy. The discussion of these elements provides a better understanding of the challenges that prevent the country from attaining such ideal policy. Medical liability reform is the preservation of the patients’ access to care and different organizations work to lessen medical liability premiums (AMA, 2008). There is also a need to give voice to the uninsured. The expansion of the coverage of the uninsured will increase access to care and solve the health coverage crisis for all uninsured patients (AMA, 2008). Patient safety and improvement of quality health care is also something that is needed and caused the establishment of the Patient Safety Law (AMA, 2008).
The core concept of equity was the sense of fairness that reflected the fair treatment of individuals, in whatever walk of life they belonged in (Umbarger et al., 2005). Services need to be distributed equitably through resource allocation decisions made out of people’s needs instead of their characteristics. In the same manner, the physical access to health care facilities is as important (Umbarger et al., 2005). Cultural competence is another concept that defined a set of congruent behaviors, attitudes, structures and policies that allowed health providers to give service even in intercultural situations.
Health policy in the America is a reflection of its past. It always had a culture of individualism. The pilgrimage to the land is about finding their freedom and having to create a new world of their own. It can be related to how the health care system could be viewed. It can be defined by stakeholders and politicians who pursued their preferences as they mobilized to protect their own rights as individuals (Morone, 2005). This perspective will explain the presence of self-interested politics in the nation. People always look out for their own interests and not the welfare of their society. The Puritan view in the United States also provides dangerous divisions in the society. The personal transgressions of the people has provided for them grounds to ostracize certain people in the society. Poverty and disease becomes punishment for private and personal choice. This was something that judges differences and allowed for inequalities as well as unfairness in the country (Morone, 2005).
Budget constraints and compromises are also major factors to health reforms. While health care organizations are doing their part to identify the gaps that existed in cultural understanding and competence, the lack of internal resources shuts their efforts down (Center for Health Policy and Research, n.d.). The costing of reform proposals has been the avenue of debates because of the interest groups that controlled the system. There is little budget priority given to cultural gaps that were present, even when this was closely related to gaps in economic class (Center for Health Policy and Research, n.d.). Individualism provides contrasting views as to who must benefit from the budget reserved for health care.
While there is an outrage that existed because of the inequities of the United States health care policy and it is undeniable that 15 percent of the population has no guaranteed access to medical care (Oberlander, 2006). The regressive burden of health financing arrangements that is imposed on private insured lower and middle-income Americans is very problematic.
For example, Southwestern Alabama is known as the “Black Belt,” partly because of its racial makeup. It is considered one of the highest poverty-ridden states that have the high infant deaths, poor education, births to single mother, unemployment and visible gaps in health care (Equal Access, 2005). Aside from this, the cancer death rates for prostate cancer are 54 percent higher in this region than in the rest of Alabama (Equal Access, 2005). Lower-income Americans are shortchanged on the receiving end when it came to utilization of medical care; it became substantially different with income (Oberlander, 2006). There is a distributive injustice that was observed when it came to ordinary Americans who are unknowingly getting the raw end of the deal when it came to what they pay for as to what they receive from the health care industry. According to Oberlander (2006), “Unfairness is inarguably a cornerstone of the U.S. health care system” (p. 245).
In 2004, there are almost 46 million Americans who lacked health insurance (Oberlander, 2006). The uninsured are those who are found in working families that meant the system failed to the extent that workers who deserved health insurance as a reward for economic contributions to the nation’s well being and for contributing to the country’s workforce as well as living up to its work ethic.
The fact that the uninsured population lacked purchasing power to be part of the insurance pool is terrible because they suffered from being charged with higher prices than insured patients, who has greater purchasing power (Oberlander, 2006). As if it is not bad enough, even well insured and financially secure Americans found them selves having a hard time financially when it came to handling chronic diseases in the family. Challenges to a fair and equitable policy include the long history of individualism and Puritan views in the United States. Interest groups and judgmental provision of health care are major barriers in achieving health care policy that would provide everyone equal opportunities for quality care.
While European health has more of a “solidarity culture” and have a shared concern for the “people’s health”, Americans have always had individual pursuit of self-interest (Morone, 2005). This is at time when health care provider needs to treat rather than punish and look beyond past personal behavior and address complex social causes. Social justice is essential in the promotion of collective responsibility for all the members of the community.
Advocacy efforts. (2008). American Medical Association. Retrieved on September 30, 2008, from http://www.ama-assn.org/ama/pub/category/8659.html.
Center for Health Policy and Research (n.d.) Cross-cultural. Accessed on October 8, 2008, from http://www.umassmed.edu/commed/education/cross_cultural.aspx.
“Black belt” ranks among highest in poverty rate. (2005). Equal Access 2(1), p. 6.
Morone, J. (2005). Morality, politics, and health policy in Policy challenges in modern health care, Mechanic, D., Rogut, L., Colby, D. and Knickman, J. New Jersey: Rutgers.
Oberlander, J. (2006). The political economy of unfairness in U.S. health policy. Law and Contemporary Problems 69 (4), p. 245.
Umbarger, G., Stowe, M. and Turnbull, H. (2005). The core concepts of health policy affecting families who have children with disabilities. Journal of Disability Policy Studies 15(4), p. 201.