The Health Care Crisis in the United States: A Call to Action

By Redmond, Helen | Health and Social Work, February 2001 | Go to article overview

The Health Care Crisis in the United States: A Call to Action


Redmond, Helen, Health and Social Work


At the millennium, the health care system in the United States continues to be in crisis. The United States, to its shame, is the only industrialized country in the world that has not established universal health coverage. It is estimated that 42.6 million people have no health insurance--10 million are children (U.S. Census Bureau, 1999). The loss of health coverage and delays in care have resulted in thousands of deaths. (Himmelstein & Woolhandler, 1994). Despite the numbers, we can never calculate all of the human suffering that results from not having access to medical care. As social workers in the health care industry, we are eyewitnesses to this suffering on a daily basis. Medical social workers are expected to alleviate much of this suffering. We are on the front lines of the health care crisis in the United States. We explain the eligibility requirements for insurance programs and how to enroll in programs to purchase low-cost medication and counsel patients who cannot pay medical bills. Medical soc ial workers have a vast knowledge base and access to resources in the community to help patients and their families cope with illness and disability.

PROFESSION UNDER ATTACK

The profession of medical social work itself has come under attack. Social workers are laid off when hospitals and clinics close or merge. Entire social work departments have been eliminated in hospitals, and nurse discharge planners or case managers have assumed the role of social worker. Social work as a discipline in the medical setting is struggling to survive (Globerman, 1999). Health care administrators often do not value the role social work plays because they do not see how it contributes to profitability. Social worker's "productivity" is increasingly measured by the number of patients seen (patient contacts) and how quickly the patient was discharged. Shortened length of stay and other efforts to lower acute-care costs have greatly affected social work practice in hospitals (Hammer & Kerson, 1998). It is becoming more difficult, and at times impossible, for social workers to do comprehensive and patient-centered discharge planning. Downsizing and hiring freezes leave social workers with higher casel oads and less time to spend with more patients and families.

In the current health care environment, which is driven by the pursuit of profit not patient need, the social work code of ethics is being profoundly challenged (Riffe, 1998). Access to health care in the United States is not a right but instead a commodity to be bought and sold. If you cannot afford it, you cannot have it. Worse, if you are sick, if you have a "pre-existing condition" you can be denied insurance coverage. If you need health care you are less likely to get it. This is the perverse logic at the center of for-profit health care provision--insurers do not want to insure groups that are considered "high-utilizers." Among the groups targeted as heavy users are chronically ill and elderly people. Social workers reject this categorization of patients as dehumanizing and stigmatizing.

MEDICARE AND MEDICAID

Wilbur Cohen, assistant secretary of health, education, and welfare under President John F. Kennedy, and other social workers played leading roles in the development of Medicare. Medicare finances health care for 38 million people and pays 20 percent of the U.S. health care bill (McFall & Teitelman, 1998/1999). From its inception the Medicare program has had serious limitations and gaps in coverage. Most notably, Medicare does not pay for prescription medication. Recent statistics indicate that 18 percent, or 7 million, of the 38 million Medicare recipients are enrolled in managed care (McFall & Teitelman, 1998/1999). Seniors chose to enroll in HMOs because of the prescription drug benefit as well as little to no co-payments and deductibles. After many years of Medicare managed care, we know it is a disaster for elderly people and people with disabilities. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

The Health Care Crisis in the United States: A Call to Action
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.