memories

Health care is the basic necessity as well as right of every citizen in any welfare state. It is the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical, nursing, and allied health professions.

Talking about US Health care system , it might be concluded that medical care is probably is the fastest growing industry in United States. As a share of its economy, U.S. spends more money on health care than any other nation in the world. In 2004, total health expenditures totaled almost to $1.75 trillion. Health care spending in the U.S. is 13.5percent of GDP which is still much higher than in the nations with the next highest levels -Germany, France, and Switzerland- where health care spending accounts for about 10 percent of GDP.

Currently, the U.S. health care system is outrageously expensive. The reason we spend more and get less on major health indicators (life expectancy, infant mortality and immunization rates)than the rest of the world is because we have a patchwork system of for-profit payers.

*Present health care system of US

The Census Bureau broadly classifies health insurance coverage as either Private coverage or Government-sponsored coverage.
* Private health insurance is coverage by a health plan provided through an employer or union or purchased by an individual from a private health insurance company.
* Government health insurance includes plans funded by governments at the federal, state, or local level. The major categories of government health insurance are Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), Military health care, State plans, and the Indian Health Service.

In the United States, these publicly-funded health care programs provide help to the elderly, disabled, and the poor; however, a system of universal health care has not been implemented here yet.In spite of the considerable amount of expenditure on health services, number of people getting benefits of medical health care in US is much less when compared to the other developed countries. 15.6% of the population are still away from the medical insurance coverage. This counts to around 45 million citizen, not counting some 7 to 11 million illegal immigrants. Reason for this, is the cost of family health care since 2000 coverage has risen 87 percent. During the same time, consumer prices rose just 18 percent and the pay of workers rose just 20 percent.

No American should lack access to health care because he/she lacks the ability to pay for it when needed, and No American should suffer serious financial distress or personal distress or personal bankruptcy as a result of unpaid medical bills- -UWE Reinhardt.

It is a fact that without insurance, the cost of care becomes a barrier preventing the uninsured from obtaining recommended health care services and treatment. Nearly half (47%) of the uninsured reported in 2003 that they postponed seeking care because of costs, and about a third did not fill a prescription (37%) or skipped recommended treatment (35%) because of cost.
While the problem of insurance was formerly confined to low-income Americans, but now more and more middle-class citizens are becoming directly affected by it. The rising health care costs in US has also affected the insurance provided through employers in a dramatic way. Now, fewer employers are able to provide their workers with health insurance; the percentage of employers offering health insurance dropped from 69% in 2000 to 60% in 2005. Even if employers are able to provide health insurance benefits, the trend is towards providing high-deductible insurance that covers an ever-shrinking percentage of health care cost. The net result is that more and more employed middle-class Americans find themselves with low-quality or no access to health care.

The issue of health care is not a matter of economics. Little more than 1% of GDP could cover all. It is a matter of soul”-UWE Reinhardt.

This disparity between insured and uninsured is due to corporate model of health care in US that has failed to control costs, and to maintain quality of care for all. According to the World Health Organization (yr 2000) US is on 37th position on best health care indicators. Now, on the basis of the success of health care system of other industrialized countries it is being argued by thinkers that universal/ nationalized may be a better alternative.

*Understanding universal Health Care System (UHCS)-

UHCS refers to the idea that everyone should have access to affordable, high-quality health care. It is the health care system in which all residents of a geographic or political entity have their health care paid for, regardless of medical condition or financial status. Universal health care systems vary in what services are covered completely, covered partially, or not covered at all

It is important to understand how this system works. It is observed that most European systems are financed through a mix of public and private contributions. The majority of universal health care systems are funded primarily by tax revenue. Some advocates of universal health care assert that single-payer systems save money that could be used directly towards health care by reducing administrative waste. "Single-payer" describes a type of financing system in which a single entity, typically a government-run organization, acts as the administrator (or "payer") to collect all health care fees, and pay out all health care costs.

The Moral case for universal Health care

At its root, the lack of health care for all in America is fundamentally a moral issue. The United States is the only industrialized nation that does not have some form of universal health care (defined as a basic guarantee of health care to all of its citizens). While other countries have declared health care to be a basic right, the United States treats health care as a privilege, only available to those who can afford it. Health care is targeted not to medical need, but to the ability to pay. In this sense, health care in America is treated as an economic good like a TV or VCR, not as a social or public good.

Common arguments waged for universal health care systems

It is time to recognize that all the civilized countries have a solution that we must adapt in this country. Advocates of UHC consider health care as a right or entitlement that all Americans deserve.It provides coverage to all citizens regardless of ability to pay and also benefits a nation economically. It is assumed that UHC would reduce wastefulness and inefficiencies in the delivery of health care and align incentives for investment in long term health-care productivity, preventative care, and better management of chronic conditions.

American values Vs universal health care

●Americans propose to believe in equal opportunity. Yet, in the current situation, those who do not have health care are at risk for financial ruin and poorer health, both of which disadvantage them in society and thereby do not give them equal opportunity. Education is guaranteed in America in part to further the ideal of equal opportunity, but health care is not treated in the same way.
● The Declaration of Independence states there are certain “inalienable rights”,including life, liberty and the pursuit of happiness. If Americans believe inalienable right to life, how can we tolerate a system that denies people life saving medications and treatments?
● Finally, a value that is not clearly specific to Americans but that certainly is held by is economic efficiency–getting good value for money. The United States spend almost twice per capita on health care on average than other countries do.

Conclusion:

It is time to recognize that all the civilized countries have a solution that we must adapt in this country. It is also time to realize the fact that American businesses can no longer shoulder the entire cost of health care. The only way Americans can avoid the health care crises is by adopting the solution other civilized and develop countries are adopting. We need to ask our selves that is it indeed acceptable to deny people health care based on their ability to pay Or is health care a basic need that should be provided to every American as a matter of course. If the answer is the latter, then we need to overcome the unending debate and reach to conclusion and create a society in which health care is available to all

A doctor try to diagnose health problems in the human body similarly social workers observe social problems in the societies...I think I do it all the time!!! with my stay in America of about four months i have realised that like India America , is also facing several social problems...

- In-spite of having the best available medical facilities and doctors in the world , American people are fighting with health care services every day. High medical expenses minimised the access of people to health care. It was sad to read a news article which said " A women delivered a still born child because of lack of medical attention. Her poverty and immigrant status did not allow her to go for medical insurance". Progress in medial feild has now inspired man to make clones through DNA but if we are not able to save natural born human being then what is this progress for. Some say that absence of universal health coverage is root cause of this disparity..well!! I feel that increased influence of wealth and depriciation in humanity is the root cause. Balance between these two will eradicate the problem by itself.

-It came as a surprise to me that around 700,000 women in America are sexually harrassed every year. A country where women are independent, take their own decisions and they have equal rights as counter sex are being abused on the basis of their sexuality??.. It seems that the fairer sex suffer similar trauma any where and every where in the world:(

While surfing I came across the inspirational lines said by Mahatma Gandhi.

"Seven Blunders of the World"

1. Wealth without work

2. Pleasure without conscience

3. Knowledge without character

4. Commerce without morality

5. Science without humanity

6. Worship without sacrifice

7. Politics without principle

Elucidating on my past experiences in social work I would start by saying that there were may instances where I was in the capacity to help people needing my support but there were also times when I felt desperate for not being able to help the needy. While working as training officer (senior executive)in HelpAge India I met many elderly(especially women) who were disowned by their children at the time when they wanted them the most. I still remember the day when I went for a community visit to the rural area of Barabanki* . The community visit and my meeting with 90 year old woman Savita left me thinking about miseries of ageing.

Savita’s husband died few years back leaving no savings and property behind, her only son had also abandoned her! With no shelter, food and money, she lived on the mercy of neighbours. With noone to take care she spent her days lying alone in the courtyard of others. Although she was a listed beneficiary of Helpage India which allowed her to receive grains and clothes on quarterly basis to live upon but this was not enough to improve her living conditions as her mellowing body denied to support her too. The urinal disorders and the weak body forced her to make suicidal attempts few times. Her weak fragile body, pathetic living condition and the pain of the chronic disorder made me spiritless about humanity.

Engrossed in the miseries and infirmity of Savita I went to her son and daughter in law to discuss. I counseled the son to make him realize of his responsibilities towards the dying mother. Initially it was difficult to make him understand but then the son recognized mothers efforts in raising him. Eventually after a long discussion he agreed to bring her mother back. Before leaving the village I gave some money to savita going against my own values. The miseries of savita also inspired me to write a case study on her which was later published in the quarterly magazine of HelpAge. I also tried hard to get savita shifted to a proper Old-age home but she denied. This incidence taught me the complexities of Indian culture which doesn’t let a person move apart from its roots and relations in spite of the sufferings.

As I grew up, I saw India, with all its turbo charged economic boom and development but it was full of social issues from within. Poverty, lack of education, unavailability of health services and other basic amenities has made lives of many citizens a nightmare. Human miseries sometimes made me emotional and full of remorse and at the other times it gave me courage to work for human spirit. Passion for social service since the very childhood inspired me to become a professional social worker. The inclination toward social work grew slowly but steadily and I became more and more enthusiastic to make myself capable to bring change in the society.

“The purpose of my life is to be happy, to be useful, to be responsible, to be compassionate. It is, above all to matter, to count, to stand for something, to have made some difference that I lived at all.”

Helping others was within me but somehow developmental aspect of social work inspired me more than welfare aspect. I discovered that helping someone to help themselves is a better strategy as it focused on long run development whereas welfare mode could only bring change in the present situation. Working continuously to bring social change, to resolve social problems, to help individuals, family and community cope with crisis I feel social workers have to have enhanced interviewing, assessment, and intervention skills. We deal with human and their behavior rather than computers and machines therefore fiddling with their emotions or I should say not caring about their personal insights, knowledge and feelings may worsen their conditions as opposed to bringing any improvement.

Looking at the more practical side of it, most of the social work fields like child welfare and family, ageing, health care, women, school social work count on counseling and interviewing. This skill stands apart in all of the social work fields. Thus, considering both my philosophical as well as practical arguments I decided to opt for the course on interviewing and counseling.