Chapter 14 Government and Health Care Defining the State Power and Authority Theories of Power Government: Power and Politics in a Diverse Society Health Care in the United States Theoretical Perspectives on Health Care The Health Care Crisis in America

The Institutions of the State Institutions comprise the state as the organized system of power and authority in society: Government Legal system Police Military

Types of Authority Weber postulated that there were three types of authority in society: Traditional Charismatic Rational-legal

Theories of Power The Pluralist Model - Interest Groups compete in a struggle for power. The Power Elite Model - power stems from the top down. The Autonomous State Model - power of the state feeds on itself. Feminist - men hold power in all institutions.

Political Participation The U.S. has one of the lowest voter turnouts among democratic nations. The higher a person’s social class, the higher the likelihood that she or he will vote. When Black Americans are approached directly by party representatives, the likelihood that they will vote increases substantially.

Political Participation Race, ethnicity, and gender influence political attitudes and behavior. Women are more likely than men to identify and vote as Democrats and to have liberal views. The gender gap is manifest in women’s views on peace keeping, gun control, and compassion issues.

Political Power: Who’s in Charge? The class, race, and gender composition of the ruling bodies in the U.S. is not representative. Most of the members of Congress are White, well educated, men from upper-middle or upper-income backgrounds.

Political Power: Who’s in Charge? 1/3 of the people in Congress are lawyers. 1/3 are businesspeople and bankers. Many of the 535 U.S. Congressmen are millionaires.

The Military The function of the military is to defend the nation against external (and sometimes internal) threats. Considered one of the most hierarchical social institutions. There is a strong connection between the military and corporate America, through the military-industrial complex.

Race and the Military Desegregation of the armed forces has promoted awareness among Black Americans of their right to equal opportunities. African Americans and Latinos are over- represented in lower ranking support positions. African Americans and Latinos earn more in the Military, but don’t share the earnings premium of white veterans.

Health Care in the U.S. There are many discrepancies among people in the U.S. in terms of longevity, general health and access to health care. The AMA, founded in 1847, was successful in outlawing alternative therapies. In the late 1800’s, medicine became an upper class profession.

Social Factors in Illness Race-ethnicity, social class, gender, and age are major factors in disease and health. White women live longest, and Black men the shortest. The mortality rate of Native Americans is one and a half times that of the general population.

Social Factors in Illness Hispanics contract tuberculosis at 4x the rate of Whites. The more money one makes, the more healthy one perceives oneself to be. The lower one's social class status, the greater are one's chances of tuberculosis, heart disease, cancer, arthritis, and infant mortality.

Role of Gender in Illness Older women are more likely to suffer from stress, overweight, hypertension, and chronic illness than older men. There is still a tendency for the male- dominated profession to regard the problems of women as nonmainstream and "special".

Functionalist View of Health Care Health care system has positive and negative functions in society. Positive: prevention and treatment of disease Negative: unequal access to healthcare by race, class, gender, region and unequal health education.

Conflict Theory View of Health Care Health care reflects the inequalities in society. U.S. Health system is burdened by excessive bureaucratization.

Symbolic Interactions and the Role of Perceptions Illness, wellness, and health care are socially constructed. The ways we behave toward the ill, toward doctors, and health systems are all social creations.

Health Care Crisis in America Modern medicine in America is a highly structured, high-status profession. High costs, malpractice suits and abuse of the fee for service system have resulted in a health care crisis. Programs for large HMO's and national universal health insurance have met defeat in Congress.