Healthcare Systems: Challenges and Solutions

This assignment delves into the complexities of healthcare systems worldwide. It requires a critical analysis of existing challenges faced by healthcare systems, including effectiveness, quality, resource allocation, and policy implementation. Students are expected to examine various solutions proposed to address these issues, considering their impact on patient care, system efficiency, and societal well-being. The assignment encourages students to explore diverse perspectives on healthcare reform and contribute to a thoughtful discussion on shaping the future of healthcare delivery.

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Hierarchy and power are intrinsic to the current health care system in
Australia.
Introduction
In the 20th century, a term called medical dominance introduced prior to which most of
the population use to take consultations from midwives, chemists or herbalists. Along with the
term, medical dominance Peter Chamerlen introduced obstetrical forceps which helps the user to
deliver a child without any complications. This concept enabled male doctors to be present
during surgeries as they had the exclusive rights on these forceps (Lockwood, Friedman &
Christian, 2015). Doctors also introduced various professional strategies which gave a boost to
their practice and undermine the practice of midwives. Gradually doctors started charging high
fees from women by convincing them of the danger in childbirth and incapability of midwives. It
became a habit, doctors deliberately starting making every pregnancy a risky one, moreover the
children’s bureau conducted a campaign wherein people were educated about the biomedical
model of pregnancy and childbirth, and it was a deliberate effort to demoralize the role of
midwives among people permanently (Lockwood, Friedman & Christian, 2015). Obstetrics was
a newly introduced concept in the year 1920’s and in order to justify the high cost and regular
customer base doctors needed regular teachings and medical sessions, despite all these loop holes
doctors were still getting a license for this profession by using their medical association powers
and gradually were imposing legal sanctions against midwives. In Australia, doctors were
gaining power by adopting two political strategies one is they formed a medical association

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which was unifying them against other professions and secondly they forced governments to ban
other practitioners from practicing (Lockwood, Friedman & Christian, 2015). For instance, in
1862, the Victorian government gave powers to doctors to sue people for non-payment, sign
death certificates and right to use medical titles. All these powers ultimately declared doctors as
experts.
Now if we talk about hierarchy, in Australian health care system it is characterized by
occupational hierarchy, where doctors are supreme power. This means that they are not under the
direct control of any other occupation; moreover, they have the authority to control other health
workers (Turan & Turan, 2016). Historically, it has been observed that more of the doctors are
male and more of the nurses are females, with this division of labour in the health care system it
is the nurse who comes to doctor always. But later in the 1970s, there was a boom in the entry of
men into the nurse profession and some commentators started seeing it as a shift in the ideology
of nursing as a feminine profile. Some studies also show that male nurses are most likely
preferable in the positions which demand advancement into specialized areas of nursing and
nursing education (Turan & Turan, 2016).
Discussion
The healthcare industry is among one of the huge social institutions which people use
throughout their lives, every group and culture has different viewpoints of seeing the industry.
Specially, it viewed differently by three sociological theories –the interactions, functionalist, and
conflict. All of the three perspectives can be easily applied to the industry and it focuses on
social relation building which influences people’s behaviour, human groups, and societies.
Initially, we will discuss the events which lead to the current health care system (Elshaug, Hiller,

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Tunis & Moss, 2007). In the early 1920s, in Australia, there were three issues which were
classified as overuse, underuse, and misuse. Overuse referred to as the provisions of service with
the harm of exceeding potential benefits. Underuse means that when we could have provided
better outcomes but was not able to do so and misuse means intentionally created complications
which could be avoided. But in the year 1970, the Australian healthcare industry started
focusing on quality assurance by extending hospitals to include aged care facilities, focusing on
evidence based medicines and health outcomes (Reading, 2007). Natural human phenomena like
death, birth, and pain are no more realm of normalcy and have been incorporated into the
medical discourse. Being overweight, underweight, ageing, or adolescence everything now
comes under the medical microscope (Volchok, 2005). Health professionals were now
answerable for quality measurements, nursing quality measures were introduced on a large scale
along with the quality managers which were placed in hospitals and other health agencies. Many
Australian states and territories introduced patient complaint commission. Many public hospital
budgets were cut and new process CASEMIX introduced as incentive where treatment cost
should not be exceeded (Volchok, 2005). But the principle of CASEMIX remains in
controversies as in order to cut the cost, it may override the principle of best practice. Other
factors which affected the cost were consumer demand, increase in wages and salaries, over
servicing and medical fraud and use of high technology. Various approaches to cut the cost were
implemented in Australia which included limiting the number of subsidies under PBS and MBS
resulting in the best of practice behavior. An allied health professional, according to their
association the AHPA, involves professionals who; have client contact, a professional
association, a university course and standards and assessment procedures (Volchok, 2005). They
have a code of ethics and a defined scope of practice. Like the work of nurses, allied health

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professionals are also dominated and supervised by the medical profession. Like medicine, each
discipline tries to align itself with science in order to gain legitimacy and claims a form of
“truth” tested in research. By becoming legitimate the discipline can gain access to recourses like
government funded consultations, the university system and a greater charge of the health market
(Volchok, 2005).
Now if we correlate the conflict theory with Australian health care system then we can say that
conflict theory has contributed to our understanding of system but has many drawbacks related to
inequalities among healthcare system like age, gender. There are various organizations who are
now working with both men and women. Some other conflict theorists also discussed that there
is a relationship between premature death and poverty (Duncan, 2010). If we correlate this with
private hospitals it has been observed that many medical types of the council are not giving any
type of free services to people who are below poverty lines. This is the same with public
hospitals; they are misusing their powers under the influence of many political references. Today
the unstoppable use of dangerous chemicals in the production of medicines is probably an area of
concern and it is affecting badly the health of workers (Duncan, 2010). The Australian
government provides a universal taxpayer funded system across all hospitals and medical
treatments known as Medicare, they also get pharmaceutical benefits under pharmacy act. As per
researchers, it has been observed that poor use hospitals more often than rich people but they do
not get any benefit neither they are covered under any scheme (Duncan, 2010).
There is another perspective called functionalist perspective under which it emphasizes the way
in which part of society is structured to maintain its stability. This means that one should avoid
being sick so that not too many are released from their societal responsibilities and if this
happens than it will prevent our society from being stable and functional (Ameri, 2015). There is

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also a role called sick role where in whenever anyone gets sick then they take off from social
responsibilities by either staying at home or seeking medical help. Now here comes the role of
doctor, it is his prime responsibility to check whether a person is genuinely sick or not if he is
then providing him with the medical help. But here also doctors have made it a profession, not to
give genuine advice to patients and charge maximum money from them (Ameri, 2015). As per
the current Australian Bureau of Statistics survey, national health survey and a national survey of
wellbeing it has been observed that 45% of an individual’s age between 17-82 are being
mistreated by doctors. There is a controversy in Australia that medical care is it right or a
commodity which says that if medical care provided in Australian health care system is right
then it should provide access to all citizens and if it is a commodity then doctors will keep on
misleading patients and charging irrelevant amount from them (Ameri, 2015). In 2005-06 spent
43% more on healthcare services the reason for this hike was growing number of elder people,
the introduction of new technologies and more expensive malpractice by doctors. Australia GDP
has a lesser share of the amount spent on the healthcare industry (Rosati, 2006).
As per World Health Report, it has been evidenced that per capita spending on health is strongly
measured by some health indicators and other factors like female/maternal education, income
inequality and cultural characteristics which are directly correlated. In Australia, there is a
concept of aboriginal health workers (Rosati, 2006). These workers work under the authority of a
white professional’s ad from a critical perspective it can be said that aboriginal/non-aboriginal
health workers relationship is colored by colonial beliefs. In 1997 there were approximately
13000 aboriginal workers employed in various hospitals and health care centers in Australia and
according to National Health and Medical Research Council, the lack of recognition of
aboriginal health workers resulted in difficulties in accessing secure and ongoing funding for

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training. The Australian Nursing federation has addressed these low numbers of participation of
aboriginal health workers in various health programs. Another aspect of culturist is non-English
speaking Australians who are working in various health care centers that are represented in lower
socio economic group; therefore a relation between poverty and social disadvantage and health is
again highlighted. This is a clear example of cultural proximity. Cultural definitions of
femininity and masculinity and the prescribed roles for males and females may affect illness
experiences, health behaviors and treatment modality choices. In some cultures, for example,
females are healed (or assisted in the case of childbirth) by females. Confrontation with a male
doctor may upset and even offend some women.
Conclusion
On the basis of above discussion, it has been observed that there are many loop holes in
the Australian healthcare systems. Initially, midwives were removed from the system in order to
promote doctors by way of creating fear in the mind of patients that their pregnancy is risky,
gradually doctors started charging high fees from women by convincing them of the danger in
childbirth and incapability of midwives. It became a habit, doctors deliberately starting making
every pregnancy a risky one, moreover the children’s bureau conducted a campaign wherein
people were educated about the biomedical model of pregnancy and childbirth, and it was a
deliberate effort to demoralize the role of midwives among people permanently (Stanley, 2014).
secondly, there are various malpractices adopted by doctors and as per researches it has been
seen that it is most common in hospitals, increased the frequency of avoidable surgeries
nationwide, few injured patients were sued these findings were noted any Australian Professional

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Indemnity Review’s final report. Influence of medical knowledge is not restricted to the
interpretation of medical illness; it is the process where the increasing aspect of life is defined as
a medical problem (Stanley, 2014). Natural human phenomena like death, birth, and pain are no
more realm of normalcy and have been incorporated into the medical discourse. Being
overweight, underweight, ageing, or adolescence everything now comes under the medical
microscope (Stanley, 2014). The pathway to beauty is through medical interventions. A doctor
patient relation is described by the patient’s expectations that the doctor will listen to all his
problems and provide him the best of solutions; he relies on the expert knowledge of the doctor
(D, 2016). The power of this profession is legally prescribed and doctors are being expertise by
taking numerous training and education. Despite all the role of doctor remains within the limit of
relationships of authority and subservience and patients remain dependent on medical
professions. Exclusionary practices of the past, although challenged over time, are deeply
embedded in contemporary practices. They continue to reflect the values and beliefs of the
dominant culture’. As a health practitioner, you need to be aware of your own specificity, how
this affects your world view and how this might impact on your practice. Reflective practice is
intrinsic to ensuring inclusion.
Language and your use of language when working cross culturally is also important, an example
of this is the abbreviation ATSI which stands for Aboriginal and Torres Strait Islander which can
be viewed as disrespectful
Most importantly your commitment to knowing who the person is within their cultural context
and how they identify themselves is vital. Here comes the role of the functionalist theory of
sociology which says that this approach adopts a perspective towards a society which is
somewhat similar to biologists who adopts human body. In order to understand any part of the

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society such as family, government or religion it is mandatory to understand the functions of
those social parts or structures. Whereas the interactions perspective generalizes about daily
forms of social interactions in order to explain society as a whole. From an interactions point of
view, the Australians are generally not passive, they are more open to the doctors to discuss their
problems with health care practioners, in fact, they are also interested in knowing how the
doctors have come into this profession, how they have achieved this position, how they have
done their studies. This allows them to earn lot more respect from their patients and coworkers
because doctors have the authority and patients follow their instructions rigorously but some
patients fail to do so. For example, some patients don’t follow doctor’s instructions and stop
medications much before time.
All the three sociological theories have different perspectives on the healthcare industry. The
functionalist theory focuses on functions and stability of the society, conflict theory concentrates
on the conflicts between the people in the society and lastly interactions theory focuses on the
interaction between people in society including doctor-patient relationship. These theories not
only elaborate the views of healthcare social institutions but also understand the outlook of other
issues related to societies.

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D, R. (2016). The Future Evolution of the U.S. Health Care Entitlement System. Health Care :
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Duncan, P. (2010). Health, health care and the problem of intrinsic value. Journal Of Evaluation
In Clinical Practice, 16(2), 318-322. http://dx.doi.org/10.1111/j.1365-2753.2010.01392.x
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Turan, H., & Turan, G. (2016). Implementing Analytical Hierarchy Proses In The Nurse
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