Socio-Economic Aspects of Healthcare in Australia

Sociology is the study of human behavior in relation to the development, structure, and functioning of the society (Wallace & Elias, 1979).  On the other hand, health is a broad term that was defined by the World Health Organization as the state of complete physical, mental, and social well-being or a person and not just physical health as many people think ("Constitution of WHO: principles," n.d.). According to Malcolm in his study of human needs, health is a physiological need meaning that a person cannot survive without good health (Nain, 2013). Hierarchy in healthcare stands for order in which human being put in order their needs such that they give attention to the need which they think is most important. Power in sociology according to Max Weber, is the ability a person or a group to achieve change or objectives regardless of the resistance they face from other forces ("Weber’s definition of power," 2018). A healthcare system is a complex organization of hospital systems, patient care systems, and healthcare programs that work together to providing comprehensive health need to a population, in our case Australia. This paper looks at the integration of sociology to healthcare in Australia majorly the effects of hierarchy and power which are social aspects of the Australian population to its healthcare. The text will expound in depth how hierarchy and power systems formed as a result of social characteristics of Australians affects the healthcare programs in place.

Weber Theory of Capitalism

            Weber theory of capitalism was released in 1904 and has been a subject to discussion among many elites with some buying its ideas and some rejecting. The theory of Capitalism is also referred to as the three component Theory of Stratification because it is based on class, status, and power (Hurst, 2015). Max Weber, the founder, argued that social stratification was based on these three aspects.

Marxist Theory of Socialism

            Socialism theory was developed in Russian in the year 1917, a few years after the capitalism theory as a result of Vladimir Lenin disagreement with the capitalism theory. Marxist theory of socialism is based on common control and sharing of resources (Mohun, 1977). When healthcare was first introduced in Australia, the political leaders had assumed socialism aspect of view because they were looking forward to communal and collective sharing of resources which are the two main aspects of socialism.

            The theories of capitalism and communism have contributed to the unstable position of Australia healthcare system. Apart from the two theories of sociology, there are other theories that have been contributing to the change in Australian healthcare system like the theory of feminism which promotes gender equality favoring the female and many more. All sociology theories are based on sociology concepts and perspectives of sociology that determine whether a person or a society will be ready to conform to the theory.

History of the Australian Healthcare System

            Australian healthcare is one of the best-established healthcare programs in the world. Even though, currently the healthcare system is facing challenges which lead to instabilities and potential disruption of the system. Founding its Medicare program in first October 2005 Australia had the best terms and conditions that promoted healthcare systems. Australia healthcare program was introduced in 1975 by the Whitlam government as Medibank with the intention of making healthcare affordable to every Australian citizen. Whitlam's government was based on the Marxist theory of socialism. Marxism theory insists on socialism, equal re-distribution of wealth through tax systems, and that the government is responsible for a wide range of services to its citizens. Medibank was free for all citizens regardless of you were contributing premiums or not. Fraser government which took over scrapped off free Medibank services and changed the services only to the people who could afford premiums. President Hawke reintroduced the medical plan again in the year 1984 with the current brand-name Medicare (Blakeney, 2009). Since then, Medicare has been running together with private healthcare schemes that were introduced before Medicare was revived (1981). Running of Medicare from 1984 was faced by many challenges due to competition with private insurance schemes.  

Impact of Hierarchy and Power to Healthcare in Australia

            Most hospitals in Australia are public because of the role played by the government in promoting and funding. The public hospitals are generally adequately equipped as the private hospitals because of the support from the government healthcare program. Medicare plays an important role in determining general healthcare structure standards all over the country. Since the year 1981 when the private health insurance coverage policy was introduced in Australia, private insurance companies have grown steadily posing a great threat to Medicare. Healthcare systems in Australia are greatly influenced by sociological dimensions of the Australian citizens with recent studies expressing conflict and threat to Medicare which is the public healthcare system.

Factors that lead to Social Stratification thus Hierarchy and Power

            From Weber’s capitalism theory money, power, and wealth govern the position that a person occupies in the society, therefore, Hierarchy. Many aspects have led to the development of Hierarchical and power differences among Australia citizens.

Urbanization

Urbanization is the characteristic of one’s residence being a town or a rural residence. Urban life is characterized by industrialization and availability of social amenities and infrastructure hence creating a division between people who live in urban areas and those that live in rural areas. The people that live in urban areas are considered to be classy and occupy higher social classes. People living in the rural areas, where there are no equitable better infrastructure and amenities tend to feel less fit and end up segregating themselves and so do people living in urban areas. According to national rural health alliance, only 518,000 (2.2%) live in marginal areas in Australia. According to the 2015 burden of disease report, people living in the rural areas suffered 20% more cases than their counterparts in urbanized areas. The same report puts out that about 40%-60% more people die of chronic diseases in remote areas when compared to towns (Crikey, 2016). There are also fewer health practitioners in the rural areas. The stratification leads to political power wrangles between different hierarchies leading to disagreement when making decisions about the promotion of Medicare. The richer people who live in town develop some sense of social pride that make them withdraw from public healthcare program (Medicare) for private insurance companies that are more expensive which tend to give them a sense of being better than poor citizens. On the contrary, people living in the marginal areas will tend to promote Medicare since it offers low premiums, therefore, cheaper treatment. Withdrawal of some members from the Medicare program means reduced pool of finances that should be shared all through the country hence making the system weaker.

Power and Status

            Power is the concept of an individual having more influence than others in the society. Karl Marxist suggested that in a capitalist society, power is possessed by the working and the ruling classes which can control production and finances which means that they are in control of their subordinates (Cook, 2011). According to the conflict perspective of sociology, an industrialized country like Australia is divided into two, the owners of means of production and the workers ("Sociological Perspectives Reviewers," 2007). The two classifications play different roles in Australian healthcare systems. Cook also put out that Marxist theory is based on the fact that the ruling class holds all power and they use it to exploit others. Power in Australia is based on politics and Economic value. However, Cook also insists that those individuals who have economic potential also held a stronger political influence, therefore, more power. Pillars of the Australian economy are education, agriculture, mining, and Manufacturing (Green-UTS Business School, n.d.). Manufacturing holds a huge share of the Australian economy contributing 6.2% of Australia GDP compared to other pillars.

Income is directly linked to the ability to afford to afford medical services. The lower income earners have a higher percentage of people failing to see a medical practitioner or failed to get prescribed medicine due to poverty (Duckett, 2017). Money is a kind of power in capitalism theory leading to hierarchy. The richer you are, the more important the society thinks you are, this is because you possess the ability to reward other with the most important aspect of capitalism, money.

Businesses owners are the main employers of the Australian population with bosses having power over their workers. In some sense, employers act as mentors and the people under them tend to emulate their behaviors and ideologies with the belief that if they emulate what they do and how they think they stand a better position to be like them economically. Some employers misuse the economically possessed power by forcing subordinates to buy personal ideologies otherwise face punishments like job sucking and failure to secure employment in their organizations. Individuals who have more power in the society have a stronger political say than those sithout.

Due to power stratification based on economic class difference, different classes tend to segregate themselves in Australian healthcare. The more powerful individuals segregate from public Medicare plan to private healthcare insurance that they relate to class because they are expensive and not considered affordable to the common citizen. They sell their ideologies to upcoming powerful people who also tend to leave Medicare for private health insurance services with a perception that public Medicare program is for the common citizen and the rich should move to more expensive health cover policies as suggested by Karl Marx.

Gender and Sociology

            Gender differences play a major role in Australia sociology. According to feminist theory, the society is organized into hierarchical systems led by men. There is an exception to the feminist theory in that political, economic, and social powers play a role in the destabilization of the theory.  Women are valued part of the society in the society in the Country (Thomas, 2013). Australian men treat their women as special and tend to protect them from anything that might not be favorable. In typical Australian society, women are convinced that men who are more protective are better mates than those that don’t care. Negative publicity about public healthcare systems in Australia promotes a shift in preference for men when it comes to their family and mates health. With the intention of making sure that their families are protected and contented of the efforts they put in their lives, men might secure private healthcare programs for their families as a prove of care towards their families and power.

Ethnicity and Healthcare

            Australian ethnicity is a complex phenomenon that plays a major role in influencing the path taken by healthcare systems in Australia. Minority ethnic groups have been related to poorer healthcare status over the world ("Sociology in nursing 4: the impact of ethnicity on health inequalities," 2015). Australia has a rich cultural diversity with about a quarter of Australian population origination from out of Australia. British are the majority in the ethnic make-up having about 67.6% of the total population, Irish occupy 8.7%, Italians 3.8%, German 3.7%, Chinese 3.7%, and other ethnic groups represented by the remaining percent.

            Study has shown that one reason for health differences across different ethnic groups is the cultural norms and values of the minority groups. Even though Nazroo (2004) argued that blaming a minority culture to their culture is nothing but a blame game but not facts, according to Nazroo the main cause of the difference in health status is the social and cultural values of the mother country. The major ethnic group in Australia like the British have more power than the minority groups. Their power is sourced from cultural support and the already existing perspective that the major ethnic groups are better than the minority because they are portrayed to have better social and economic class.  According to Marxist theory, an individual or group of people having better social and economic class are placed in higher hierarchies of power than others.

Conclusion

            Australian healthcare program (Medicare) is based on socialism theory concepts where the government exercise common control and sharing of healthcare as a resource among Australian citizens. Based on the fact that Australia economy as a country is founded on capitalism concepts and perspectives, Medicare has been faced by many challenges as capitalist try to challenge the system. Factors like urbanization, feminism, ethnicity, power, and status have led to the development of Hierarchical and power classes which have posed as opposition to common healthcare plans that take care of all classes of citizens without minding hierarchy. Since 1981 when private healthcare insurance firms were legalized in Australia, more people are drifting from Medicare to private healthcare plans which has been weakening Medicare each day because of reduced pool contributions in the form of premiums. The poor just as the rich and highly placed social classes deserve good healthcare programs from the government because no one can survive without good health. Therefore, the government should work on ways of making Medicare platform strong regardless the mushrooming private insurance companies without destabilizing the business environment in the country. In conclusion, Hierarchy and power stratification factors should not be allowed to interfere with the Medicare program to ensure equality and that every Australian citizen gets access to good healthcare.

References

Blakeney, A. (2009). Part III: Oral History and the Birth of Medicare: Witnesses to Medicare in Saskatchewan: Medicare Workshop at the University of Saskatchewan—Wednesday, 20 May 2007: The Struggle to Implement Medicare. Canadian Bulletin of Medical History, 26(2), 527-532. doi:10.3138/cbmh.26.2.527

Constitution of WHO: principles. (n.d.). Retrieved from http://www.who.int/about/mission/en/

Cook, S. (2011, November 29). Marxist perspective of power. Retrieved from https://revisesociology.wordpress.com/2011/11/29/6-marxist-perspective-of-power/

Crikey. (2016, July 21). Rural Australia has always worried about access to Medicare. Retrieved from https://www.crikey.com.au/2016/07/05/rural-australia-medicare-funding

Demographics and Ethnic Groups of Australia. (2018, June 13). Retrieved from https://www.worldatlas.com/articles/ethnic-background-of-australians.html

DeRosario, J. M. (1999). Healthcare System Performance Indicators: A New Beginning for a Reformed Canadian Healthcare System. Journal For Healthcare Quality, 21(1), 37-41. doi:10.1111/j.1945-1474.1999.tb00937.x

Duckett, S. (2017, September 21). Australia's health system is enviable, but there's room for improvement. Retrieved from http://theconversation.com/australias-health-system-is-enviable-but-theres-room-for-improvement-81332

Green-UTS Business School, R. (n.d.). Australia’s ‘five pillar economy’ - manufacturing | University of Technology Sydney. Retrieved from https://www.uts.edu.au/about/uts-business-school/news/australias-five-pillar-economy-manufacturing

Hilless, M., & Healy, J. (2001). Healthcare systems in transition: Australia. Retrieved from www.euro.who.int/__data/assets/pdf_file/0008/96434/E74466.pdf

Hurst, C. (2015). Social Inequality. doi:10.4324/9781315662817

Mohun, S. (1977). The Communist Movement: From Comintern to Cominform. A Review. Capital & Class, 1(2), 128-142. doi:10.1177/030981687700200107

Nain, B. (2013). Nain's Porous Hierarchy of Needs: An Alternative to Maslow's Hierarchy/Theory of Needs. SSRN Electronic Journal. doi:10.2139/ssrn.2279375

Sociological Perspectives Reviewers. (2007). Sociological Perspectives, 50(4), 617-618. doi:10.1525/sop.2007.50.4.617

Sociology in nursing 4: the impact of ethnicity on health inequalities. (2015, October 26). Retrieved from https://www.nursingtimes.net/roles/nurse-educators/sociology-in-nursing-4-the-impact-of-ethnicity-on-health-inequalities/5091396.article

Thomas, S. (2013). A Transnational Perspective on William Dawes’ Treatment of Women. History Australia, 10(1), 187-204. doi:10.1080/14490854.2013.11668452

Wallace, W. L., & Elias, N. (1979). What is Sociology? Contemporary Sociology, 8(5), 767. doi:10.2307/2065457

Weber’s definition of power. (2018, May 1). Retrieved from https://sociologytwynham.com/2013/06/04/webers-definition-of-power/

Nazroo JY (2004) Genetic, cultural or socio-economic vulnerability? Explaining ethnic inequalities in health. In: Bury M, Gabe J (eds) The Sociology of Health and Illness: A Reader. Abingdon: Routledge.