When you think of environmentalism and environmentalists, you may picture “tree huggers” trying to stop loggers in an old-growth forest. While there may be a grain of truth in this image, environmentalism is just as important an issue in urban areas as it is in the wilderness. Historically, polluting industries like power plants, chemical factories, slaughterhouses, and oil refineries have been cited in communities inhabited by the working poor, especially people of color.
According to this study by WalletHub (Links to an external site.), the greenest state in the United States, based on environmental quality, eco-friendly factors, and climate change contributions, is Vermont. How does your state rank, and what factors contribute to that ranking? What initiatives to preserve the environment and make it healthier for everyone are happening at the local or state level? What specific suggestions would you make to your local and state leaders to make your community a better place to live for all its inhabitants?
Consider two different kinds of healthcare models. With first, doctors are paid based on each service or procedure they provide to their patients. The more services or procedures, the more they are paid. With the second model, doctors are paid based on patient outcomes and the efficiency of achieving favorable outcomes. In this case, doctors are paid best when they diagnose and treat effectively within what is considered to be a reasonable time given the nature of the medical condition. They are paid less well if they provide ineffective treatments, take an unreasonably long time to correctly treat a case given the nature of the medical condition, or call for a large number of marginally effective or unnecessary treatments.
Which model would you prefer if you were the doctor? Which model would you prefer if you were the patient? Explain your responses.
Environmental health refers to the aspects of health, illness, and disease that result from environmental factors. Putting it under context, although our understanding of how to improve health outcomes has varied over time, there is renewed interest by the medical community in the influence of social determinants on health outcomes. Patterns of health and illness are related to social structures and arrangements. The struggles of doctors and other healthcare specialists to establish professional credentials and institutionalize their authority to treat patients reveal the importance of power in shaping healthcare practices and health outcomes.
Watch the following TED TalkaTckling Ethnic Health Disparities (Links to an external site.)
wherein Dr. Cooper, an internationally recognized health services researcher and medical educator at the Johns Hopkins University School of Medicine, discusses interventions that enhance patient-physician communication, improve health outcomes, and reduce healthcare disparities.
After watching the video, reflect on the following questions.
Lending your discussion response with an objective mindset; discuss the differential treatment that exists for dominant and minority groups. Have you experienced differential treatment based on the color of your skin?
Do you think medical practitioners carry within them biases against patients just like in other aspects of society?
After some research, I think you will find the information below about the best healthcare system from a global snapshot insightful:
The medical care system in the United States is a mix of different approaches. Private insurance is provided to many workers through their employment. A “single payer” system operates for people over the age of sixty-five through Medicare. The government provides and manages medical care for low-income people through Medicaid. Just about all hospitals operate as private businesses, with the exception of those run by the Veterans Administration, which provides free care to military veterans.
So, there is no single “system” for medical care in the United States. But there is fairly widespread agreement that the U.S. healthcare system doesn’t do a very good job. The two major complaints are: It is too expensive, and millions of people do not have health insurance coverage.
To gain a sense of the alternatives, here is a brief summary of the ways in which some other high-income nations handle health care.
Canada and Great Britain: Single Payer: Both Canada and Britain use this system. In Canada’s case, the government directs tax revenue to pay for health insurance. In Britain, government operates the National Health Service (NHS), while allowing a fee system to operate as well. The U.S. draws inspiration from both countries: Our Medicare is similar to the Canadian system, and our Veterans Administration is more like the British NHS. The cost for both the Canadian and the British system is about 10 percent of each country’s GDP (the cost in the United States is 17 percent of GDP).
Singapore: The government operates hospital facilities that provide basic care for little or no cost. Higher-level care and upscale hospital accommodations can be purchased for additional cost. The government has a requirement—probably unique in all the world—that every worker contribute 37 percent of their pay to a savings account that can provide funds for medical care, as well as housing and education. Government has a broad role in guiding the health care industry, including regulating costs, regulating the use of high-technology equipment, and setting the salaries of physicians and other medical personnel. The health care system in Singapore costs just 5 percent of GDP.
France: The French government requires everyone to purchase health insurance from nonprofit insurance companies, and this protection covers about three-fourths of all medical costs. Almost all people in France also purchase private insurance to cover the rest. The government has a large hand in the operation of the health care system, regulating costs and the availability of services. The cost of operating the French system is about 12 percent of GDP.
Australia: The government in Australia operates public hospitals and covers most of the cost of inpatient care, as well as most of the costs of outpatient services and drug prescriptions. About half of Australia’s hospitals are public, and the other half operate privately. People may also buy private health insurance. Most physicians operate in group practices. The price tag for Australia’s health care system is 9 percent of GDP.
Source: Based on Carroll, Aaron E., and Austin Frankt. “The Best Health Care System in the World: Which One Would You Pick?” The New York Times (September 18, 2017).
Discussion Questions:
1. What do you like about the health care system in the United States? What do you not like?
2. What are the features of the health care systems in other countries that most appeal to you?
Select a migrant population, either within the United States or globally, that you wish to learn more about. Identify immigration and emigration patterns and impacts on this group and discuss push and pull factors that likely impact these patterns. For example, factors such as war, persecution, or other natural disasters might impact refugee status, and economic factors, such as unemployment might impact emigration from high-income nations.
What strategies besides cultural competencies can you posit in creating an equitable healthcare system?
