Home > Sample essays > Exploring Classism in Healthcare–Why Doctors Prioritize Rich Patients over Poor

Essay: Exploring Classism in Healthcare–Why Doctors Prioritize Rich Patients over Poor

Essay details and download:

  • Subject area(s): Sample essays
  • Reading time: 8 minutes
  • Price: Free download
  • Published: 1 April 2019*
  • File format: Text
  • Words: 2,119 (approx)
  • Number of pages: 9 (approx)

Text preview of this essay:

This page of the essay has 2,119 words. Download the full version above.



Abstract

For the most part, many types of discrimination and prejudice – being of a certain race, a certain religion, certain skin color. However, being too poor is often on that gets over looked or not fought for. For the purposes of this paper, I aim to explore possible reasons as to why doctors in hospitals are forced to not give the same amount of care to all patients. To show that it is not all because of prejudice. There is definite classism being seen in the hospital setting. Setting aside from the personal perspectives of workers, there are facts that I will explain that show reasons as to why it is not the hospitals fault that there is a preferred class and preferred group, that doctors put more care towards. This paper mainly focuses on the rich versus the poor and only a few of the characteristics of each group that allow for this classism to happen. At the end of this paper I will offer some insight from professionals as well as my personal opinion on how this divide between the level of care can be handled and everyone from each spectrum can somewhat be offered the same or close to the same treatment when it comes to their own well-being.

Classism in Healthcare

According to the World Health Organization, “the enjoyment of the highest standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political belief, economic and social condition” (n.d). Though, this is simply not the case for all that are living in the United States, let alone the world. People from all rural parts in the United States are not offered the same privilege or ability to have access to a doctor, to quality care or to the means to pay for care. In some cases, this is not their fault nor is it the hospitals that treat them. The United States is becoming a more class based society (Tomilson, 2016). With the middle class shrinking, it is more evident that the gap between the rich and the poor is shrinking as well. Meaning, one is either part of the rich, or part of the poor. One is either a “have” or “have not.” In 2012, the wealthiest 1/5 of people in the United States received 43% more care than the poorest 1/5 of people in the United States (Tomilson, 2016). There are reasons that offer an explanation to this gap. For one, the poor of the U.S tend to live in rural areas where access to care is not within reach. Another reason being the type of insurance they have, if they do have, is not letting them benefit as much as they should. Doctors are limited by what their patient’s insurance offers. These two reasons alone are the main contributors to why there is classism when it comes to how doctors see and treat their patients in the health care field.

According to an article by Maynard Seider, WANTED: Hospitals That Fully Serve Their Communities, as of 2014, 1/3 of hospitals emergency rooms in the United States have shut down in the past 2 years. Seider goes on to say that this closure has disproportionally hit the poorer communities where patients heavily rely on their insurance and the close proximity of the hospitals (2014). These hospitals, ones in the more rural areas, are typically the first ones to close due to the fact that there is not enough revenue coming in and the population of incoming patients is below that of a hospital in a more prominent, populated city. By closing these hospitals, or sections of these hospitals, is hindering when it comes to the care of the patients living in that area. Which in itself, is classism. The government, the hospital officials, whoever decides which hospitals to close in situations when there is a money issue, is putting a preference to hospitals where more people and money is coming in. Which in reality, makes sense from a profit and resource standpoint, but who is to say and deny a whole area and group of people access to care? That community is now forced to travel longer distances in search of places for their medical needs. The main problems with keeping a hospital running in those rural areas are of course, money, resources, which include number of beds, medications, etc. and lastly, qualified and willing personnel to travel and work in those areas (Chen et al, 2014). Shutting down hospitals effects the whole community and makes the gap bigger. As a result, forcing the poor to forgo care, but also pushing people of their jobs, leaving their town where they could have given can help.

Classism is defined as prejudice against or in favor of people belonging to a particular social class (Merriam-Webster Online, n.d). Some or most, believe that classism or anything ending in “-ism” is intentional. That it is negative. While true, in this particular care, the act of classism that is portrayed by doctors, can be argued as being unintentional from a certain standpoint. Not only does classism effect the poor, but it also has a negative impact on doctors and providers as well. The main issue being reimbursement. Doctors and hospitals are not getting enough money back from certain insurance companies to help keep hospitals running. There is simply not an adequate amount of resources for patients and other supplies that are needed to properly administer care to everyone. For this purpose, we will focus on the Affordable Care Act which offers Medicare and Medicaid to poorer communities. First, we will address the problems that come with this specific insurance. The main issue at hand is reimbursement. Doctors are receiving lower reimbursement rates from the government (Bengel, 2014). Doctors are not able to focus on the needs of their patients and give them the care they deserve, but rather switch their focus to the funds the government issues back to private practices and hospitals. This in turn, conflicts with the level of care and resources that could have potentially been given. Kem Anderson, a senior Medicare Advisor in Northern Texas was interviewed in an article by Tate McIntyre “Why More Doctors Are Walking Away from Medicare” he was quoted as saying the medical system is becoming more and more complex, time consuming and less profitable. Therefore, doctors are choosing to opt out to servicing those with Medicaid (2016). Nationwide, physicians are paid 20% less than the private payers. Moreover, during 2010, 70% of hospitals noted a loss in money from treating Medicare patients (Brayer, 2010). In these cases of doctors declining patients based on their insurance which just happens to be the poorer class, it is not a case of hate or their own negative prejudgments of people, but rather the constrictions of money. Like stated earlier, this unfortunate circumstance places a conflict with doctors that forces them to not want to treat certain classes because of its limitations. While more people are afforded the opportunity to receive healthcare, this proves problematic because there is no incentive for doctors to service the poor and puts an added pressure to treat more patients with less room too. It is like the basic principle of supply and demand. The demand to treat patients is high but the supply to do so it low. Essentially, it will cost the hospital more to deliver the care to patients than the government allows them to. In circumstances where doctors are given the chance to provide more for their patients, patients are able to receive more care and better care.

To say that the Affordable Care Act (ACA) is solely to blame for classism is unjust. It has been a source of solution. Although yes, the ACA contributes to one of the bigger problems, it is also one of, if not the biggest success of closing the gap between rich and poor in the health care setting. There are positives to the ACA in that as a whole, it has reduced health inequalities in much of the United States, particularly for minorities (Powell, 2016). The rate of the uninsured dropped significantly from 20.4% in nonelderly adults in 2013 to a little over 12% in 2015 (Key Facts about the Uninsured Population, 2016). Millions in the lower income class families are now offered the opportunity to have access to healthcare. An otherwise luxury, that would not have been possible. In the same fact sheet, it states that as of June 2016, the number of people signed up under the ACA had gone up to roughly 15 million people since the start of the open enrollment in October of 2013. The purpose of the Affordable Care Act is to make health insurance more affordable to those with little coverage or no coverage at all. Which that, it indeed does. Although one can argue that under Medicaid and Medicare it is nowhere close to what other insurances can cover or it does not cover everything a person could potentially need, it is a start. With doctors that deliver care and have clinics still in rural areas, patients with insurance is far better for both patient and provider than having none at all. John McDonough, professor of practice of Public Health at Harvard Chan School says that, “What is fairly indisputable is that by expanding coverage to so many millions of otherwise uninsured Americans, we’re saving lives” (Powell, 2016).

To offer solution to the money lost through reimbursement, some hospitals incorporated “value assessment teams.” The purpose of these teams is to put in a place multi-year strategy that would ensure that hospitals are getting the best value for costs in all areas, whether it be medicine, equipment or whatever it may be (Herman, 2012). Among other issues that hospitals face when it comes to patients, is to reduce readmissions, infections and falls. Anything they see as a problem that prevents patients from having prolonged stays, are what they are trying to limit. For example, encouraging preventative care is a way to limit the time patients stay. Insuring that problems like sickness and infection is handled before it becomes a greater problem makes patients stay a day or two rather than weeks or months. In addition to these predicted and anticipated efforts, in the mental health sector, health care workers are joining and working with public policy initiatives to help create a structural change in how patients are admitted, what medicines are given and the kind of care being given to them (Greene, 2014). Hospitals administrators can follow suit in working to move towards policies and initiatives that help both patient and provider together, insuring they both benefit.

 “To say that our healthcare system is broken is an understatement. Until the medical needs of all Americans, poor and working class as well as middle class and rich, are fully met, that system is a failure” (Tomilson, 2014). I believe it is a cycle between patient needs, governmental funds, and provider needs. There is not one solution in which all work cohesively. Although it would be nice to believe that in this nation, everyone receives the best quality care and getting quality care is a right, it is not simply so. It is more complex than that. Aside from the limitation set by the government, providers need not have prejudice to the lower class and constrain themselves to those limitations. We, patients and providers, must focus on creating a greater awareness to these problems. Racism, discrimination and classism require a structural change. There must be a focus on multiculturalism, empathy and understanding the “other,” (Greene, 2014). We must fight discrimination against those of the opposing or less fortunate group. A huge part of fixing a problem is realizing there is one and understanding the steps needed to move forward. Doctors should change attitudes and actions and perceptions of those who, in this case of classism, have no insurance. Doctors should learn and educate them and their patients of the differences and the setbacks of which healthcare they have but still have the tolerance and the courtesy to maximize, utilize and administer the best possible care they are capable within the boundaries set. Hospital administrations and policy makers must put more money towards preventative medicine, community health and have larger hospitals help fund those smaller clinics. For example, provide the means to supplies, medical professionals, transportation (Chen et al., 2014). Patients, especially those in the lower class, should force government officials to give them a chance to fully offer what it means to be covered by insurance. Not just insurance, but a place to receive the care they need. Like stated in the beginning of this paper by the World Health Organization, having the best quality care for human beings should be a right, and there should demand to that right.

...(download the rest of the essay above)

About this essay:

If you use part of this page in your own work, you need to provide a citation, as follows:

Essay Sauce, Exploring Classism in Healthcare–Why Doctors Prioritize Rich Patients over Poor. Available from:<https://www.essaysauce.com/sample-essays/2017-8-7-1502077468/> [Accessed 29-03-24].

These Sample essays have been submitted to us by students in order to help you with your studies.

* This essay may have been previously published on Essay.uk.com at an earlier date.