Discuss about the Pluralist Elitist and Marxist Perspectives.
In this discussion, we will confer about hierarchy and power and how they are fundamental in Australia’s existing health care system. To have clarity about the same, we discuss about the concept of sociology and describe its perspectives. We further discuss biomedical model of health which is one of the most accepted model of the 20th century. Moving forward, we discuss in details both our primary topics i.e. hierarchy and power and theories which explains both. Lastly, we have given description about modern Australia’s health care system and how all the above discussed concepts apply and affect distinct people in distinct communities which are divided so because of hierarchy and power. Hence, by discussing all these topics in details our aim of comprehensible understanding of the inheritance of hierarchy and power in recent health care system existing in Australia will be clear.
Sociology is the organized learning of the expansion, communication, composition and combined conduct of structured groups of individuals. It is one of the divisions of social sciences that scrutinizes and describes significant events related to individual’s lives, their groups and the humanity as a whole (Department of Sociology, 2017). It provides a distinguishing and informative means of perception of the social world that affects an individual’s behavior and his life. The sociology of health and illness describes the relationship between health and the society at large. This particular study helps medical practitioners across the world to ascertain the causes and to prescribe the correct treatment of diseases as it enables them to relate the diseases with sociological factors. Certain diseases are more widespread in a particular area whereas only few people get affected from the same in other areas. Socio-economic factors such as religion, culture, cast, creed, ethnic background, education etc greatly affects individuals as far as their health and sickness are concerned.
Further, we discuss different approaches to the said concept also known as sociological perspectives of health and health care. Created by Talcott Parsons, the functionalist approach stresses on being healthy and highlights the importance of valuable health care. They both are indispensable for a community to function resourcefully. ‘Sick role’ which a person performs, when he becomes ill excuse him from performing his duties and impairs normal operation of society. The role of hierarchy is also well established in the said approach between the sick person and medical practitioner. The latter is responsible for confirming sick role of an individual who is then exempted from performing his duties and is also responsible for the treatment of the former. Societal disparities and capitalism are the focal point of conflict perspective. It takes into consideration disparities that groups or communities face on various grounds such as cast, culture and sexual category. Standard of living depends on an individual’s education. An educated person is bound to be healthier with awareness of the accessibility of medical care services as compared to less educated individuals (Lee, 2017). Profits are the main reason of running private health care services and rich people are given preference over poor. This particular approach directed medical practitioners to consider about providing more equality amongst distinct groups as far as health is concerned. However, the symbolic interactionist perspective highlights illness as societal interpretation than just a medicinal state. As per this model, individual’s forms prejudiced philosophy for distinctive ailments. It helps medical practitioner in eliminating the disgrace which ill people faces and helps them in getting not only therapeutic healing but also collective and psychological assistance.
Biomedical model is the leading model in most of the western countries which relates health with only biological factors. It takes into consideration only the bodily or biological causes of an illness. The role of patient in the said model is considered to be submissive with detection of infection or ailment through health care professional’s knowledge of symptoms and other various investigative tools (Jkonoroth, 2013). Further, appropriate procedures are taken in ameliorating the health through proper course of treatment by the health care professionals. This model has progressed through several years with advancement in medicinal knowledge and healing (Smith, 2017). Health analysis and treatment are done irrespective of other factors including standard of living and concentrates only on physical aspects. Accounting for over 90% of government health care funding, it is by far the most prevailing model. Health professionals play major role with anticipation of treating the ailment. Blood test, ultrasound, x-rays are some of the examples of the said model. Progression in technology, successful treatment of routine issues, expansion of life expectancy and overall enhancement in standard of living are some of the advantages of said model. However, promotion of tapered sight of health by ignorance of other causes of sickness and being expensive are some of the major grounds of criticism of the biomedical model.
Firstly, we will discuss the concept of hierarchy and theories related to same. Hierarchy is referred as the cluster of individuals placed in sequence on the basis of position, division, status or capability. It is the collection of individuals forming a mounting succession of influence or authority. In today’s society, people are still divided in communities or groups on the basis of several factors such as cast, creed, ethnic groups, culture, education background etc. which determines the overall health and medical facilities available to them. Problems related to social disparities and hierarchy has been widely discussed by famous philosophers like Thomas Hobbes, John Locke and Jean- Jacques Rousseau. The descendants of Saint-Simon initiated the theory of urban working class which was the base for the outcome of Karl Max’s theory of class. It highlighted the significance of class inconsistency on the criterion of direction of the way of production. Marxist social hierarchy comprised of upper, middle and lower class wherein upper class was the uppermost class with rich individuals who owned huge areas of land. Middle class comprised of professionals who worked for the upper class with the help of their skills and lower class comprised the most pitiable individuals with little earnings (Heirarchystructure, 2017). Further, there were other theorists who have given their key perspectives on hierarchy including Jim Sidanius and Felicia Pratto who initiated social dominance theory. They explained people are divided into groups on the basis of numerous factors such as economic standing, age, sex etc and how hierarchies formed influences the distribution of resources amongst them. The governing hierarchy will dominate subordinate groups by handing over certain unwanted work to them keeping in interest their own self motives. It intended at elucidation of domination, inequity, cruelty, and autocracy as a result of division of communities on the basis of number of socio economic factors (Roccato, 2014).
Secondly, we will discuss power and theorists perspectives related to same. Power is regarded as a main sociological perception with diverse connotation and explanation by various theorists. It is the capability of an individual or group of individual to manage actions and possessions and despite of impediment to make things happen as per Max Weber (Cook, 2013). However, as per Karl Max, power is directly associated with societal classes divided on the basis of ways of production and not related with people (Crossman, 2016). Further, for the attainment of goals, power runs from a societal system’s prospective to harmonize individual movement and wealth as per Talcott Parsons. Hence, three major theories of power explicitly Pluralist, elitist and Marxist clears what power is. Pluralist model describes how power is disseminated and disjointed. Bigger group has more dominance. Instead of election, formation of groups provides improved way of depiction. There are two groups specifically insider groups which are more authoritative than outside groups as per said theory (Barry, 2017). However, as per the elitist theory, power is resided with governing elite who are voted or selected for the said roles and is widely displayed by several democratic countries. At the end, as per Marxist theory, power is related with wealth. Rich people with possession of capital dominate the working class. We have discussed different perspectives of different theorists and these perceptions of hierarchy and power applies to health and medical practitioners across the world including Australia.
Australia’s health care system is considered as one of the greatest amongst all countries. Medicare program followed by the government and private hospitals provides worldwide health care facilities to general public. The country not only caters its own citizens but also spent around $26 million on tourist’s health care. Despite of all this, great inequality exists amongst several groups on the basis of cast, religion, ethnic culture, education background specially amongst Indigenous people and rest of Australians as far as health and medical services are concerned clearing that hierarchy and power plays an important role in Australia’s contemporary health care system. Political parties and other wealthy people with power and who stands in the uppermost class of authority have lower risk of being affected by several diseases and have superior accessibility to health care services than those residing in rural and belonging to lower class of society. Life expectancy amongst non-indigenous Australians is much higher as compared to indigenous community. Role of hierarchy and power is well established from the fact that the amount spent on indigenous community was AUS$3,630 as against AUS$1860 for non-indigenous Australians in the year 2010 in hospitals which proves shortage of proper precautionary facilities available to indigenous population (Eckvahl, 2014). As per the Australian Health Care Agreement, there should not be any disparity in accessing health care services. However, there is dominance by health professionals in Victoria and huge inequality still exists between individuals residing in rural and metropolitan areas (Kenny, 2014).
There is health disparity across Australia amongst old age people and youth, males’ preference over females and several other groups. In the rural areas, there are inadequate housing facilities, poor sanitation, poor water supply, increased unemployment and lack of proper education, all these factors accounts for increased diseases. Also, unawareness and inaccessibility of proper health care services with dominance by health care professionals aggravates the inequalities amongst all these groups. Power is exercised by the political parties who have different views for different health policies. Lower income people especially indigenous community suffers greatly and has poorer health as compared to others. They are more prone to diseases such as mental illness, depression, increased suicidal rates, cardiovascular diseases etc. There is discrimination against homeless people, people belonging to lower economic groups, refugees, prisoners, older people, people with mental illness, people residing in isolated areas as restricted medical services are available to them and those which are offered are not used properly. There is discrimination not only from the political parties but medical practitioner also exercises his power and utilizes his role in hierarchy by discriminating against several groups, there is insufficiency of knowledge and self-belief. Shortage of labor force and neighboring services, deprived incorporated services, lack of communication are also obstacles faced at the professional level (Bywood et.al. 2011).
This above inequality related to hierarchy and power can be explained by taking an example of tobacco usage and tobacco smoking policy incorporated in Australia. Smoking tobacco is recognized as the major cause behind several diseases in Australia. Although several steps have been taken by the government to curb the usage of tobacco by incorporation of several policies of smoking in public area, flights, restaurants and numerous campaigns have been started to increase awareness amongst people with overall decrease in smoking rates from 34% in the year 1980 to 15% in the year 2010 (Maddox et.al. 2013). Still, indigenous community accounts for around 46% .This proves the ineffectiveness of the said policy and how underprivileged people are deprived from the awareness of the said campaign and establish the aim of our discussion that hierarchy and power are central in today’s Australia health care system. Smoking has been considered as the major cause of ill health amongst indigenous community and is also primary cause of premature deaths and lower life expectancy. As per the statistics, smoking rates also differs on the grounds of ethnic groups, age, sex and genetic factors. Although consistent measures are being taken by higher authorities, there is a need of building gap amongst the higher and lower class, indigenous and non indigenous, poor and rich, aged and young, males and females for the successful eradication of smoking problem in Australia.
It is evident from the above points, hierarchy and power plays an important role in all economies and amongst patients as well as health practitioners. There are different perceptions of holding power amongst health practitioners. Owing to the knowledge and training in medical field, we as health practitioner are in the position of power and rank higher in the hierarchy. We have an ethical accountability towards assessing and prescribing correct treatment to our patients. As patients have faith on us, we should not take undue advantage of our ability. However, with changes in the medical field and with more awareness amongst the patients, this relationship between patient and health professional is undergoing a constant change as individuals are becoming more sentient of their rights as patients and what all health care facilities are available to them. Hence, through various concepts and theories explained above, we conclude that they impact greatly on all health practitioners. But we as a health professional should abstain from being in the dominant position and be more concerned and be more empathetic and provide correct and timely treatment to the patients and remove the discrimination amongst several groups as far as health and health care services are concerned.
At the end, we summarize that hierarchy and power as explained in details above are very much in existence and plays the most important role in the trending Australian health care system. Higher authorities with power dominates and makes governing policies beneficial for themselves and for those in authority and lower poorer class is utmost affected in terms of health and also with the availability of health care services.
References:
Department of Sociology. (2017). What is Sociology? Retrieved from https://sociology.unc.edu/undergraduate-program/sociology-major/what-is-sociology/
Lee, G. (2017). A closer look at the sociological perspectives of health care. Retrieved from https://today.mims.com/a-closer-look-at-the-sociological-perspectives-of-healthcare
Jkonoroth. (2013). Models of Health. Retrieved from https://www.slideshare.net/jkonoroth/321-models-of-health
Smith, W. (2017). What is Biomedical Model of Health Retrieved from https://www.allassignmenthelp.co.uk/blog/what-is-biomedical-model-of-health/
Hierarchystructure. (2017). Marxist Social Hierarchy. Retrieved from https://www.hierarchystructure.com/marxist-social-hierarchy/
Roccato, M. (2014). Social Dominance Theory. Retrieved from https://link.springer.com/referenceworkentry/10.1007%2F978-94-007-0753-5_2753
Cook, S. (2013). Weber’s definition of power. Retrieved from https://sociologytwynham.com/2013/06/04/webers-definition-of-power/
Crossman, A. (2016). Power. Retrieved from https://www.thoughtco.com/power-p2-3026460
Barry, J. (2017). Theories of power: pluralist, elitist and Marxist perspectives. Retrieved from https://www.academia.edu/3270103/Theories_of_Power_Pluralist_Elitist_and_Marxist_Perspectives
Eckvahl, C. (2014). Healthcare Disparities in Australia. Retrieved from https://borgenproject.org/healthcare-disparities-australia/
Bywood, P., Katterl, R., & Lunnay,B. (2011). Disparities in primary health care utilisation: Who are the disadvantaged groups? How are they disadvantaged? What interventions work? Retrieved from https://www.phcris.org.au/phplib/filedownload.php?file=/elib/lib/downloaded_files/publications/pdfs/phcris_pub_summary_8358.pdf
Kenny, A. (2014). Medical Dominance And Power: A Rural Perspective. Retrieved from https://www.tandfonline.com/doi/abs/10.5172/hesr.13.2.158
Maddox, R., Davey, R., Cochrane,T., Lovett, R. & Sterren, A. (2013). Study protocol – Indigenous Australian social networks and the impact on smoking policy and programs in Australia: protocol for a mixed-method prospective study. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-879
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