In The Rise of the Modern Hospital, Rosenbergon discusses the medicalization of the hospital setting and the hospitalization of physicians and private practice. As mentioned in lecture, he discusses how hospitals transformed into a fully integrated medical setting from a previously personalized, potentially less effective social model. This joining of healthcare directly coincides with other articles discussing over-medicalization, which brings up the question: was the hospitalization of physicians potentially one of the first steps in over-medicalization of society? Though critical to our idea and perceptions of modern day hospitals, did this transformation push hospitals to be too medical for proper health and healing?
As suggested by the article written by Nicholas Bakalar of The New York Times, one’s marriage status may increase one’s likelihood to recover from serious surgery. Such a statement takes support from a study conducted by JAMA Surgery, a monthly medical journal published by the AMA, which included approximately 1,567 individuals who had cardiac operations and ranged between 50 and older. Of the 1,567 research participants 1,026 individuals were married, 184 were divorced or separated, 331 were widowed, and 35 were never married. Information regarding their need for aid in six specific ways prior to the surgeries was first recorded, and then compared to similar data collected two years after the operations. The six activities included rising from bed, walking, bathing, dressing, and consuming food. The results showed that roughly 20% of married individuals pass on or increase in dependency, whereas 28.8% and 33.8% of divorced/separated and widowed individuals showed similar outcomes, respectively, even after factors like personal habits were controlled for. The survey is praised for the implications it poses on social supports on patient health outcomes.
While the studies does shine light on the importance of support systems for patients, researchers limit themselves by the use of labels like “marriage,” “never married, etc. Marriage does not necessarily equate to the reciprocation of care and comfort, as individuals may fall out of love while holding such a status, compelling them to perhaps despise and or cheat on their partner. In addition, marriage is sometimes used as a tool to gain individual benefits between two parties, and in such cases may not entitle one to receive such personal care from their partner. In contrast, individuals who have never married may receive care and comfort more so than those of married couples. Non-marriage does in no way characterize the lack of social support. For example, the LGBT community has spent many years fighting for the status of marriage, and has very recently made profound advancements in its goals nationwide. Many of this community, while not legally married, upheld relationships or familial units similar to society’s ideal conceptions of married units, displaying that support can be received outside the confines of “marriage.” Also, the inclination to pursue the institution of marriage has waned amongst the younger generations over the years, regardless of their sexual preference, thus increasing the likelihood of long-term couples with supporting partners that may not fall into the categories established in the study described above. The result of non-married individuals are not even included within the results reported by the article, providing an inaccurate view on the social implications of the study. Factors such as whether individuals remained in hospital care or were discharge home were not mentioned either, or whom played a primary role in patient recovery care.
“The United States is the only western industrialized nation that fails to provide universal coverage and the only nation where health care for the majority of the population is financed by for-profit, minimally regulated private insurance companies” (Quadagno 25). As a hopeful future participant in the healthcare industry, I feel that expanding one’s perspectives and understanding the market, its influences, and its failures are critical to evoking any future change in the system. Sociology of Healthcare has surely created a more expansive personal perspective of the U.S. healthcare crisis, along with portraying how the poorly U.S. healthcare holds up when compared to a variety of other systems. More importantly and shockingly, however, it has made it clear the substantial amount of propaganda circulated by major players in the industry in order to resist change.
In Atual Gawande’s article “Testing Testing” he highlights what he believes to be the two main problems of America’s fragmented health care system, cost and coverage. Not all Americans have access health insurance and even with coverage out of pocket medical costs continue to soar. With the passage of the Affordable Health Care Act more Americans have insurance coverage but the bill has done little to make “significant long-term cost reductions.” According to Gawande, if costs continue to rise at the current rate more than a fifth of every dollar Americans earn will go to health care costs.
Gawande goes on in the article to give a brief history of the United States agricultural system, essentially comparing it to the current state of our health care system. In the 1900’s there was an agricultural crisis in America, there were limited crop options at high prices with differing qualities. However, through government intervention the USDA was able to implement pilot programs that improved the quality of farms county by county by providing technical assistance to local framers. This system was effective in that it standardized quality of crops, lowered prices and increased availability. The government was able to be involved in improving the country’s agricultural system without taking control away from the farmers. Additionally, this process did not happen over night, it took years to standardized the US agricultural system. It also required trial and error as far determining which farming techniques were better than others and which techniques produced the highest quality products at the lowest prices.
The history of America’s agricultural system tells us that government intervention may be the logical next step in response to the health care crisis. Because at this point we are in crisis and continuing to let big pharma, hospitals, insurance companies, and the AMA control our health care system is not a logical option. Answering to the government may not be physicians, pharmaceutical, and insurance companies want because it threatens their autonomy, but if they are not willing to come up with a standardized system the government will need to do so. There is no reason for the United States to continue to be an outlier when it comes to the amount we spend on health care. The cost of health care in other parts of the developed world like Switzerland and Norway pale in comparison to what Americans are paying. There are other less fractured and more organized systems that are working in other countries around the world. The United States needs to find another system that works without the high costs and low coverage that we are currently experiencing. Our current system is not going to get any better unless something is done because as of now it is not matter of whether or not our existing health care system will bankrupt our country but when.
In Paul Starr’s article, “The Growth of Medical Authority,” he explains that medical professionals gained their current level of authority through a combination of different factors, including scientific and technological advances, urbanization, the standardization of education and licensing requirements for medical professionals, the rise of hospitals, and the connection between medical approval for treatments and procedures and insurance payments for those interventions. In the nineteenth century, many people relied on their families and their communities in times of ill health, with medical professionals competing with each other to keep the patients that they did have. As a result, their authority was compromised and they were unable to unite with other medical professionals. As the above factors came into play, however, medical professionals gained more authority, both as individuals and as a united profession. As Starr states, “laymen have become more dependent on professionals, professionals have become more dependent on each other” for “referrals and access to facilities” (558, 561).