Group Project 4

Underlying the frame of a social problem is a set of value assumptions. The influential group that is constructing the frame (the framing group) uses their values in assessing the situation to be "bad" or harmful. From the standpoint of critical sociologists, the current historical period is characterized by a structural contradiction between elite interests and the interests of the rest of us. Often, this contradiction is reflected in the way a problem is framed or "constructed," based on the different sets of values at stake.

The health care industry–referred to by some critical sociologists as the "medical-industrial complex"– is one institution in which such contradictions are revealed. In health care, the contradiction between the needs and interests of the owners and managers of organizations that control access to health care and the needs of people seeking health care services gives rise to two questions: Who gets it; and who decides? Answers to these questions are built upon the values that a particular group uses in framing the issues they see as problems. This burning issue was fictionalized in the 2002 popular movie, John Q., in which the lead character (played by Denzel Washington) takes drastic action when his son is about to die for lack of a procedure the hospital and insurance company will not approve. Since then, many people in real life have been faced with similar (not always so dramatic) situations, and by 2005 medical bills were the leading cause of bankruptcies, according to a Harvard study. And most of those people had health insurance, at least at the start of their illness (http://aflac.wordpress.com/2008/03/19/medical-bills-leading-cause-of-bankruptcy-harvard-study-finds/),. Health care is also a major issue in the current presidential campaign. You can compare the respective plans of the two candidates here: http://decision.healthcare.com/obama-mccain/

The goal of this assignment is to take the next step in the critical analysis of social problems by assessing the importance of contradictions in values as these affect the construction of a social problem. This time, we are not as concerned with causes of the problem or evidence regarding the existence and extent of the problem as we are with why it is a social problem. Recall that values are beliefs about what is good or bad, right or wrong, desirable or undesirable. Whose values are violated, and how do different groups use different values to define or frame the issues in different ways? In order to assess these things, we will first need to clarify what our personal and group values and goals are with respect to health care, and then assess whether the current system adheres to those values and is able to meet those goals. We will also need to assess the values used by elite groups in framing the issues as they do.

For your review, here is a diagram of our social problem critical analysis model.

1. Read the articles in Intersections and on the web assigned in the course schedule:

 Consumer Reports, "Does Canada Have the Answer?" (138-151);Gordon & McCall, "Healing in a Hurry" (152-162);  Mangan, "Strong Medicine for Doctors" (163-167)

and the following web sites: The U.S. Health Care System: Best in the World, or Just the Most Expensive? http://dll.umaine.edu/ble/U.S.%20HCweb.pdf ; Polling Report on public opinion polls regarding health care delivery: http://www.pollingreport.com/health3.htm   .                             

As always, you can also search for additional information on your own.

2. Between Wednesday, October 29 and Friday, October 31 discuss all the questions below first among members of your own small group.  You should see your group show up on your Discussion page as “GP4 Group x” where x is the number of your group.

3. In the topic in the Discussion board  titled “Group Project 4 Summary,” each member of a group will be responsible for presenting a brief summary of their group's discussion of only one of the questions. I will indicate which question each group should present in the description of the Group Project 3 Summaries topic by Friday.  You should complete these summaries by Sunday, November 2. For a bonus point on the summary/report section of the project, you must also comment (discuss) at least one other class member's summary, preferably someone in another group.

1. What are your personal values regarding health? Who should receive care: anyone who needs it, or those who can pay for it (including those with insurance)? Who should decide how much and what kind of care they receive? Are your values in line with those expressed by most Americans in surveys? Since this is an election year, you might also want to discuss the plans presented by the presidential candidates. What values do they reflect? What should be the goal of a health care system?

2. Managed care (HMO’s, etc.) is promoted as a way of addressing the problem of the high cost of health care. The influential groups that see the problem of health care as its high and increasing cost have advocate the system of managed care as a solution to that problem. What values are these groups using when they frame the problem that way?

3. Advocates of universal care (usually single-payer, government funded--such as in Canada and all the other countries discussed in the University of Maine report, http://dll.umaine.edu/ble/U.S.%20HCweb.pdf ) define the problem as lack of health care insurance coverage for significant numbers of people. What do the influential groups that advocate that type of system value?

4. Describe the system by which health care is provided in the United States, referring as much as possible to the readings assigned in this project (citing specific page numbers). How do most people receive care? How are decisions made about what kind of care people receive and how they receive it? Who makes those decisions? What are their primary goals? What are their priorities? What contradictions can you identify between the values and goals you stated in question 1 and the values and goals of the structure you identified in question 2? Would universal care or managed care be more in line with your values? Explain.

5. Bonus: Discuss Obama's and McCain's health care plans. Which, if either, do you support? Why? Be sure to refer to values in your response.