Government, Power, and Health Care in America: An Analysis of Institutions and Inequalities

1. Chapter 14 Government and Health Care • Defining the State • Power and Authority • Theories of Power • Government: Power and Politics in a Diverse Society • Health Care in the United States • Theoretical Perspectives on Health Care • The Health Care Crisis in America

2. The Institutions of the State Institutions comprise the state as the organized system of power and authority in society: • Government • Legal system • Police • Military 

3. Types of Authority Weber postulated that there were three types of authority in society: • Traditional • Charismatic • Rational-legal 

4. Theories of Power • The Pluralist Model - Interest Groups compete in a struggle for power. • The Power Elite Model - power stems from the top down. • The Autonomous State Model - power of the state feeds on itself. • Feminist - men hold power in all institutions.

5. Political Participation • The U.S. has one of the lowest voter turnouts among democratic nations. • The higher a person’s social class, the higher the likelihood that she or he will vote. • When Black Americans are approached directly by party representatives, the likelihood that they will vote increases substantially.

6. Political Participation • Race, ethnicity, and gender influence political attitudes and behavior. • Women are more likely than men to identify and vote as Democrats and to have liberal views. • The gender gap is manifest in women’s views on peace keeping, gun control, and compassion issues.

7. Political Power: Who’s in Charge? • The class, race, and gender composition of the ruling bodies in the U.S. is not representative. • Most of the members of Congress are White, well educated, men from upper-middle or upper-income backgrounds.

8. Political Power: Who’s in Charge? • 1/3 of the people in Congress are lawyers. • 1/3 are businesspeople and bankers. • Many of the 535 U.S. Congressmen are millionaires.

9. The Military • The function of the military is to defend the nation against external (and sometimes internal) threats. • Considered one of the most hierarchical social institutions. • There is a strong connection between the military and corporate America, through the military-industrial complex.

10. Race and the Military • Desegregation of the armed forces has promoted awareness among Black Americans of their right to equal opportunities. • African Americans and Latinos are over-represented in lower ranking support positions. • African Americans and Latinos earn more in the Military, but don’t share the earnings premium of white veterans.

11. Health Care in the U.S. • There are many discrepancies among people in the U.S. in terms of longevity, general health and access to health care. • The AMA, founded in 1847, was successful in outlawing alternative therapies.  • In the late 1800’s, medicine became an upper class profession.

12. Social Factors in Illness • Race-ethnicity, social class, gender, and age are major factors in disease and health. • White women live longest, and Black men the shortest. • The mortality rate of Native Americans is one and a half times that of the general population.

13. Social Factors in Illness • Hispanics contract tuberculosis at 4x the rate of Whites. • The more money one makes, the more healthy one perceives oneself to be. • The lower one's social class status, the greater are one's chances of tuberculosis, heart disease, cancer, arthritis, and infant mortality.

14.  Role of Gender in Illness • Older women are more likely to suffer from stress, overweight, hypertension, and chronic illness than older men. • There is still a tendency for the male-dominated profession to regard the problems of women as nonmainstream and "special".  

15. Functionalist View of Health Care • Health care system has positive and negative functions in society. • Positive: prevention and treatment of disease • Negative: unequal access to healthcare by race, class, gender, region and unequal health education.

16. Conflict Theory View of Health Care • Health care reflects the inequalities in society. • U.S. Health system is burdened by excessive bureaucratization.

17. Symbolic Interactions and the Role of Perceptions • Illness, wellness, and health care are socially constructed. • The ways we behave toward the ill, toward doctors, and health systems are all social creations.

18.  Health Care Crisis in America • Modern medicine in America is a highly structured, high-status profession. • High costs, malpractice suits and abuse of the fee for service system have resulted in a health care crisis. • Programs for large HMO's and national universal health insurance have met defeat in Congress.