Different Cultural Views on Health, Essay Example

Health has become an issue of increasing political, sociological and economic importance in recent decades. Such is its political importance that in some European countries spending on healthcare is ring fenced, which essentially means it is virtually immune to spending cuts that may need to be made in other areas of governmental responsibility. However different developed states take different viewpoints on the role and responsibility for healthcare provision. This essay will examine the main cultural views to healthcare in the United States and the United Kingdom.

The different approach to health in the US and the UK essentially mirrors their differing economic ideologies. The US takes an agency based approach, whereby it is generally the responsibility of the individual not the state, to provide healthcare coverage for oneself and one’s own family. The overall emphasis is on negative freedoms which are freedoms from undue state interference in society. Consequently most of the freedoms that comprise the US’s Bill of Rights are negative freedoms, which actively require a curtailing of state intervention. Therefore the right to freedom of movement is essentially a right to move freely without undue state control, scrutiny or interference. This agency based approach explains the preponderance of private as opposed to state funded healthcare in the US. It also explains the antipathy towards President Obama’s initiative to extend healthcare provision, which was viewed as health centred socialism. This, despite the fact that his policies extended government backed private health insurance to poorer families, rather than state funded and controlled coverage.

The UK, as well as most of the European Union, takes a more structural approach to health care. Illness and disability are seen as mishaps that can occur at any time and are out of the individual’s control. Basic civility and human dignity mandates that access to this most basic of human needs should not be limited to those with the ability to pay. The UK also places emphasis on the need for positive rights to complement negative rights. Positive rights are the right to a basic standard of living and quality of life. Negative rights alone tend to make little rational difference. For example the right to freedom of movement is pointless if someone is ill and in distress but is unable to afford medical care. Freedom of speech is irrelevant if you cannot afford to educate your children to speak properly. Therefore the UK has a fully state funded health service that provides free health care at the point of service. The system is predicated on the basis that combating illness is difficult enough without the added strain of financial worries. It also eradicates the problem of long term health coverage by insurers or the infamous get out clause of ‘previous conditions’ that allows insurance companies to escape liability.

These two concepts of individualism as opposed to collectivism are deeply embedded in the cultural psyche of both nations, and are based on their different and unique historical experiences. However there are other approaches to health they share that are not quite as stark and polarizing. The medical approach to health views the body as a machine, and ill health as a malfunctioning of that machine. Sickness is therefore due primarily to biological factors and dealing with it is achieved through scientific investigation and knowledge.

Social scientists take a different view. They do not believe that ill health is only about biological malfunctioning. They believe that social factors play a part in both the cause and the aftermath of illness. Factors such as lifestyle, diet, exercise, social habits such as smoking and drinking, housing etc, can play a part in contracting an illness, whereas others such as employment, adequate housing, access to available health care, affordable drugs, social security etc can play a part in dealing with the course of an illness. Dealing with ill health therefore requires both a medical and a social approach and input.

The third approach is the complementary approach. This agency based perspective emphasizes that maintaining a healthy body requires a holistic approach which depends on a union of the body and the mind. Ill health is conceived as an imbalance between the physical, emotional and mental aspects of the body. The approach utilizes complementary therapies and techniques that are meant to facilitate the body’s own healing mechanisms.

The final approach was initiated by the World Health Organization back in the 1970s along with several leading western governments and envisaged ill health as encompassing most of the above points. This approach is termed the New Public Health model and views ill health in both structural and agency terms in that it emphasizes the respective roles of both the state and the individual in maintaining a healthy society. Uniquely it is aimed at both treating the sick, but also targeting the physical maintenance, lifestyles, behaviour and environment of the healthy so as to prevent illness in the first place.

Health and health care provision are obviously contested subjects, and like so many other important areas of life are dominated by ideological perspectives. This means that access to health care will always be subject to the dominant political, economic and cultural ideology in each state. The different perspectives presented in this essay, coupled with recent economic developments in both US and UK politics ensures that it will remain this way for the foreseeable future.

Bibliography

Crawford, R. (1993) ‘A cultural account of “health”: control, release and the social body’ in Beattie, A., Gott, M., Jones, L. and Sidell, M. (eds) Health and Wellbeing: A Reader, Houndmills, Macmillan

Davey, B.  Gray, A. and Seale, C. (eds) (1995) Health and Disease, Buckingham, Open University Press

Department of Health and Social Security (1976) Prevention and Health: Everybody’s Business, London, HMSO

Hoffman, J. and Graham, P. (2006) Introduction to Political Ideology, Harlow, Pearson Education Ltd

Smith, B. And Goldblatt, D. (2000) Whose Health Is It Anyway? in Hinchcliffe, S. and Woodward, K. (eds) The Natural and the Social: Uncertainty, Risk, Change, Milton Keynes, The Open University