Hierarchy and Power in the Australian Health Care System

This article explores the power dynamics and hierarchy in the Australian healthcare system. It discusses the biomedical and social models of health, and the impact of social inequality on healthcare access. The article also examines the three perspectives of sociology - functionalist, conflict, and symbolic interactionist - and their views on healthcare.

Running head: HIERARCHY AND POWER IN THE AUSTRALIAN HEALTH CARE SYSTEM
Hierarchy and Power in the Australian Health Care System
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1HIERARCHY AND POWER IN THE AUSTRALIAN HEALTH CARE SYSTEM
Hierarchy and power are intrinsic to the Australian health system as the position which
one belongs to in the society determine the quality of the healthcare services that one will get.
It has been seen that the social actors who belong to the lowest band in the hierarchy have to
scavenge often to get the best quality of healthcare services (Scambler, 2013). On the other
hand, the powerful or the affluent seem to get the best quality of medical services and a clear
power play can be noticed. The widely followed biomedical model refuses to recognize any
other facets of illness and health as it solely focuses on the Biological aspects of health ( Henslin,
et al. 2015). On the other hand, it has been seen through decades that there are certain if not
all, types of diseases that do have a strong socio-economic or socio cultural background. The
following paragraphs will discuss in depth the power and hierarchy that lies in the heart of the
Australian healthcare system. It will also discuss the key concepts and the dimensions of
healthcare with appropriate theoretical underpinnings.
The study of the relationship between the individual and the society is known as
Sociology. This particular branch of study is concerned with how each social actor in a society is
affected by each other’s actions and how different institutions influence the actions of
individual social actors. Medical Sociology helps us decipher the many ways in which cultural
and social conditions affect health, medical practices and illness. Medical Sociology presents an
alternative view to the medical sector which vies illness in the light of bio medical model.
Sociology comes handy in order to prevent medicalization, a concept where health
professionals force the concept of medicines on a large portion of the society without having
adequate knowledge of the depth and the epistemology of a health problem.
The bio medical model focuses completely on the biological aspects of illness and
diseases. It encourages to treat an illness based on the symptoms that may be visible on an
ailing patient. The model focuses on individuals and restores their health so as to return him or
her to the pre-illness state, where there would be a lack of disease. The model generally
excludes the social and behavioural aspects of health. The biomedical model certainly has some
advantages in the fact that it encourages advances in technology as it moves science in the
direction of discoveries to treat the ill and the unhealthy. It also extends life expectancy as it
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2HIERARCHY AND POWER IN THE AUSTRALIAN HEALTH CARE SYSTEM
prevents diseases and other ailments as well as promoting a better quality of life by constantly
promoting a healthy body and mind. The biomedical model comes with some limitations also. It
is expensive as it involves technologies and healthcare professionals who are highly trained.
Besides, the quick fix aspect of the bio medical model often promotes a superficial fix and fails
to prevent or to ensure the demise of any disease. On the other hand, the social model of
health deals with the broader aspects of health that takes into consideration economic,
environmental, social and cultural facets of illness. It has been developed in order to present a
different perspective of lifestyle-related diseases like cardiovascular diseases, obesity and
diabetes (Jolley, et al. 2014). It is often seen that the population does not enjoy a condition of
being healthy even though there has been more than enough medical advances. The model
acknowledges that there are several factors which affect the condition of health. It could be
access to health care systems or socioeconomic status.
To define health, it can be inferred that it is nothing but an extent of a person’s mental,
social and physical wellbeing. Being a multi-dimensional concept, health is closely related to the
social institution medicine which thrives to prevent, treat and diagnose illness as well as
promoting health in various facets (Cockerham, 2016). Health care can be referred to as the
provision of the services that the social institution medicine has to offer in order to treat health
problems, to prevent and to diagnose it. It is of utmost necessity that there be effective
healthcare services and appropriate medicines for the society to be able to function properly.
Social actors of any society will not be able to perform their given roles in the society if their
health degenerates or suffer from the lack of an effective healthcare system. Thus lending from
the functionalist perspective of Talcott Parsons (Turner & Holton, 2014), it is safe to assume
that premature death of any member of the society will be a hindrance in the way of carrying
out social responsibilities and roles and perpetuate social disharmony. In other words, the
premature death of any member of the society also prevents that social actor to fully return to
the society. It is only evidence that a society which lacks proper medical assistance will offer
nothing but greater difficulty to people who are already ill as they will be susceptible to more
illness. On the other hand, it has been seen that a society in which there is no medical or
healthcare system adequate for the social actors, even healthy people develop greater chances
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of falling sick. Apart from that, a person must be meeting some expectations if he or she is to be
treated as a legitimately sick person. A sick person must be treated by the doctor or a physician,
who according to Parsons definitely has a role to perform in validating the sickness of the ill
person. Parsons has also estimated the patient and physician relationship as a hierarchical one.
The physician is to give orders which must be carried out by the patient so as to return to the
adequate state of being healthy. The criticism of Functional theory comes in the way for several
reasons. The theory has ignored the fact that any social actor’s condition of health and the
quality of medical care that they receive is dependent on the society and the class of society
that one belongs to. Furthermore, it is safe to assume that the hierarchy that Parsons has
talked about does not thoroughly imply on the current scenario as patient and physician
relationship has moved from an authoritative one to a relationship where the patient
consciously submits in order to be at the best state regarding his or her health. The second
perspective, the conflict approach acknowledges the face that just like any other services,
medical and health care services are also coagulated in the hands of the fortunate one from
which, the disadvantaged mass has been exiled. It takes judgment, based on the fact that social
inequality exists and the social actors at the bottom of affluence will inevitably suffer from the
lack of healthcare services. The disparity between the rich and the poor and the channels that
they receive health care through varies drastically. Conflict theorists also view physicians as the
one who ate seeking to control the healthcare and medicine industry so as to centralize the
means and channels of distribution. It has been also believed that social problems and medical
problems are deeply entangled and intertwined. The physicians are said to have seized the
healthcare industry so as to monopolize it and deprive the less affluent mass of its benefit by
only catering to the affluent class. The health monopoly business has turned out in such a way
that conflict theorists also believe that the physicians often turn social problems into medical
problems. Once a social problem has been medicalized, it is often seen that the real reasons for
that problem get ignored and no solution gets offered. For example, the healthcare industry has
monopolized medicine at such an extent that alternative medicines are radically shunned by
the healthcare professionals. Conflict theorists believe that although there must be possibilities
that alternatives to medicine does work since there is no such evidence that all of the
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alternative medicines are ineffective, it is also the insecurity of the medical professionals that
they radically oppose the very idea of an alternative medicine system. As soon as the
alternative medicines start working, it is obvious that the monopoly of the medicine market will
lose its centralized power hold and power position. The medicalization of social problems can
be understood clearly in the form of eating disorders which are treated medically. Eating
disorders have a deep connection to the societal ideas of beauty but instead of eradicating that
menace, the healthcare professionals are more focused on treating the disorder by the use of
medicines. For the example of ADHD, it can be mentioned, that this particular disease was not
even considered to be a disease before the discovery of Ritalin. Before the invention of Ritalin,
ADHD was considered to be a state of hyper activity but as soon as the drug was discovered,
the health professionals started tagging it as a disease only to be treated by Ritalin or some
similar drugs. This gave the health professionals an excuse to encash the ADHD disease and
make the most out of it. With conflict theorists’ harsh criticism of medical professional, it has
also received flak. True, that medicine remains the most dominant form of health care but it is
also necessary to understand that not all healthcare professional take monetary benefits as
motivation for their respective jobs, there exists passionate doctors and medical professionals
who thrive on the wellbeing of the mass. The third perspective, the symbolic interactionist
approach views illness as a social construction (Carlson, 2013). This effectively means that this
particular approach takes illness as having zero objective reality and believes that illness is a
social construction which deems a member of the society to be sick or healthy based on
different parameters. To take an example, the opium ban in the USA would be appropriate.
Opium infused products were not seen as anything unnatural and harmful as over the counter
products sold in the U.S.A contained questionable amounts of opium. Opium only became a
menace, medically and legally as the prejudice against the Chinese became prevalent only to
give birth to a complete ban of the substance (Gabe & Monaghan, 2013). Just like the opium
dilemma, the obesity related prejudice was not present in the global scenario until recently. Pro
obesity activists claim that the vilifying of fat people and the medicalization of obesity places
too much importance on fat people just because they do not fit the society’s standard of
beauty. It is only normal, that this approach has also received criticism. It is true that symbolic
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interactionist negates the facts that serious illness and ailments do exist and proper medical
assistance must be taken when in need. It must be remembered that illness has a subjective as
well as objective reality, which could coexist.
As a medical practitioner, one can always get caught in the labyrinth of hierarchy and
power which are indigenous. Health service inequality exists just like any other inequality which
creates barriers amongst divisions of the society. In fact the social divisions which are based on
socio economic conditions decide the fate of each individual. An affluent citizen can easily get
access and come close to reach the best of healthcare services but on the other hand, it is
impossible for the non- affluent to get a reach of the best healthcare services (Mengesha, Dune,
& Perz, 2016). Even with the intention of reaching the fringes of the best services, one might
suffer for his or her socio-economic position in the Australian society (Artuso, et al. 2013). The
biomedical model, a core implemented part of the health care system makes the procedures all
the more expensive as it involves high quality technologies that cater to the needs of the
human beings. Besides, the aboriginal and the indigenous tribe of the Australian land who live
in the lowest strata of the socio economic system do suffer from the lack of proper medical
interventions. It has also been seen that the children who are living in poverty will be the
sufferers who do not have the channels to reach the best of the healthcare systems (Duckett, &
Willcox, 2015). It can be safely assumed that the social consequences also affect one’s health
and the lasting effects that one must suffer from the impact of the lack of a healthy body.
Lifestyle diseases such as obesity, cardio vascular diseases that have been led by the obesity
disorders are purely consequences of an unhealthy lifestyle. Some people have been seen
developing over craving for food from mental health problems such as anxiety, self-esteem
issues or depression. A patient can develop biological sickness that is obesity from overeating
and a lack to take care of his or her own body (Halfon, et al. 2014). The will to live a healthy life
and be free from ailments can go missing not only from the lack of a healthy lifestyle but
different social stigma. It has been often noticed, that the obese kids are also the most bullied
and the hurt that they face from the constant rebuttal leads them to find solace through the
medium of food.
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6HIERARCHY AND POWER IN THE AUSTRALIAN HEALTH CARE SYSTEM
In conclusion, it can be inferred that power and hierarchy are inseparable aspects of the
Australian healthcare system. It is pre-determined, that what quality of services one would
receive from the medical and healthcare system. The position one occupies in the socio
economic strata of the society determines his or her fate, thus the relationship between the
patient and the physician is one that is subjected to the power play and a hierarchy where the
physician plays a dominant role.
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References
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