This paper will highlight aspects of hierarchy and power that are fundamental in the Australian Healthcare system. It will extrapolate from sociological theories and models. The implications of hierarchy and power in the Australian healthcare system. The paper will also address the implication of all these to me as a medical practitioner. It is essential to understand the definition of the terms that are in use throughout the paper (Burau & Fenton 2011). Sociology is the study of how humans behave. It includes aspects of human society such as their culture, relationships, and patterns. Hierarchy is how society categorizes their people due to their authority through economic or political ranks. Power is the capacity to steer people's ideas or the occurrence of events.
Sociology includes aspects that directly influence the healthcare system across the world. We have to understand the concepts of its embodiment in healthcare. Social stratification in this perspective talks about the different social classes that have differentiated individuals in the society. Social classes are brought about by inequality in the allocation of resources. Resources are the focal point of any societies' growth and development healthcare interventions (Germov, 2014). The lack thereof of a segment of the populace of these resources shows decreases their opportunity to better healthcare. Perspectives on social stratification from different researchers will assist to understand. It is essential for every individual to exercise regularly to avoid being obese. Parents who have children should ensure that they are under a balanced diet to avoid being malnourished (Karlsen, 2012). The choice of fast food restaurants instead of organic foods should not be a preference for anyone's lifestyle. Cultures and behaviors of different social groups define the health repercussions of the group. Cultures are prolonged behaviors, and they are deeply embedded in people's everyday life (Evans, 2013). For example, countries that experience more winter months tend to have a populace of smokers. These residents while likely have a higher rate of suffering from oral and lung cancer. They would, therefore, need adequate and quality health care on these areas. Inequalities in healthcare due to behaviors is highly dependable on the lifestyles embraced. It is essential for every individual to exercise regularly to avoid being obese. Parents who have children should ensure that they are under a balanced diet to avoid being malnourished. The choice of fast food restaurants instead of organic foods should not be a preference for anyone's lifestyle.
Physical health in social stratification and health care addresses how different people are affected by factors such as housing and their place of residence. Poor people have the terrible housing conditions which are not safe for their physical health. Bad houses that are not proper roofed or adequately insulated for all seasons are not advisable. Diseases like fever and pneumonia have been majorly caused by extreme exposure to cold. Poor working conditions where machine operators are not provided with protective kits as required by their profession causes injuries (Harrison, 2017). On the contrary, individuals who have better housing and better working conditions due to their place in society are considered to be in a position to avoid these harmful inequalities.
A biomedical model is a concept of using biological methods to provide treatment for full recovery. This model generally highlights the medicinal forms of treatment. It encompasses the use of medical practitioners such as doctors, surgeons, midwives, and nurses to ensure that a patient is treated (Schofield and Berti, 2015). This model has its basis in some fundamental assumptions. The first is that the normal state of a human being is when he/she is without illnesses. It assumes that any sickness or disease is a deformity that needs addressing. It, therefore, bases its arguments on the feelings that the body undergoes. The sense of pain or discomfort should not occur. For example, stomach upsets due to amoeba make the body not function properly biologically (Kuhlmann & Burau 2015). The second assumption has its foundations in the theory of specific etiology. This theory states that one particular identifiable agent causes every disease. The recognizing of these agents and knowing them resolves the problem. The approach has been beneficial for the studies of genetic complexity. The third assumption is generic diseases. This assumption has its foundation on the facts that generic diseases are not influenced by other factors such as historical or cultural. The symptoms and the stages of these diseases remain constant. The fourth assumption is the scientific neutrality of medicine. Medical practitioners use this assumption due to the way they see themselves as scientists and medicine as the science.
The assumption claim that the process is completely unbiased and that there are no other factors that influence their objectivity in medicine. The procedures are universal and neutral. The biomedical model has developed over time, and it gained dominance in the 1940's as the preferred model (Marcarelli, 2016). Although other social and economic factors have always been considered to affect the model, its processes have provided for its credibility. Its growth has been a consistent process of research and outcomes. As a model that has seen technological advancements of creating structures and equipment to address different medical conditions. There have been preventive measures like the introduction of vaccinations of polio and measles for example. This model has gained prestige due to its treatment orientation. The investments and undertakings for development have yielded results (Rothgang, Schmid and Wendt, 2011). Currently, medical facilities are all over Australia and the world. Medical research centers such as the Center for Disease Control have been put to address pandemic outbreaks and terminal diseases. Hospitals are in use for practical education after classwork for students taking medical courses. Laboratories and therapeutic centers that have been set up rely solely on the biomedical model.
Hierarchy and Power
A hierarchy has several means of describing it. The definition at the beginning of this paper, it is seen as a way in which societies categorize authority. Politics play a crucial role in the administration of every nation. Whereas power is mainly concerned with peoples' idea, the two work together. Power is embedded in a hierarchy meaning that the higher the hierarchical ladder, the more amassed power the individual(s) has. Competing interests in any society are due to the distribution of scarce resources. These resources are diverse, and healthcare is a critical component in the delivery. To understand how power works, we need to extrapolate on its three dimensions. The first dimension is where the conflict is open and noticeable. This is seen in cases of serious conflicts. The second dimension of power is when the conflict is covered (Molina?Mula & De Pedro?Gómez 2013). This is done when those in power make sure that those they are in conflict with do not get a say in the resolving process. This works well when for example an issue has been raised to the Senate and a committee is formed to address it without taking insights from the public. When this is done, those who are affected by the conflict do not get their views heard. Those in power, in this case, the committee members choose their interests at the expense of others. The third is the use of those in power to shape their ideas, tastes, choices, and preferences (Kuhlman and Burau, 2015). In this case, those in power openly focus on their interests while others are not noticing.
An example of this is the use of social media for political gain or financial. Until people provoked, they would never know what has happened. It leaves those in power protecting their interests. While relating power to health, it is important to note that those in authority make choices on matters of health. In every state, health policies are vital for the oversight and implementation of healthcare. These policies are drafted by lawmakers and members of Congress who debate it in the house before it is approved or declined. It means that the decisions will hugely rely on the social, political or economic situation of a state (Roberts, 2012). The downside of this is that the interests of those in power might not necessarily be overall good interests. In the case of health insurance, those with vested interests are in it for financial gain. It means that health insurance rate at offered at exorbitant packages. These rates end up benefitting a minority group that is in power. This hierarchy is the same in the medical profession. The medical dominance with regards to their level of study is highlighted in this research. Doctors who are in positions of power are mandated to make decisions that influence healthcare (Karlsen, 2012). In Australia, this is also experienced and those in private practice set monetary standards for the services that they offer. Despite the government having standardized fees for different illnesses this does not stop the private sector from setting their own.
The Australian Healthcare System
Australia has diverse healthcare systems that are founded on two important scales which are selective-universal coverage and public-private provision. The universal coverage is founded on the idea of socialism where the state caters to the collective healthcare of its citizens. This is then financially achieved through taxes from citizens (Australian Institute of Health and Welfare, 2013). The second is the private provision which is mainly founded on the economic and financial tenets. This solely relies on the economic liberty of individuals who choose to cater to their bills. They attend private healthcare facilities for general or specialized treatment (Rodon & Silva 2015). They, therefore, seek the services of private insurance firms. These two different spectrums have shaped the perception and current situation of health care in Australia.
Implications to the Australian Healthcare System
Hierarchy and power have played both constructive and destructive roles in the Australian Healthcare system. Regarding funding, the three tiers of government have played different roles. While taking an example of the healthcare funds sources in 2012, 44% of the funds have their origins from the Commonwealth government. It was the most significant contributor due to the collection of taxes and from the Medicare levy charged on those that have packages. This, however, is not levied the same across all Australian citizens. Those with average pay have their taxes at 1.5 percent of their taxable income. The state is also responsible for managing more aspects of health than any other tier. These areas include public health services that include dental, mental, psychiatric and child health. The local government is responsible for environmental and other preventive roles (Rothgang, Schmid, & Wendt, 2011). These implications are between the private and public segmentation of responsibilities. In 2012, approximately 30% of the national funds came from the private sector. Collecting of the federal funds is through insurance schemes both from hospitals and motor vehicles and cash that was given to facilities. The private sector also champions for more constructive of the provision of comprehensive healthcare services (Health Workforce Australia, 2012). In 2004, politicians took a central role in favoring the private sector under the leadership of John Howard, the then Prime Minister. They reformed changed Medicare and amended a few clauses to enable the privatization agenda was a success. It was in line with their ideology. This Coalition government ensured that they changed health care from a socialist perspective to an economic one. The socialist perspective was to mean that only the individuals that could not afford health care would be the ones that the state would pay for their covers. Those that could afford it needed to fund it themselves (Kuhlmann & Burau 2015). Health is a universal facet of survival of the human species and not an economic categorization. In 2007, the Labour Government took a different approach to make the system to appear equal and balanced through rechecking the remissions.
Issues that arose in Australia brought the need for national health reform. The Australian healthcare system with matters like the public and private divisions, unexpected outcomes from the policies put together and the different funds sharing rationale between the state and local governments. In 2009 the National Health and Hospitals Reform Commission was formed through the joint of the Prime Minister and the Minister of Health. This report aimed to ensure that the universal aspects of healthcare are given the priority. It was expected to ensure that those accessing public facilities still got free services. This reform identified three objectives to address and provide recommendations. They included; the securing of the sustainability of the health system by making it more self-improving, the ensuring the repositioning of the system to address emerging issues and lastly to tackle equity and accessibility for all to health care (Burau & Fenton 2011). Power is seen changing the course of the reforms in the year 2010. Change of the leadership of government from the then prime minister Kevin Rudd to Julia Gillard led to the modification of the recommendations of the reforms.
Hierarchy and power are essential to the full realization of primary health care. It is, however, essential to know that guidance and moderation for the use of these factors are vital to steer healthcare in Australia in the right direction (Belcher, 2014). The purpose of the biomedical model as the leading model in healthcare has necessitated for the address of emerging issues that have come with it. Medical practitioners need to embrace best practices, and those in the positions of authority need to prioritize the interests of better healthcare. The local and commonwealth government should come to an understanding that will see cheap insurance packages for the citizens. Harmonious coordination of the two forms of government will lead to better resource allocation and better steering of healthcare interests (Evans, 2013). Politicians in their quest for furthering their interests should ensure that those of the health care system is not left out. Recommendations for the solution to the Australian healthcare system would include embracing equity to accessibility to every citizen irrespective of their financial capabilities. The recommendations of the health reform should be implemented to adhere to the universal healthcare principles.
Australian Institute of Health and Welfare. (2013). The health of Australia’s males: From birth to young adulthood (0–24 years). Retrieved from https://www.aihw.gov.au/reports/men-women/the-health-of-australia-s-males-from-birth-to-yo/contents/table-of-contents
Belcher, H. (2014). Power, politics and health care. In J. Germov (Ed.), Second opinion; An introduction to health sociology, 5(1), 359-387.
Burau, V., & Fenton, L. (2011). How healthcare states matter: comparing the introduction of clinical standards in Britain and Germany. Journal of health organization and management, 23(3), 289-303.
Evans, D. (2013). Hierarchy of evidence: a framework for ranking evidence evaluating healthcare interventions. Journal of clinical nursing, 12(1), 77-84.
Germov, J. (2014). Challenges to medical dominance. In J. Germov (Ed.), Second opinion: An introduction to health sociology 5(1) 388-408.
Harrison, S. (2017). The politics of evidence-based medicine in the United Kingdom. Policy & Politics, 26(1), 15-31.
Health Workforce Australia. (2012). Australia’s health workforce series - Doctors in focus. Retrieved from https://www.medicaldeans.org.au/wp-content/uploads/australias_health_workforce_series_doctors_in_focus_20120322.pdf
Karlsen, E. (2012). Refugee resettlement to Australia: What are the facts? Retrieved from
Kuhlmann, E., & Burau, V. (2015). The ‘healthcare state’ in transition: national and international contexts of changing professional governance. European Societies, 10(4), 619-633.
Marcarelli, G. (2016). Multi-criteria decision making for evaluating healthcare policies: the benefit/cost analysis by the analytic hierarchy process. International Journal of Medical Engineering and Informatics, 8(2), 163-181.
Molina?Mula, J., & De Pedro?Gómez, J. E. (2013). Impact of the politics of austerity in the quality of healthcare: ethical advice. Nursing Philosophy, 14(1), 53-60.
Roberts, A. (2012). The politics of healthcare reform in postcommunist Europe: the importance of access. Journal of Public Policy, 29(3), 305-325.
Rodon, J., & Silva, L. (2015). Exploring the formation of a healthcare information infrastructure: hierarchy or meshwork?. Journal of the Association for Information Systems, 16(5).
Rothgang, H., Schmid, A., & Wendt, C. (2011). The self-regulatory German healthcare system between growing competition and state hierarchy. In The State and Healthcare, 1(1) 119-179.
Schofield, T., & Berti, M. (2015). The state and health. In T. Schofield (Ed.), A sociological approach to health determinants, 1(1) 123-147