Please remember that you are choosing to read my opinions.

In the last post, I began to get people ready to hear more about the world of heath care by trying to make the point that for the amount of money per capita that American's spend on health care, which was nearly $4,000, we should be healthier. It’s been a lot longer than I meant it to be, but here I am with part two.

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So, let's talk about the seedy underbelly of our existence. You know, that aspect of the way things work behind the things most of us are used to seeing. The part we don't like to address. Let's talk about who benefits from the way things are right now, and who is getting the shaft, so to speak.

Wouldn't you assume that a better, more affordable healthcare system would be better for everyone? It would make healthcare affordable for everyone, so why wouldn't it be "better" for everyone. Well, in a sense it would be better for everyone, if you define better as more people having access to better treatment.

In reality, though, the system isn't driven by what is best for the most people, but by what is profitable for drug companies, hospitals, and insurance companies.

This includes such practices as HMOs (health management organizations) punishing doctors for not keeping costs down and rewarding them for keeping costs down for the HMO at the expense of the patient. Ironically, this has the same sort of effect that opponents of national health programs are worried about. It takes the power away from the physician and patient and gives it to a foreign entity. Instead of the government, however, it gives it to another organization. Then there is the practice of Medlining, which is where HMOs limit the number of at risk and unhealthy patients it serves to maximize healthy patients. Healthy patients don't use their services as often and therefore are more desirable.

But this is merely rehashing some of the things I said in the last post. Let's look at who is getting the shaft most often.

As with many aspects of life, the dreaded cycle of discrimination affects the availability of health care. Race, social class, and gender are all factors in the discussion of health care because, as you may have noticed these things matter. You will hear opponents to this say things to blame the victims. That these people cause their own problems or anything to take the attention away from the what should be obvious. That access to health care is not equal for everyone because everyone doesn't have the same opportunities in life. This lack of opportunity leads many people to live a life less healthy than they would like.

Is it enough to just say that race, class, and gender matter?

Perhaps it would be best to shed some light on what that means. I used to be someone who though that race, class, and gender were trivial compared to things more under our control. Now I have come to believe that some things that we have no control over matter more than I'd like them to. In an ideal world, no matter what walk of life you came from, you would have the same opportunities as everyone else, at least up to a certain point. This is not the case in the United States or most places.



Race, class, and gender are all things beyond our control for the most part. Class is the most flexible of these, but while it is possible to move up and down the social hierarchy, it is likely that you will not move significantly up in class. That being said, your economic position is one of the most important factors in your health. If you are poor you likely work in stressful (and much less than ideal) conditions, You don't have access to good medical care. And perhaps you've noticed that nutritious food is more expensive than the alternatives, so being poor is likely to mean that you aren't eating healthy.

Just think of all the things that are different between the poor and the affluent! There are likely to be differences in work conditions, diet, sanitation, shelter, lifestyle, education and so much more. The rich have better working condition, can afford a better lifestyle, and have access to all sorts of health resources that the less fortunate do not.

The poor don't have the luxury of adequate insurance for the most part because it is so closely tied to employment, and most lower paying jobs don't insure their workers.

And the kicker is that the uninsured pay more than insured people do. If you are insured, a company that demands discounts covers you, so when an insured person goes to the doctor for a covered exam, they might be charged $50 whereas the uninsured patient is charged $150. By shifting the burden to the uninsured, the people who are least provided for are now supporting the wealthy. Yikes!



Race as a factor in health care is less obvious, but when you think about it, it should become more obvious. Non-white people in the United States are disproportionately poor, and therefore suffer from many differences when it comes to health. For example, a black man is t30 - 50 % more likely to die from heart disease before they reach the age of 65 than a white man, nearly 40% of Hispanics in the US are uninsured. Nine of the 11 million are from working families. 20 percent of Black Americans are uninsured, compared with 11 percent of white and the infant death rate for Black Americans is 2.5 times as high as for whites. (taken from http://www.americansforhealthcare.org/facts/groups/minorities.cfm)

Gender is the complicated subject. It does not play out are obvious as race and social class. For the most part, women have the advantage over men when it comes to health. Think about it. What aspects of being a typical female give them an advantage over the typical male? Let's face it, guys are slobs compared to women. We are also supposed to be outgoing, which leads to us doing a lot of stupid things, sometimes even to impress girls. Women on the other hand are more in tune with their bodies, visit the doctors more often, and don't care. Men see going to the doctor as a sign of weakness. My step-dad is a construction worker. He’s done his fair share of duct taping wounds shut. The one time I know he went to the doctor was when he nailed his fingers together. I believe the only reason he went to the doctor was because he couldn't get the nail out.



Of all the advantages women have over men, they are disadvantaged in the system. They are less likely to work full time jobs; therefore they are less likely to be insured. Females tend to be passed over by the medical community when it comes to researching drugs. Until the 1990's, most medical research was done entirely on men. Women also face sexist attitudes, and over all just don't receive the advantages that men get from the medical community.

These three things, race, class, and gender at the very least show us that there are very real differences in the health care we and the life that we life. As a poor man, it is not your fault that you don't have access to the same health care as everyone else. It isn't you fault that as a black man, you can't afford to live in the rich neighborhood and had to reside in the slum next to the chemical factory. As a woman, it isn't your fault that drugs that work on men weren't researched for you.



So, this is going to conclude this session. In the next and (hopefully the final) part, we will talk about all the things that can be done to make the health care system better. This is hopefully going to be a much more interesting segment. haha.