Reflective Journal Submission 3

Nicholas Horton, 2150171

22 May 2017.

In class, week 9 entailed the exploration of Power, Politics and Health

Care, three topics that are interconnected with each other and are

important for me to understand, as a health student and future health

educator, because they are constantly impacting the health system in

which all Australians are a part of.

Acting as a network of various services, the way in which people are

divided through private or public health care, or somewhere in-between is

reflective of their individual situation in various ways that I had never

realised (Belcher 2014). As I still live with my parents and come under

their health cover, I have never tried to understand the thought that goes

into organising it. I now see that not only personal factors contributing to

the socio-economic position of individuals or families in the community,

but also the health care system and the government all affect how health

care is provided and available in Australia.

The choice between private and public health care primarily comes down

to the individual or their family, where their lifestyle, socio-economic

position and preference based on pre-existing health conditions (Broom &

Germov 2014). My family, for example, now only consists of myself, my

mother and my father as my two brothers have their own health care

plans. In this sense, my mother and father decided that opting for the
public health care system but paying for extras cover (optical, all dental,

chiropractic) and having a financial buffer for unexpected medical

emergencies was more beneficial for our circumstances as, at present, we

are all in good health. This is a feature that I did not know about and that

we did not discuss in the workshop which I believe is great for the

Australian health system as it gives the population the flexibility to choose

what they want rather than leaving them with either one option or the

other, which is what I originally though happened. During the tutorial

debate, I had to argue for private health care, and in a sense, it seemed

impossible to win the argument, as it proved to be difficult to persuade

people to pay more money for private health care when Australias public

health care system is so effective already. The only ways in which I saw

private health care to be above public, is for elderly people who make

frequent visits to health professionals or those with serious health

conditions that require equally as much attention.

Another element to this debate that was helpful in expanding my

knowledge was the input from health professionals and information about

health facilities such as hospitals and private practices (Belcher 2014). At

first glance, it seems obvious that health care professionals and facilities

would be affected, but the scope in which they are influenced by the

government and can provoke change amongst Australian health was

underappreciated by myself. I came to understand the influence of health

professionals through their opposition to the Chifley Governments

attempt to create a free national health care system in the 1940s to

maintain the power which they had in the health care system (Belcher

2014). The influence that they had at this time was strengthened in 1946,

where changes to the constitution enabled them with more control over

medical practices (Belcher 2014). With the introduction of Medicare in

1984, health professionals were against it, seeing it to be the end of

private practice and medicine as health professionals sided with the

Liberal party of Australia to maintain a fee-for-service approach (Belcher

2014). However, these areas of health are shaped by the government,

where politics and political movements such as equal rights have the

power to challenge the way that health care is modified, where the

Australian Labour party takes lead and aimed to maintain a universal, free

health care system (Belcher 2014). If you look at Americas health care

system, they only provide public health cover to people who have retired,

over 65 years of age (Department for Professional Employees 2017). The

government does this for several reasons, primarily because the United

States dislikes socialism, which is what Australias Medicare system is

based on and because the American government does not see it as a

priority over spending money on other things such as military and

defence, resulting in a medical insurance system that only a percentage of

the population can afford (Department for Professional Employees 2017).

This makes good health care unattainable for many, especially those of

lower socio-economic status and reflects a health care system available to

higher income individuals and families.

Looking at the American health care system with my knowledge of social

difference and the socio-economic levels of a population that I have

developed this year in health, it is important to identify the social effect

that Americas health care system must have on its population. As a

future health educator, I believe it would be effective to compare the

health systems of countries such as Australia and America with my

students as it identifies the ways in which different countries, populations

and governments influence their own health care systems.

Regarding the socio-economic effect of health care on the population, it

reverts to the topic of well-being and wellness and global public health.

This is where the well-being of individuals is considered as it is heavily

dependent upon biological, social, psychological, economic and cultural

influences that ultimately determine the choice people make with regards

to health care (Heil 2014). In Australia, we are lucky enough to have public

health care where communities of the lowest socio-economic level can

attain medical assistance, such as the Indigenous population, for example,

who unfortunately continue to experience a major health gap in Australian

society (IndigenousGovAu 2017). However, in America the gap between

socio-economic groups grows enormously, where public health cover does

not exist for the unemployed and personal cover is only available through

employment, leaving approximately 33 million without it from 2014

(Department for Professional Employees 2017). Understanding the

devastating effect that a low socio-economic position can have on an

individuals mental health, I could only imagine how much more helpless
those in this position must feel to have even less assistance from the

country that they live in.

In a system where the lower your socio-economic position is, the harder it

is to attain health insurance this, in my view, leaves a significant

inequality on the population, where those higher up on the social ladder

are less likely to require medical assistance due to the difference in nature

of lifestyle (Germov 2014). Dangerous work or manual labour that is

strenuous on the body is more likely to be undertaken by those less well-

off along with factors such as living conditions, nutrition and sanitation

that will greatly affect this demographic as opposed to those living in

higher status (Broom & Germov 2014).

I strongly believe that in Australia, the public health care we have

available is an excellent feature to our system that has been balanced

between public and private efficiently, something that other countries

such as India, that has poor health insurance where the population still

pays for a majority of their health care costs (Bhatia 2017). Furthermore,

its lower-class people, especially workers, would be so grateful to have

Australias health care system with minimum level private health care

cover and high out-of-pocket expenses despite the number of dangerous

events that they face, as I saw in the Four Corners report on fashion

victims in week 4 (Bhatia 2017; Ferguson & OBrien 2013). In my opinion,

America needs to change its health care system, as it is providing health

insurance to those, that I would argue, need it the least in their

population. This reiterates they key message in chapter 5, which is that

lower socio-economic status groups have higher rates of mortality and

morbidity (Germov 2014).

I see the topic of power, politics and health care to be one that is not

easily understood and a definitive answer will most likely never be found

in relation to it. Reflecting on week 2, applying a social imagination

template can be an effective way of investigating the structural, historical,

cultural and critical areas of a topic for further sociological analysis

(Germov 2014). With much concern, I have accepted the fact that

applying this strategy to health care is very challenging due to the broad

and diverse nature of each of the areas of analysis. On a worldwide scale,

the historical and cultural areas are unique to the country of observation

where influences on the health system can be from centuries ago. In

Australia specifically, to successfully understand the cultural and historical

aspects of health care we would need to first recognise the work of the

Indigenous people of Australia and then move into the countries of origin

of the masses who came to our country. Even now, our health system is

constantly being influenced by culture and history of a later date, where

today we constantly have people from different countries living in

Australia, creating constant change where the events of the past are still

present and working in conjunction with the changes of today.

Word count: 1,465.

References:

Broom, A & Germov, J. (2014). Global Public Health. In A. Broom & J.

Germov (Eds.), Second Opinion: An Introduction to Health Sociology (4th

ed., pp. 63-80). Melbourne, Vic: Oxford University Press.

Belcher, H. (2014). Power, Politics and Healthcare. In H. Belcher (Ed.),

Second Opinion: An Introduction to Health Sociology (4th ed., pp. 360-

387). Melbourne, Vic: Oxford University Press.

Germov, J. (2014). The Class Origins of Health Inequality. In J. Germov

(Ed.), Second Opinion: An Introduction to Health Sociology (4th ed., pp.

82-102). Melbourne, Vic: Oxford University Press.

Germov, J. (2014). Imagining Health Problems as Social Issues. In J.

Germov (Ed.), Second Opinion: An Introduction to Health Sociology (4th

ed., pp. 6-22). Melbourne, Vic: Oxford University Press.

Heil, D. (2014). Well-Being and Wellness. In D. Heil (Ed.), Second Opinion:

An Introduction to Health Sociology (4th ed., pp. 41-58). Melbourne, Vic:

Oxford University Press.

Ferguson, S. (Reporter), OBrien, K. (Presenter). (2013, June 24). Fashion

Victims. Four Corners [Television Programme]. Sydney, NSW: ABC

Television.
Department for Professional Employees. (2017.) The U.S. Health Care

System: An International Perspective (Fact Sheet 2016). Washington, DC:

Jennifer Dorning

IndigenousGovAu. (2017). Closing the Gap 2017. [YouTube video].

Available from https://www.youtube.com/watch?v=ceLUlgzTr-0 .

Bhatia, M. (2017). The Indian Health Care System. Retrieved from

http://international.commonwealthfund.org/countries/india/
Reflective Journal Submission 2
Nicholas Horton, 2150171
05 May 2017.

In week 8, the focus was on Indigenous Health. Personally, learning about

the cultural and historical past of Australia and its Indigenous people
helped me to realise just how narrow-minded I was about the topic.

I find that the difficulty of addressing Indigenous health, is the fact that it
can be a very personal issue for both white and Indigenous Australians as
the area of health cannot be addressed on its own, and those who may be
unknowledgeable about the broader historical context, just as I was, take
offence or quickly reach conclusions, rather than trying to understand
alternative views and opinions.

Interestingly, while there is a clear deficit in life-span between Indigenous

and non-Indigenous Australians, 11.5 years less for males and 9.7 years
for females, many of the illnesses which they suffer are the same as those
of white heritage (Gray et al., 2014). However, deaths from these illnesses
occurred between 1.5 and 6 times more than in non-Indigenous people
and this is where you must delve deeper into the reasons for statistics
such as these, which are absolutely devastating to the Australian
population, and where I felt like I had leaped over a hurdle in my
understanding of Indigenous health (Gray et al., 2014).

Historically, the colonization of Australia was, what I feel to be, the biggest
impact on the mental and physical health of Indigenous Australians (Gray
et al., 2014). The Indigenous people of Australia had developed a home in
which they had complex religious, spiritual, linguistic and navigation
systems and better health conditions than any of the years after European
settlement, even better than that of Britain (Gray et al., 2014). With
colonization came the oppression and dispossession of the Indigenous
population, around 750,000 at the time, leaving them vulnerable to social
problems such as racism and racial violence, economic disadvantage and
drug addiction (Gray et al., 2014). These social factors created poor levels
of mental and physical health amongst Indigenous Australians that have
been present throughout generations to this day (Gray et al., 2014). This
division in social classification was made clear in the movie Beneath
Clouds, where Indigenous boy, Vaughn, was alienated by the white-
Australian population in an abusive and racial manner, where he was
labelled with a bad persona for no other reasons besides being
Indigenous, generating anger and an obvious mental and emotional stress
and fear of life within him (Hall & Sen, 2002).
Studies show that there is a strong correlation between socio-economic
grade and causes of death in individuals, meaning that the dispossession
and oppression in which the Indigenous people suffered and continue to
suffer is having a severe negative effect on their mental and physical
health and well-being (Heil, 2014). Alcohol is a major contributor within
the Indigenous population for the amplitudes of Indigenous
hospitalisations (Gray et al., 2014). Unfortunately, it too stems from
colonisation, where it was used by European settlers to bribe Australias
natives, a luxury used then used by the Indigenous people to excess to
cope with their traumatic experiences (Gray et al., 2014). It became an
uncontrollable addiction for many Indigenous Australians which has been
passed to younger generations (Gray et al., 2014). A staggering figure of
hospitalisation resembles this, where hospitalisation for chronic kidney
disease was 15 times more than in non-Indigenous people (Gray et al.,
2014).

When studying results such as this, there is one thing that stands out in
my mind and that is the fact that the numbers that we read are not
merely statistics, rather they are real people and part of a population,
one that is native to my country. This means that those individuals who
are hospitalised for kidney disease or another problem such as mounting
drug-related violence are also part of a family. Based on the socio-
economic position of Indigenous people, a family that is not of high social
status, so how are they supposed to turn away from the very behaviour in
which they see and experience all the time and break the inequality of
living as an Indigenous person in Australia?

With my inquiry project being on the health inequality of Indigenous

Australians and white Australians, I am sure that I will come to see that
there is far more being done about this than in past decades, but I feel as
if Australia is still in the early stages of a serious movement to equality as
it was stated in the textbook that it was not until 1972 where the policy
of self-determination was introduced, allowing for expression of cultural
difference and for Indigenous people to have some say over their
destinies (Gray et al., 2014, p. 152). was introduced to enable Indigenous
people to have a say over their own lives, which was not that long ago. In
Australia today, we have government projects that are forms of apology to
the natives of this land like Closing the Gap, which is excellent as it not
only combats Indigenous inequality in health, but also education,
economic development, and culture recognition in a community based
approach (IndigenousGovAu, 2017). With that being said, I see the biggest
barrier obstructing serious change to be the fact that todays generations
of Indigenous and white Australians have a hard time comprehending the
historical events of colonization, dispossession and oppression and while it
is true that it was not our generation responsible, this way of thinking
creates a mental block in individuals and needs to be left behind. For
Australia to find equal ground for both its Indigenous and white
populations, equal contribution from both parties is required, yet as a
health student expanding their knowledge on important social topics such
as this, I look at the problem as a whole and see that neither side is
comfortable with receiving and sacrificing things to reach something
greater, equality.

Word count: 896.

References

Gray, D., Saggers, S., Stearne, A. (2014). Indigenous Health: The

Perpetuation of Inequality. In J. Germov (Ed.), Second Opinion: An
Introduction to Health Sociology (4th ed., pp. 5-22). Melbourne, Vic:
Oxford University Press.

Heil, D. (2014). Well-Being and Wellness. In A. Broom & J. Germov (Eds.),

Second Opinion: An Introduction to Health Sociology (4th ed., pp. 63-80).
Melbourne, Vic: Oxford University Press.

IndigenousGovAu. (2017). Closing the Gap 2017. [YouTube video].

Available from: https://www.youtube.com/watch?v=ceLUlgzTr-0 .

Hall, T. J.(Producer), & Sen, I. (Director). (2002). Beneath Clouds. [Motion

picture] Australia: New South Wales Film Commission.
Reflective Journal Submission 1
Nicholas Horton, 2150171
20 March 2017.

In week 2, there was a strong focus on collaborative work to convey key

ideas and topics present in health education. I felt that my group had a
creative way to present our topic of Social Medicine and Public Health.
In the group, I wanted to reinforce the idea of social medicine and public
health over time, along with how difficult it was for the different classes to
receive treatment in the early stages of medicine (Germov, 2014). After
week 4s workshop and reflecting on this presentation, I can see that my
character was suffering from what I believe to be problems with his health
and indirectly, his well-being. At the time, we did not put much thought
into the setting, but now I would explain that it was in Australia in the
early twentieth century where, according to the textbook, Second Opinion,
public health had become part of the nation-building project in Australia
(Germov, 2014, p. 11) and despite disagreement from doctors, public
health became a priority for all classes because infectious disease knew
no class barriers (Germov, 2014, p. 11).

Also in week 2, we were asked questions about society and I came to

realise that I am slightly disappointed in the way society is in todays
world as I described our society to be that of high privilege and
technology driven. Two things that I believe were not as relevant in the
past and we were better off with less of. We discussed questions about
puppetry and strings, which I immediately saw to have a strong
correlation with society and todays world. This, in turn made me think
about the way the evolution of medicine has been controlled by the
governments of the time where people who may or may not have
adequate medical resources available are like puppets controlled by the
government and professionals who decide on how this evolution unfolds
(Germov, 2014).
We looked at sociological imagination templates, relating them to us as
individuals and then to a popular topic of health. Reflecting, I thought
about my life and saw that my values and beliefs through my family are
very strong within me and my lifestyle. I find sociological imagination
templates to be vague and to think of applying it to educating students on
health seems confusing. The historical and structural factors would be
straightforward for students but when I address the cultural and critical
factors of health for teenagers, diversity scales endlessly with the way
that classrooms have become so different in terms of culture and up-
bringing (Germov, 2014). However, thinking critically, during the
workshop in week 4, I came to an understanding of how complex these
categories are when addressing global health. In my opinion global health
and the social model of health or new public health (Germov, 2014, p.
16) would need to be addressed in the classroom and would link into
unfair working conditions in foreign countries. With that though, how are
teenagers supposed to learn about this when it is influenced by so many
other factors that make the subject broader including environment or
geography, living conditions, accessibility to health care, power, culture
and economy? Especially, as I have learned from chapter 3 in the
textbook, when terms such as well-being and wellness (Heil, 2014, p.
41), which would be applied to those people in struggling global health
situations, are so transparent between individual opinions (Broom &
Germov, 2014).

Word count: 545.

References

Germov, J. (2014). Imagining Health Problems as Social Issues. In J.

Germov (Ed.), Second Opinion: An Introduction to Health Sociology (4th
ed., pp. 5-22). Melbourne, Vic: Oxford University Press.

Heil, D. (2014). Well-Being and Wellness. In J. Germov (Ed.), Second

Opinion: An Introduction to Health Sociology (4th ed., pp. 40-58).
Melbourne, Vic: Oxford University Press.

Broom, A. & Germov, J. (2014). Global Public Health. In A. Broom & J.

Germov (Eds.), Second Opinion: An Introduction to Health Sociology (4th
ed., pp. 63-80). Melbourne, Vic: Oxford University Press.