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HLST 1011 (1)
Chapter 1-12

HLST 1011 Chapter 1-12: Required Course Readings

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Health Studies
HLST 1011
Claudia Chaufan

HLST 1011 Course Readings Week 1: January 9 (Foundations of Health Studies: Sociological Imagination and the Political/Social Roots of Health and Disease) Everyday Sociology blog posts – selection, 2013 – 2014 Asking Sociological Questions by Peter Kaufman:  Sociological questions consider the structural dimension of the issue and strive to understand the bigger picture  We ask these questions because the individual and blamed questions which are the norm in society do not tell us the full story  Before concluding with the dominant narrative, you must always pose the counter narrative to understand the full description C. Wright Mills, 1959, The Sociological Imagination (excerpts)  The life of an individual nor the history of society cannot be understood with understanding both areas  Take into account the individuals’ lifestyle, daily experience and social positions  Sociological imagination enables us to grasp history and biography and the relations between the two within the society  Troubles: occur within the character of the individual and within the range of his intermediate relations with others  Issues: matters that transcend these local environments of the individual and the range of his inner life Engels, F. 1845, The Conditions of the Working Class in England (excerpts)  The Great morality among children is proof of unwholesome conditions that were in force during the first couple of years  Women were also treated unfairly along with children  Friedrich Engels was a businessman and journalist Week 2: January 16 (Foundations of Health Studies: Neoliberal Globalization and Health) Navarro, V. (1999). "Health and Equity in the World in the Era of “Globalization”." International Journal of Health Services 29(2): 215-226.  Discusses major arguments given for the growth of inequalities in health in the world today  Globalization has become a major force behind the setting of public policies, including health policies  According to a WHO report, countries that resist globalization will find themselves marginalized in the world community and in the world economy  Growth in inequalities resulted from unprecedented growth in wealth and income derived from capital vs. labour, polarization of wages, diminishing welfare state  Globalization is a specific form of internationalization that responds to specific financial economic interests that are articulated in the class relations of each society  Understand how exploitation and domination occur, this will provide the understanding of the growth of inequalities and the deterioration of health George, S. (1999). "A Short History of Neo-liberalism: Conference on Economic Sovereignty in a Globalizing World (Bangkok, 22-24 March)." Global Exchange: http://globalexchange.org. A Short History of Neo-Liberalism: 20 years of elite economics and emerging opportunities for structural change by Susan George  In 1979, Margaret Thatcher came to power and undertook the neo-liberal revolution in Britain and justified her programme with TINA- there is no alternative  The central value is the notion of competition between nations, regions, firms and individuals  We should stop talking about privatisation and use words that tell the truth: we are talking about alienation and surrender of the product of decades of work by thousands of people to a minority of large investors  At international level, neo-liberals have focussed on three points: free trade in goods and services, free circulation of capital, freedom of investment (IMF have strengthened enormously)  Lack of transparency and democratic accountability is the essence of neo-liberalism  Neo-liberalism changed the fundamental nature of politics and has to be ready with replacement policies which restore power to communities and democratic states while working to institute democracy, rule of law and fair distribution at the international level. Leo Panitch and Sam Gindin (2012), The Making of Global Capitalism (Wikipedia summary)  This novel is a study of the growth of a global capitalist system over more than a century, they argue that the process known as globalization was not an inevitable outcome of expansionary capitalism but was planned and managed by America (world’s most powerful state)  Globalization was driven by multinational corporation that have become more powerful than nation states  Neoliberalism led to an array of free trade agreements that promoted worldwide corporate investment and production  The authors added that the collapse of housing prices led to sharp decline in US consumer spending because housing represented a main source of worker’s wealth John, Perkins, Confessions of an economic hit-man -- Documentary (26 min.) Week 3: January 23 (ONLINE LECTURE-The Politics of Health Policy and Systems: The Politics of Health Policy and Systems)  Policy: “procedure, rule, course of action adopted on principle or for the sake of expediency”.  Private sector: e.g. business  Public sector: e.g. state (usually ‘government’ – comes and goes ; a ‘state’ – a more permanent structure) o Domestic policy: education, health, energy, law enforcement, money, taxes, business, natural resources, social welfare, personal rights and freedoms.  Economic policy: e.g. taxation, public budget, money supply, interest rates  Civic rights: e.g. the right to vote  Political rights: e.g. right to free speech  Social policy: e.g. food, shelter, child/old age, education, health etc. (‘pillars of welfare’) o Foreign policy: international trade, commerce, immigration, self-defence etc.  Basic guarantees of Lord Beveridge:  Freedom from ‘want’: social security (retirement money)  Freedom from ‘disease’: comprehensive health system  Freedom from ‘ignorance’: publically funded educational system  Freedom from ‘squalor’: public housing program, shelter  Freedom from ‘idleness’: guaranteed employment  Good healthcare system:  World Health Report 2000 (Health Systems: Achieving Performance) - 215 pages)  Goodness: how much a system contributes to health  Fairness: how much a health system protects people from going broke when they seek services.  Respect for Persons: how much a health system protects the dignity of people and treat them with respect.  Infant mortality rate: less to more Sweden – Canada – United States  Life expectancy: less to more United Stated – Canada – Sweden  Amenable mortality rate: less to more Canada – Sweden – United States (Males) Sweden – Canada – USA (Females)  Infant mortality: Cuba 4/1000 and Nunavut about 18/1000  T.H. Reid proposed 5 health systems  The Beveridge Model: financing (government pays for health services through taxes); Public health, Not-for-profit ; Great Britain, Spain, most of Scandinavia and New Zealand, Hong Kong  The Bismarck Model: Social insurance approach (sickness funds- financed by employers and employees through payroll deduction and overseen by the state). Hospitals and doctors are private and not-for-profit; Germany, France, Belgium, the Netherlands, Japan, Switzerland, and to a degree in Latin America  The National Health Insurance Model (“Tommy Douglas” model): government-run insurance program funded through taxes (Beveridge) but most doctors are private and hospitals are a mix of private and public (Bismarck). Private sector providers, but payment comes from a government run insurance program that every citizen pays into; Canada, Taiwan, South Korea  The Out-of-Pocket Model: those with money get medical care  The ‘Exceptional’ American Model: Beveridge for veterans (publicly financed and publicly delivered system); NHI for those over 65 and disabled; Out-of- Pocket (for those with health insurance); variant of Bismarck (profit or commercial health insurance for workers whose employers sponsor collective purchasing)  21 ways Canadian healthcare is better (5.5): everybody in, nobody out  Medicare to Private Sector: supported by Dr. Brian Day and Gary Mason  Medicare to Private Sector: Rejected by Canadian Doctors for Medicare, Ulli Deimer, Danielle Martin?  Finish Medicare Quiz Answers Week 4: January 30 (The Politics of Health Policy and Systems: The Canada Health Act Challenges to Medicare) Moving beyond the Hospital Walls: Health Activism health is determined by factors- called the social determinants of health access to safe neighborhoods, clean parks, quality homes, great schools and well paying jobs is rooted in and influenced by politics, economics and histories of oppression shaped by the isms. most powerful health movements in NYC, was the sanitary reform to advance health and equity push the public health agenda: promote the safeguard the public health infrastructure that protects people before they get sick and before they touch the health care system ex. campaigns for immunization, clean drinking water etc. expand our physician role to include social change work Jack believes that it is essential for physicians to see health care as an instrument of social change and partner up with the community to confront the social, economic, environmental and political circumstances that shape the population health status of the disadvantages and marginalized. Align with other movements fighting for social and health justices physicans need to expand their boundaries and become allies with those that influence or give comfort. other activists have considered the need to fight for better health ex. the movement for black lives- calls for equitable health care for all, mental health benefits, paid parental leave and care for children and elders- policies that most health professionals support Learn the language of power and privilege, unconscious bias, and the history of structural oppression americans struggle to engage in convos regarding racism and bias related to gender, sexual orientation and religion expressing anxiety described by the perception institute. This causes a barrier to advancing justice in all corners of the country and levels of the government. Week 5: February 6 (ONLINE LECTURE-The Politics of Health beyond Healthcare: Education Policy, Politics and Health) Education and health go hand in hand educated girls have fewer babies, and make wise decisions of having them later in life make better mothers more likely to be health literate lifts the status of women protects their sexual health, against domestic violence those who have a share of the household income tend to invest in the welfare of their families education breaks poverty, ill, health, misery and low status However, health issues such as diseases can keep a child out of school for longer periods children may need to stop education early in order to take care of an ill parent or sibling tropical parasitic diseases reduce nutrient absorption, impair the development of mental functions and compromise educational outcomes education and health has the ability to drive one out of poverty and provide them with opportunity to develop their full human potential. Insured, but Not Covered The Affordable Care Act participates in a complex new health insurance products which follow out of pocket fees, high deductibles and narrow provider networks. the reality behind these policies is that patients are now to bear more financial risks, and are expected to be conscious and cautious about health care spending even with insurance. However some experts claim that the new policies have resulted into americans being able to watch over their expenses such as separate deductibles for network and non-network care, or payments for drugs on an insurers ever changing list of drugs that require high co-pays or are not covered at all Although some can necessitate footing bills privately, others who face constant changes in policy guidelines- whats covered and not, monthly shifts in which doctors are in and out of network- can be a hassle and produce surprise bills for services they assumed would be covered. for others, new fees are confusing and unsupportable that most of them avoid seeing doctors. Affordable Care Act has disregarded and removed some of the destructive practices of the American health insurance system that has resulted into patients facing bankruptcy or even losing homes for the purpose of paying bills. insurers can no longer deny coverage to those with pre-existing conditions defeats the purpose of its signature promise: health care being accessible and affordable to all. Premiums have went down, however, in reality premiums are kept down because they have shifted costs to patients in the form of co-pays and deductibles as well as other types of out of pocket expenses, leaving patients vulnerable. This policy can be either good or bad, but in reality it remains in the middle. since affordable care act, 31 states have seen a slow rate in the rise in health insurance premiums. but premiums were still rising faster than median incomes. patients were paying more in health care expenses than before during a time of low wages. 10% of median household incomes goes towards premiums and deductibles now, disregarding the many other health expenses. silver plans; cover 70% of charges, leaving the rest 30% to the customers. Rising number of postgraduates could become barrier to social mobility many good jobs expect a postgraduate degree, not those with only A-levels as it used to be numbers of people holding a postgraduate degree is high, yet another barrier to social mobility for poorer students arises as they take on a bigger debt burden poor students would have to take on more loans to pay for their undergraduate courses predominance for higher qualifications could become yet another barrier for entry into top professions in reality, the real danger is that the talents within the generation is now squandered, losing the change to stretch ones brightest minds so they develop the innovations and ideas that is essential to the economy in the future. It also threatens to widen income inequalities, reducing social mobility. to solve the inequality, systems such as bursaries is offered to students to help attain such qualifications Average student debt difficult to pay off, delays life milestones - unemployment is a huge barrier to paying off student debt former students whose loands have been defaulted are not eligible to enter the CSLP’s repayment assistance program- which lowers their monthly payment by 20% of their family income, every 6 months. Intergenerational income mobility: New evidence from Canada a childs future income level is strongly determined by his or her fathers income sons that are born to fathers with lower earnings have significantly higher intergenerational mobility than sons born to father wit
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