Health Care Assessment

Emmanuela DeSanges-Sobia

                              Healthcare debates remain an especially important issue in the development of a country. The need for stabilization of healthcare continues to grow globally like an infectious tumor. Each country’s degree initiative when dealing with human rights is exposing the importance of human rights and why life expectancy rates rise when a country’s healthcare is stabilized and resources are affordable for everyone. The framework of the healthcare system of a country is an implemented social structure. Its institutions and systems ultimately say a lot about a country’s priorities and the country’s identity. Here the topic analysis of my research is maternal health care policies and demography. The unit of analysis is the United States compared to India.

Healthcare funding is set aside in a nation’s government budget and medical insurance is a vital expense in the lives of people. The fact that human life is not expendable in a society notes its conscientiousness’. The stratification of the moral aspect is then embedded, why do all things have to be protested in order to get attention. Women have yet to be given proper care. With puritan cultural beliefs was the United States was founded and as always blood is sacrificed, and the blood of those who sacrifice when they don’t have proper healthcare are the poor and the old. People die from illnesses that there are cures for because they don’t have the access to the resources in India and at times in the United States. This too harshly is the case for all nations that specifically need to make healthcare a priority.

                        During an observant and the birth era of westward expansionism for the United States Nathaniel Hawthorne (1850) an early American fiction writer famous fiction novel The Scarlet Letter would discuss moral dilemmas of adultery in a puritan society. The composer used education, health and nutrition, mind and physical state of the union. This negotiated a feeling of importance connecting women and the Americas the states. As for me, if the people are not healthy; nor is the state. It is a continuous fact that we are still at the set of the Gospel of Success stages here in the United States and abroad when dealing with Health care. As says the gospel of success there is an enormous and growing gap between the rich and the poor. The story is that one may become wealthy with enough hard work and determination, this Ideology was supported by Horatio Alger, a noted theorist. This idea of the Gospel of success still applies to today’s global discourse; it leaves out those who lack the personal funds to acquire the opportunity to do hard work and or mobile access to social services. In my discussion here we refer to what healthcare is. Shall only the rich and wealthy have access to healthcare? When looking at the social indicators of health and demography for these two traditionally different countries one must ask what is each countries place on the global discourse, Pierre Bourdieu’s Structures, Habitus, Practices (1974, 1980) asses a nation’s practices:

“Its conditions associated with a particular class of conditions of existence produce habits systems of durable, transposable dispositions, structured structures predisposed to function as structuring structures-.

The base reason why healthcare was formed is to provide medical services to people at an affordable rate and ensure medics were paid. A cost-effective way to provide health care coverage to all people is orchestrated. Each country’s form of government, socio-economic status, major religions, and major industries, even its cultural traditions help understand the consciences mode in which the healthcare structure is established. The governments of the United States and India are simply oddly at different development eras however there is a case and point regarding the importance of health care of the nation. They shadow each other as they perform similar functions securing the welfare and state of the procreative sector”.

United States form of Government

        The United States is bound by a set of bylaws named the constitution and comprises fifty states of one union. In the United States, the form of government is the federal traditional democratic roles of President, Vice President, Secretary, and treasurer along with the congressional and senate seats in addition to the judicial and federal state legislature, and the power of big business moguls. There is also the libertarian press system which keeps the country at an even quill. All these offices made for and by the people, allow a check and balance system. 

India’s form of Government

        During the sixteenth century, India through trading posts come under the subjections of European powers. European expansion in the name of conflict resolution amongst internal imperial powers in India infiltrated to end civil wars. Hence, implemented colonialism under the watch of Great Britain in the mid-1800s. As national military rebels failed to gain control of India from the British East India Company strict rules applied because of protest and the Crown of Britain directly governed India for almost another century. But after losing the first war, and suffering tremendously of poverty and instability in the early twentieth century educated barristers natives would form the Indian National Congress. Led by icon Mahatma Gandhi who is known for the quote, “be the change you wish to see in the world”. I may say it is evident that India saw its value as a prospective world economist.

        India’s people held national civil disobedience non-violent campaigns and were persistent as their forms of consciousness as a nation developed. As a result in 1950, India was granted its long yearned plight for independence. Thus India became a republic of states with new constitutions. Adapted from British rule, India has a parliamentary system of democracy where though the President is head of state; the government is governed by a Prime Minister. India comprises twenty-eight states and seven neighboring territories. There is a democratic government yet the central government exercises more power, children are sold because families cannot. The constitution is said to be the most exhaustive claiming India is a sovereign, socialist, secular democratic republic.

Although the United States and India differ immensely regarding the base structure of each country’s government each takes seriously their healthcare system. India is a developing country and the United States is an established one. As per the respected Oxford reference, Health laws consist of statutes and regulations, and judicial administrative decisions pertaining to the health of individuals and communities.  Raymond Williams in his (1959) article uses Marx’s ideology of a man-made superstructure which states that:

“Upon the several forms of property of a country, upon the social conditions of existence, a whole superstructure is reared of various and peculiarly shaped feelings, illusions, habits of thought, and conceptions of life. The whole class produces and shapes out of its material foundation and out of the corresponding social conditions. The individual unit to whom they flow through tradition and education may fancy that they constitute the true reasons for and premises of his conduct”. (Selected works 1. 272-3)

As Williams states there are various forms of approaching Marx’s theory of a determining base of a superstructure. For it depends on which class implements a structure within the nation, this then shows who benefits from the form of structure. The healthcare system to which a country is committed mirrors the country’s government. Health care development in a country addresses its legal and political superstructure which then corresponds with a country’s definite form of social consciousness and existence.

I do acknowledge that within each country there are provisions made to ensure health issues are taken seriously. That health services are administered confidentially and that resources are available for the wealthy class yet in the suburban area there are minimal resources. In order to prevent the spread of disease or high number mortality rates within the procreative sector of society; the expanse of health care professionals within each country work with human-rights organizations and professionals, in a respectful, constructive, and practical partnership. However, because of the high administrative cost of healthcare; especially for maternal health care, Millennium Goal 5 has stagnated. Common healthcare services which are supposed to be affordable have become too expensive for many already living within the poverty line to afford. 

United States Health Care origins

The origins of the healthcare system date back to the late 1920’s early 1930’s, during the era known as the roaring twenties. At some point during the mid-1920s in Dallas, Texas 1929 Baylor Medical Society born the First Insurance Plan. Hospitals had begun to perform medical surgeries and there were advances in science which consequently warrants that pharmacy medicine is advanced. For example, today we take for granted the groundbreaking discoveries of life expectancy changing medicines such as penicillin, and Insulin these discoveries changed and increased overall life expectancy rates.

“Throughout the 1920s, new technologies and new science led to the discovery of vitamins and to increasing knowledge of hormones and body chemistry. New drugs and new vaccines were released following research begun in the previous decade. Sulfa drugs became the first of the anti-bacterial wonder drugs saving thousands of lives from bacterial and viral infections. 

In 1920 Herbert McLean Evans discovered Vitamin E, and its anti-sterility properties, and Elmer V. McCollum discovered Vitamin D, its presence in cod liver, and its ability to prevent rickets, a skeletal disorder. Vitamins A, B, C, K, and various subtypes of each were also discovered during the 1920s.”

Therefore, to keep these medicines in stock and to continue funding medical research hospitals began to seek to service paying patients. Thus great middle-class American foundations formed the committee to stabilize medical costs; they created a national survey about medical spending. It became apparent that people could not afford to be ill because a week in the hospital was equivalent to a whole month’s pay, yet not everyone was ill at the same time. Medical expenses were concentrated on the healthy working-class, asking these people to join a pool to contribute to a social fund which created an insurance system that warranted their coverage if they were to get ill. Hospitals would be paid and there was medical coverage for all who did get sick. During this time the President of the United States was Franklin Delano Roosevelt, who sought to get the social security act passed along with national health insurance but his advisors told him otherwise. They advised President Roosevelt that state medical societies would rise up against him and block national health insurance and in turn derail the whole social security act. So President Roosevelt left national health insurance out of his initiatives. This worked out because patients were not the only ones suffering from medical bills, hospitals were too.

As the hospitals in the 1920s began to expand, building on new facilities took advantage of all the new technologies. Their hospital wards were full of patients who could not pay their bills, hospitals too could not pay their bills yet people were going to hospitals and getting well. The healthcare status of the country then improved yet economically strained hospitals still have to be paid so that these hospitals remain open. So the medical society in each state came up with a way to stay afloat, they collectively created the Blue Cross system. Which is actually the market-based policy practiced today.

It all started in Dallas Texas, when a former school teacher, a hospital superintendent brought his idea to the school board. Teachers were asked to join in and contribute a small amount weekly or monthly and hospitals would cover their medical needs for fourteen days each month this would be the first insurance plan. This plan proliferated and the blue cross-system was designed. It operated as a social insurance system; overall it was so that hospitals would get paid. Blue cross then began approaching large businesses, unions and implemented open-door policies. Over time the individuals who could afford a policy were granted one.

The government applied tax breaks, wage and the National War Labor Board monitored and regulated the efforts of organized labor during World War II, although the board would restrict wage increases and price controls it also encouraged the extension of many fringe benefits to American workers. These fringe benefits included private healthcare. Thus, developed is the system we have today, a system of private healthcare based on employment. Employers loved this arrangement, it created employee loyalties.   From the 1920s to the 1970s it worked, those left out were old and poor but in the 1960- 2000s, the government continue to develop Medicare and Medicaid. However, more than 50 years later. Private health care corps based on employment have overtaken the majority of Americans who are insured & getting healthcare from their jobs. Now post- Covid-19 pandemic the cost of providing healthcare is getting more expensive. The economy has been hit hard, unions are dwindling and employers are forced to relinquish employees, and those they keep employers provide minimal healthcare options.

The United States’ socio-economic status is tried as a developed country that competes globally. The economy changed and medical care is getting more expensive. Unlike the Model employers such as, General Motors which loaded its employees with good health insurance in the 1950s; half a century later model employers such as Wal-Mart today have not upheld these incentives for lifetime employees. They are competing with the global economy bottomless pit.

Schaffer H. Luke and Salmon Elizabeth, assess The Development of an Unequal social safety net: A case study of the Employer-based health insurance/noninsurance, (September 2009).

-The United States social safety net stretches thin the labor market inequalities rather than ameliorating them. They trace this theme with an important study of the United States determined superstructure of the healthcare institution. They discuss Habitus, in the United States of practicing the employer-based health insurance system. Employers became the dominant tax-preferred provider of health insurance in the United States without any federal legislative action. Understanding how this happened may reform efforts. This case study highlighted the two important factors; the first path is dependency, discussed by Skocpol (1992) and Pierson (2000). They argue that ambiguous divisions of power and pluralistic governance framework favor incremental processes of social policy formation in the United States. The second factor discussed is the divisions within the American workforce (Esping-Anderson, 1990). Divisions by race and sex have very often been left out or underserved by United States social welfare policy. Because of low-wage work, most are not covered by employer benefits, because they cannot contribute to the health insurance pool-.

The real foundation of the United States healthcare system is being shaken cracked. Employers cannot garnish enough profit to fund health care for their employees. While assessing I noticed that the United States Health care structure has approached a fork in the policy road. One policy leads the United States toward a Universal health plan with strong government involvement and the other policy supplements the already existing market-based health care choices and preserves the commercial health insurance industry. Maybe the single-paying system could work. That though the United States is opposed to a Socialist health care system, a consumer-driven health care shares components of the market-based system which allows patient choice that allots individual health saving accounts and increases cost-effective initiatives. These accounts are offered to employees as a means of increasing the cost-sharing of personal healthcare expenses. One must ask how much time will be wasted on Insurance driven bureaucracy; where doctors, insurance executive programs, lobbyists, and pharmacists profit but consumers don’t. Will the United States abandon earlier practices of pooling health care expenses across a wider community?

The Origins of India’s Health Care

The Indian health services maintain a separate agency within the Public Health Services. The infrastructure of India’s health care since the mid-twentieth century is traditional yet evolving into a shadow of the United States cash for the service insurance system. It is noted that in respect of all health indicators, the average figures for Tripura are better than the corresponding national average. India’s health care infrastructure is composed of the Ministry of Health and Welfare. The Bureau of health professions provides leadership in India as it is a developing nation. It uses the nation’s health personnel and resources; it administers training programs in the healthcare field. There is a shortage of doctors and it helps to instill access to health care facilities, services, and career centers.

The United States Socioeconomic status

“Preparing our nation to compete,” said President George W. Bush in his State of the Union message from January 31st, 2006, “is a goal that all of us share, we are seeing a shift in economical resources for the United States. The U.S. is now seeing new competitors like China and India, and this creates uncertainty”. The look space the United States has is that it holds in place a stable government. Agreeing, Richard H.K. Vietor How Countries Compete states that “there is an economic crisis in the United States. The “United States’ descent into deficits and debt despite high growth, low inflation, and outstanding improvements in productivity, the United States had developed massive fiscal trade deficits, with no savings to support them. The U.S has borrowed more and more from foreign savers, who consequently owned more U.S. assets and thus this has reached a major economic crisis. This then leaves the health of the nation in panic.

India socio-economic status

According to Vietor “India, a developing country needs to open up its doors; it lacks infrastructure and lack of foreign investments. India’s economic problems lie in the fiscal deficit. India has a fragmented democracy with ethnic and religious heterogeneity. The India debt to the GDP ratio needs to decline from its current level of 86%. Doing so may push growth to 9% annually and help moderate infrastructure while alleviating poverty”.

Traditional values of medicine in India

Unger Jean Pierre; Van Dessel Patrick; Sen. Kasturi, and DePaepe Pierre’s (May 2009) paper about International health policies and stagnating maternal mortality, ask “is there a causal link between weak healthcare practices and natural population growth rates”? They discuss progress towards Millennium Development Goal 5 on maternal health care. It appears to have stagnated in much of the global south. It is reported that 500,000 women die each year as a result of pregnancy or childbirth. They discuss the past fifteen years of international health policies.  That many countries are not making progress towards the efforts to reduce these deaths by ¾ by 2015. The demographic and health status of the maternal population is the question at hand regarding total fertility rate, crude birth rate, and crude death rates, natural growth rates, and maternal mortality rates in a country. Weak health systems, weak services, and low staffing levels and managerial weaknesses and lack of infrastructure and information cause this stagnation; then relates to the inability of some countries to meet two essential conditions. One is to develop access to healthcare for all people living within a nation. Every person must be capable of accessing essential comprehensive educational health services and healthcare. The second-all-nation states & government’s budget should be set to provide the not-for-profit sector with needed financial, medical, and technological support.

In the United, there are services set up for mothers and young children. There is free government-based insurance Medicaid; there is WIC which stands for women infants and children. It is federally funded health and nutritious supplemental program for pregnant women and their small children. This program provides educational materials for expectant mothers and child-friendly recipes.

The health status of the person in the United States is confidential, health insurance companies are not to share a piece of patient information with third-party members, common healthcare services are common but are not limited to routine physicals, including gynecology, immunizations, allergy injections, classes for quitting smoking, weight control and nutritional counseling, fitness test, message, and physical therapy, pharmacy services, and birth control counseling and psychological counseling. These are traditional day-to-day health issues in the United States. In the United States, a pregnant woman does not worry about ante-natal and postpartum care because there have been provisions implemented into the United States health care infrastructure to care for women and small children.

In India, women’s health is an important factor too. Yet, there are no provisions in the infrastructure of their health system for pregnant women. Women often receive minimal healthcare coverage. However, educating these mothers on how to provide for their offspring is a challenge. As diseases such as malaria and tuberculosis are prevalent in these societies and the morbidity rates are still high in India. There are various social groups and within the groups, age at marriage is an important factor in determining a woman’s health.

The social actor which contributes to the framework of improvement in health education and nutrition in Tripura reports the Indian National Fiscal health is “access to social medical resources. Service-2 was surveyed and 78% of the population reported the use of health services at the government or public institutions. This confirms that if nations are to see improvement in their national mortality rate, the structure of their health care services must improve.

  According to the Human Development Report (2000), the mean age at marriage in India is 22years old, childbearing age. The data within the report shows that the mean age at marriage has risen within the last years and most believe this is due to literacy enhancement. Tripura State is doing better than the national average; the national mean at the marriage of women now 22 years was higher than the national figure of 19 years. India’s public health society reports that pregnant women in Tripura, India as opposed to other states in India: “have a better chance of safe delivery because of healthcare developments and access to updated technologies. The question here is- Why do we question migration/ immigrants as they seek to find better health care opportunities? When all women want to get the chance of being supported and nurtured pre & post-natal.

Overall I deem that the healthcare status of a nation is its wealth. By addressing basic human needs such as clean and safe housing; access to healthcare and medicines for all citizens or inhabitants of the region; access to nutritious foods; equitable and quality education which lead to employable, knowledgeable man-power of the nation. I deem if we take Maslow’s law- and choose to apply it to ourselves and across the global communities, we will be a healthier human body.

Advocacy 001. for

What does advocacy mean to us? Advocacy in serving our New York State residents & neighboring community. I have faith we will persevere. Putting into practice strength based communimetrics assessments for service delivery as a Public Affairs & Administration professional.

Addressing policy makers and holding the accountable for actionable strategic outcomes. Ensuring what Maslow defines as meeting a human beings basic needs is met. (Food, Belonging, Shelter & Safety). Whether at local, state or federal level.