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PEERRESPONSESNEEDED.docx
Bess
How does access to education affect health outcomes? According to Leopold (2018), research has consistently shown that health gaps between higher- and lower-educated people increase over the life course. Education reproduces and magnifies early advantages and disadvantages of social background and strongly determines income, occupational status, and wealth in later life (Leopold, 2018). Moreover, those who attain higher education increase their capacity of processing information and their sense of personal control and skills that contribute to acquiring and maintaining a healthy lifestyle (Leopold, 2018). Differences in social policies are also associated with long-term sickness and unemployment, the US the least generous policies when compared to the United Kingdom, the Netherlands, and Sweden. There are sharp contrasts in institutional factors that may strengthen or weaken the relationship between education and key determinants of health over the life course (Leopold, 2018). In past discussions research has shown how in the US those on Medicaid have worse health outcomes and poorer access to services. The above countries mentioned here are all wealthy countries. So how does education affect those in low and middle income countries? When you look at this from a different perspective, there are striking differences between low and middle-income countries. Education differences highly impact girls and women in comparison to men. Low and middle-income countries have far worse health outcomes than developed nations. The short film “Girl Rising” (Robbins, 2013) introduced the conditions of impoverished girls in Nepal, as education is offered to boys. I was dismayed by the statistics reported in “Girl Rising.” First, education enhances health, makes girls safer, and gives them status in their communities—positive education benefits. Girls in low-income counties have less freedom, less education, suffer more hunger, more violence, more disease, and 150 million girls are subjected to sexual violence (Robbins, 2013). These ideas lead me to research further on this topic. I came across an article by Hahn et al. (2018), which showed that education for girls in Bangladesh had many long-term benefits. It increases the age at marriage, reduces fertility, reduced child mortality, enhances child health, leads to better pregnancy behaviors, and improves options and opportunities (Hahn et al., 2018). It also provided more income and independence as well as enhanced female autonomy. More educated women in Bangledesh were more likely to marry more educated men. Statistics indicated that children of educated women were also healthier. 43% of children under age five in Bangladesh are stunted, and 41% are underweight. NR524: Health Policy, Advocacy And Economics In Healthcare
Children from educated women were taller and heavier in this age category. The other side of this, and noted above, is that 150 million girls are victims of sexual violence, with 80% of all human trafficking victims female (Robbins, 2013). Grose et al. (2021) found that gender-based violence against women and girls is attributed to personal, situational, and sociocultural factors. Men have disproportionate social, political, and economic power (Grose et al., 2021). This fuels some ideas that they can dominate women and may promote ideas that make them feel entitled to use coercion and aggression to meet their sexual needs (Grose et al., 2021). Overall, gender-based violence negatively affects well-being and has lifelong consequences. The United Nations is actively working to improve women’s health and eliminate gender-based violence. Policies that promote funding for education can certainly help decrease some disparities caused by lack of education. However, long cultural-related behaviors will have to be addressed to ensure gender-based equity, not just in terms of health outcomes. Grose, R. G., Chen, J. S., Roof, K. A., Rachel, S., & Yount, K. M. (2021). Sexual and reproductive health outcomes of violence against women and girls in lower-income countries: a review of reviews. The Journal of Sex Research, 58(1), 1–20. https://doi.org/10.1080/00224499.2019.1707466 Hahn, Y., Islam, A., Nuzhat, K., Smyth, R., & Yang, H.-S. (2018). Education, marriage, and fertility: long-term evidence from a female stipend program in bangladesh. Economic Development and Cultural Change, 66(2), 383–383. Leopold, L. (2018). Education and physical health trajectories in later life: a comparative study. Demography, 55(3), 901–927. https://doi.org/10.1007/s13524-018-0674-7 Robbins, R. (2013). Girl rising- nepal chapter. https://www-filmplatform-net.library.norwich.edu/product/girl-rising/
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Melinda
In the 2008 PBS Frontline Documentary “Sick Around the World”, Frontline correspondent T.R. Reid examines the healthcare systems of other advanced capitalist democracies including the UK, Germany, Switzerland, Japan, and Taiwan. For this discussion board post I’ve chosen to highlight Switzerland’s healthcare system and why I believe key elements of their system would be beneficial in improving access and quality, and lowering costs, if implemented in the United States. As then President of Switzerland Pascal Couchepin eloquently stated “Everybody has a right to healthcare. Because it is a profound need for people to be sure that if they are struck by destiny, by a stroke of destiny, they can have a good healthcare system” (Couchepin, P., 2008). In 1994 Switzerland radically overhauled their healthcare system to provide Universal Healthcare with a law called LAMal. Prior to 1994 their model resembled that of the US, with big insurance and drug companies, and medical insurance which was voluntary and largely linked to employment. Today Switzerland continues to have competitive health insurance companies and Swiss pharmaceuticals still perform in the top 10 internationally. Lack of profit has not meant a lack of competition, the insurance industry remains very competitive because each company “wants to keep its old customers and get new clients” (Revaz, P., 2008). Pierre Marcel Revaz, then CEO of Groupe Mutuel shared that a focus on low administrative costs helps to bolster profits. To provide context, Groupe Mutuel had annual administrative costs of around 5.5%, while in the US average administrative costs are closer to 22%. In addition to retaining and attracting new clients, profits for insurance companies can come from fees for supplemental costs to patients (ie: better hospital rooms), or supplemental policies. In 2008, the model in Switzerland cost Swiss families approximately $750/month in healthcare premiums. For reference, my health insurance premium today for my family of 5 costs me $491.00/month, and while the costs are higher, the benefits are acknowledged. The overall cost of the Swiss health system is ranked as the 2nd most expensive in the world, yet still much cheaper than ours. Though Universal coverage can offer private insurance, private doctors, and private hospitals, the overall tenets of Universal Healthcare are three-fold: “first, insurance companies must accept everyone and can’t make a profit on basic care; second, everyone is mandated to buy insurance and government pays the premium for the poor; and third, doctors and hospitals must accept one standard set of fixed prices” (Reid, T.R., 2008). I believe adopting a system which is in line with the Switzerland Universal Healthcare model would improve access and quality, as well as lower costs. Access would be irrefutably improved because Universal healthcare is required to cover all individuals, regardless of employment status or income. Further, it was identified by T.R. Reid that (in 2008) approximately 700,000 people per year in the US went bankrupt due to high medical bills, the incidence of medical-bill related bankruptcy in Switzerland, zero. Thus it is also irrefutable that Universal Healthcare would lower costs in the United States, because, while the average monthly premium may be more, the benefits to the economy are abundant. Though the economic cost of the Swiss healthcare system is considered to be the 2nd most costly system globally, their 2018 12.2% of GDP expenditure pales in comparison to the US’s 16.9% (Le News, 2020). In terms of quality, Switzerland outperforms the United States on all measures of health including average life expectancy, maternal mortality, disability-adjusted life expectancy, and neonatal mortality (Switzerland: Health System Outcomes, 2021). Thus, it is also irrefutable that the Universal healthcare system utilized in Switzerland offers improved quality over that of the United States. To many, adopting a Universal approach in the United States feels impossible. I believe if we continue to present sound data with irrefutable measures of increased value and improved outcomes, that eventually logic and reason will help sway the masses to reach the same conclusion that all other advanced capitalist democracies have come to, Universal Healthcare is a fundamental human right, and is the best system. Citations: Reid, T. R. (2008, April 15). Sick around the world. PBS. Retrieved January 29, 2022, from https://www.pbs.org/wgbh/frontline/film/sickaroundtheworld/ Le News. (2020, October 2). Cost of Swiss health insurance to rise in 2021. Le News. Retrieved January 29, 2022, from https://lenews.ch/2020/09/25/cost-of-health-insurance-to-rise-in-2021-in-switzerland/#:~:text=The%20average%20monthly%20premium%20will%20rise%20to%20CHF,while%20falling%20to%20CHF%2099.70%20%28-0.1%25%29%20for%20children Switzerland: Health System Outcomes. Health Systems Facts. (2021, May 18). Retrieved January 29, 2022, from https://healthsystemsfacts.org/switzerland/switzerland-health-system-outcomes/
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Jessica
After watching Sick Around the World, I have realized that one key element that all these other countries featured in the video have in common is that they have decided that a society has an obligation to see that anybody who is sick can see a doctor, and that healthcare is a basic human right that everyone is entitled to. These other rich nations seem to have accepted this concept and allowed the goal of universal healthcare to be the springboard, or starting point, when developing and reforming their healthcare systems. The US has not come to this realization yet, which in my opinion, perpetuates our fragmented system that combines the worst features of both socialism and market forces in healthcare. We can’t seem to learn from the best examples in other countries and make this basic moral commitment to universal healthcare. One repetitive argument I hear against universal health coverage centers around the concern that many do not want to lose private insurance. Lobbyists are also spending billions to ensure that private insurers maintain their status in the health system. This culminates to serve as one of the factors that keep us from moving toward universal coverage. So, I was interested to learn that Japan does have a place for private insurance within their universal coverage. In Japan, private plans play a supplementary or complementary role. Historically, private insurance developed as a supplement to life insurance. It provides additional income in case of sickness, usually as a lump sum or in daily payments over a defined period, to sick or hospitalized insured persons. The number of supplementary medical insurance policies in force has gradually increased, from 23.8 million in 2010 to 36.8 million in 2017. Both for-profit and nonprofit organizations operate private health insurance. Part of an individual’s life insurance premium and medical and long-term care insurance contributions can be deducted from taxable income. Employers may have collective contracts with insurance companies, lowering costs to employees (Tikkanen et al., 2020). I think that with our unusually individualistic culture, favoring personal over government responsibility, combined with the insurance industry who is willing to spend over $100 million to help shape the ACA and keep private insurers as the key cog in American health care, universal coverage will continued to be delayed. Insurance and pharmaceutical lobbyists have written fat profit subsidies and price supports into federal legislation, particularly the Medicare drug benefit, inflating costs unsustainably. It is these uniquely American layers of private sector “innovation” in healthcare that is forcing us to spend double what other rich countries do (Lange, 2009). However, this key element of Japan’s healthcare system offers proof to us in the US that there can be a place for private insurance in a universal coverage healthcare system. Maybe if we can look at the examples set by nations who have adopted universal coverage, we can see that there is the possibility to keep some aspects of our current healthcare system that many citizens aren’t ready to let go of, while also moving towards creating a system that works for everyone at the same time. References Lange, M. (2009, September). What can America learn from Switzerland and France about healthcare reform? Christian Science Monitor, 9. Retrieved February 15, 2022, from https://web-s-ebscohost-com.library.norwich.edu/ehost/detail/detail?vid=1&sid=ec74f029-2252-43e9-b847-2b40c9994ab6%40redis&bdata=JnNjb3BlPXNpdGU%3d#AN=44035406&db=aph Tikkanen, R., Osborne, R., Mossialos, E., Dejordjevic, A., & Wharton, G. (2020, June 5). International Health Care System Profiles Japan. The Commonwealth Fund. Retrieved February 15, 2022, from https://www.commonwealthfund.org/international-health-policy-center/countries/japan
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Ashlyn
Hello Everyone,
After watching those video’s I am in awe that we in the United States have it so good, yet pay so much for health insurance and medical bills. It was astounding to me that a hospital stay could only cost $90, and getting a cut on your hand fixed up would be $10. That is insanely cheap compared to what we have her in the United States. Another thing that was crazy to me is that some of those countries require everyone to have their countries insurance, whereas the United States has several different insurance companies with multiple different branches in those insurances. What I want to focus on during this discussion post though is how access to education affects health outcomes. I believe education makes a huge different in any aspect of health, such as physical, mental, and medications. For instance, education on medications could decrease the chances of medication misuse or errors. That could decrease doctor and hospital visits for the person because the medications would be doing their job correctly, or the person would be education on what the medications are supposed to be doing as well as any side effects to monitor for. When it comes to physical health, education is also important because it increase the patient understanding of the significates being up and active to improve their overall health. By being active, this can decrease patients chances of getting many diseases, disorders, and even cancer. Lastly, I believe that education can improve mental health as well. Boris Nikolaev stated that “people with higher education are more likely to report higher levels of eudaimonic and hedonic subjective well-being, they view their lives as more meaningful and experience more positive emotions and less negative ones, people with higher education are satisfied with most life domains (Financial employment opportunities, neighborhood, local community, children at home)”. (2018). I believe that education changes lives for the better, especially when it comes to their health outcomes. Patients can believe in their doctor’s education but If they do not listen to the doctors and do what they say, or do not well educating themselves on their health than things could go downhill quickly. Reference: Nikolaev, B. (2018). Does higher education increase hedonic and eudaimonic happiness? Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being, 19(2), 483–504.Retrieved on February 15, 2022 from https://doi.org/10.1007/s10902-016-9833-y
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