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Health Care

With the cost of health services rising faster than the national rate of inflation, the health

care industry is growing at an unstainable rater (PWC 2017). Health care cost are projected to

increase 6.5% this year, while the consumer price index has “been trending at 1% over the past

12 months and isn’t expected to pick-up pace anytime soon (Fortune 2016).” This trend has led

many in the business world to argue for employers to seek out more restrictive plans that past

cost on to their employees (Fortune 2016, PWC 2017). With the continued growth of the health

care industry, and the push from the business world to cut back or restrict employer sponsored

health care, it is almost a certainty that many more Americans will become uninsured or

underinsured. Looking at data collected by the Central Texas sustainability Project, it will

become clear that the most effected by the growing cost of health care and decreasing access to

coverage will be the lower class. Furthermore, the middle class will more than likely experience

a decrease in the number of people insured, while the upper middle and upper class will fail to

see any real change. These numbers should show us a disturbing trend of inequality in the United

States, but the frame through which we should view this inequality may seem to be in question.

This paper will attempt to describe the present situation in terms of Conflict and Functionalist

theory to identify what this inequality means from a sociological perspective.

The CTSIP data shows that the most uninsured are those with an income lower than

$35,000 a year (CTSIP 2012). A CTSIP survey shows that likelihood of insurance is tied to

income. In the survey respondents were asked if they have some form of health care coverage.

32% of respondents making $25,000- $35,000 in the Central Texas Region were uninsured. 29%

of people making $15,000- $25,000 were uninsured. And 29.7% of people making less than
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$15,000 were uninsured. These numbers change as income increases. Only 18% of respondents

that made $35,000- $55,000 were uninsured and 4% of respondents who made over $85,000

were uninsured. This shows an obvious economic disparity in health care. The wealthiest are

more likely to be able to afford the cost of health care, while those with a limited income are less

likely to be able to overcome the costs. It seems that it is easy to argue that this trend is a direct

result of the growing cost of health care services. In a separate survey conducted by CTSIP asked

respondents what the main reason why they “are or were without health care coverage (CTSIP

2012).” The majority of respondents (30%) said that they were without health care coverage

because they “couldn’t afford premiums (CTSIP 2012).” If the primary reason that people go

without health care coverage is that the cost of their premiums are too high then as the cost of

health care goes up, more people, specifically those making less than $35,000, will be likely to

go without coverage. This survey should also raise doubts that employers passing on costs or

limiting the scope of their employees’ coverage will be beneficial. According to the survey, 15%

of respondents went without coverage because they lost or changed their job. This should make

clear that people rely on their employers offering coverage to remain insured. This could explain

why the rate of the uninsured drops from the $25,000-$35,000 range to the $35,000- $55,000

range in the first survey. Middle Class Americans are more likely to have a salaried job. These

jobs are more likely to offer some form of health care coverage compared to hourly jobs (which

are more likely to occupied by those making less than $35,000). What this means is that if

employers are to follow through with passing on cost or restricting the scope of coverage, the

middle class will likely to become uninsured or underinsured. As we have already seen as the

cost goes up, people are more likely to drop coverage meaning that employees may drop

coverage or opt for a less effective policy.

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How should we as sociologist view the current health care situation? From a functionalist

perspective we should look at the parts of society involved and how they “serve to maintain

stability (Thompson and Whitworth 2016)” through their manifest and latent functions. Looking

at health care we can identify three key parts: employers, employees, and the health care

industry. The manifest function of the employer is to offer employment to employees and

provide health insurance for their employees. However, this is a very naïve way of viewing the

employee employer relationship. While employers do offer job opportunities and insurance to

employees, it is on the condition that the employee be profitable. Hiring an employee allows an

employer to full up their work force in order to run their business. Providing them insurance is

profitable as well because a sick employee is no longer profitable in so far as they can no longer

do their job. While employer of a hourly job may find it cheaper to just fire a sick employee than

to offer them insurance, in a white collar, salaried job the cost of finding a skilled worker that

can fill the employees spot may be more costly. This leads us to the uncomfortable conclusion

that under a functionalist approach, an employee’s manifest function is to provide profit for the

employer. Is this not the unspoken reality of capitalism? How else are we to view the function of

the worker? The health care industry’s manifest function is also rather ambiguous. One would

expect that it be to provide health care services to those in need, but, under a market economy, is

it not to produce a profit? How else can one explain the growing cost of health care in the United

States? What about the latent functions of these parts of society? What the manifest functions of

the employer and the health care industry should make clear is that in order to approach any

issue in a capitalist society from a strictly functionalist perspective, the manifest functions will

always be wrapped up in profit making. This is because Capitalism as an economic system is

interested in maximizing income (Thompson and Whitworth 2016). What this means for health
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care is that the trends we are seeing is the system working in harmony. Of course employers are

cutting back employee healthcare to cut cost, it is their function to make a profit for their

company. The health care industry will continue to raise prices because the goal is maximum

profits. This is why Durkheim’s theory is in opposition to progress and equity. It assumes

harmony to be positive and dysfunction to be negative. This make functionalism a conservative

theory because it seeks to maintain the harmony of the present in opposition to the dysfunction of

change. The health care situation should make this clear.

The other way sociology could view the health care issue is through conflict theory. This

would require the sociologist to identify the modern proletariat and bourgeois in order to identify

how health care is a byproduct of class conflict. This may seem easy to do. The health care issue

is a byproduct of capitalist greed that has driven employers and health care service providers to

cut back and raise prices. This is in opposition to the interests of the proletariat which is trying to

get by in a world of increasing costs. But is this a proper categorization of the employer? One

might argue that the employer is proof that Marx’s theory is outdated. This line of argument

would go that, when compared to when Marx was writing, the current socioeconomic system is

far more complex because of the middle class. This middle class occupies the manager and

employer class, while the real upper class is found on Wall Street in investment firms or in

shareholders meetings. Does this means that there is no longer a strict bourgeois and proletariat?

No. What this should highlight is the reality of class struggle. The Bourgeois investment banker

is still the one pulling the strings for the misfortune of the proletariat, he has just now employed

the middle class to help control the anger of the workers. Therefore, when we look at health care

through conflict theory, we should understand that while employers are cutting back on health
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care for their employees, it is on the whim of the investment banker or shareholder that this order

is carried out.

What should be done? The answer is unclear. While we know that the growing health

care issue will most certainly cause more people to lose insurance, what needs to be done in

order to prevent this outcome remains hidden. What the functionalist and conflict theorist

perspectives taken together show us is that we are living in a society where profit is the goal.

From here we should then begin to decide what should be done. Are simple reforms enough?

Can we properly regulate the excesses of capitalism in the health care industry through? This

seems unlikely in so far as the goals have not changed. So long as profit is the primary objective

there will be ways for employers to find loop holes. Does not the recent issue of companies

offshoring their profits not prove this point? In order to avoid paying taxes companies have

shifted their headquarters to areas with lower tax rates. The rise of Donald Trump should also

make us skeptical of the power of reform. Brought to power on a surge of populist fears

surrounding the economy, Trump made the case for a more “pro-business” administration. This

pro-business model has led to the roll back of Dodd Frank and the numerous environmental

regulations. While president Obama had fought hard for these reforms, they were ultimately

meaningless because the goal of unlimited corporate profits came through in Donald Trump. We

should then seek to change the goals of society. What that means is a change in the frame of

view that society is viewed through. This means an absolute rejection of Functionalism. We

should not just accept harmony as being good, especially when this harmony is based on

capitalist accumulation. We should reframe dysfuction as being the positive outcome of class

conflict that changes and the goals of capitalist society in order to achieve progress and equity.
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PWC. (2017). Medical Cost Trend . Retrieved June 06, 2017, from

https://www.pwc.com/us/en/health-industries/health-research-institute/behind-the-numbers.html

Patton , M. (2015, June 29). U.S. Health Care Costs Rise Faster Than Inflation . Retrieved July

06, 2017, from https://www.forbes.com/sites/mikepatton/2015/06/29/u-s-health-care-costs-rise-

faster-than-inflation/#386fe7fe6fa1

Central Texas Sustainability Indicators Project. (2012, January 01). Health Access. Retrieved

June 06, 2017, from http://indicatorsproject.com/health/health-access/

Thompson , A. L., & Whitworth, K. H. (2016 ). SociologyYou .