Exploring Hierarchy and Power's Influence on Australian Healthcare

This essay delves into the intricate relationship between hierarchy and power within the Australian healthcare system. It begins by introducing sociological concepts and perspectives, including the functionalist, conflict, and symbolic interactionist approaches, to provide a framework for understanding social structures and their impact on health. The essay then explains the biomedical model, the dominant healthcare paradigm in Western countries, and its limitations. The core of the essay examines the concepts of hierarchy and power, exploring relevant theories from sociologists like Karl Marx, Max Weber, and others, and how these theories manifest in healthcare settings. The discussion extends to the Australian healthcare system, analyzing how hierarchy and power dynamics influence access to care, health outcomes, and disparities, particularly among Indigenous communities. It highlights inequalities related to socioeconomic status, geographic location, and other factors, and the role of political influence and healthcare professionals in perpetuating these disparities. The essay uses examples like tobacco usage and its policies to illustrate these inequalities and concludes by emphasizing the need for addressing these power imbalances to achieve equitable healthcare access for all Australians.

INTRODUCTION
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.
CONCEPT OF SOCIOLOGY AND ITS PERPECTIVES
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
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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.
EXPLAINATION OF THE BIOMEDICAL MODEL
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
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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.
DISCUSSION ON HEIRARCHY AND POWER AND THEORIES ACROSS
EACH CONCEPT WITH EVIDENCE
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
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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.
DISCUSSION AND IMPLICATIONS OF THEORIES OF HIERARCHY
AND POWER ON AUSTRALIAN HEALTH CARE SYSTEM
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
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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
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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.
IMPACT OF THE ABOVE KEY POINTS ON ME AS A HEALTH
PRACTITIONER
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.
OVERALL CRITICAL DEPTH
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.
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REFERENCES:
Department of Sociology. (2017). What is Sociology? Retrieved from
http://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
http://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
http://www.academia.edu/3270103/Theories_of_Power_Pluralist_Elitist_and_Marxist_Perspecti
ves
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
http://www.phcris.org.au/phplib/filedownload.php?file=/elib/lib/downloaded_files/publications/
pdfs/phcris_pub_summary_8358.pdf
8

Kenny, A. (2014). Medical Dominance And Power: A Rural Perspective. Retrieved from
http://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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