There are certain events in our society that can affect the course of our history, but there are events that are a direct reflection of how our society is structured. Ever since we are born we are socialized in order to function in our society and this varies from place to place. Our society is made of unspoken regulations and laws that function as a form of social control. What we also see in our society are hierarchies; we see them with gender, race, and especially class. At times we deny that there is prejudice in our society, but there is. Although we may not be conscious of it, we are socialized into knowing what is better than something else. This is done through schooling, media, and even our own peers and parents. How we are also socialized is through the much bigger institutions within our societies, likes education and health.
These institutions are primarily responsible for determining our behaviors. The event that will be analyzed through a sociological perspective is the most recent price hike of Daraprim in the Unite States. Although this is not the first drug that hikes in price, this one seemed to have the most media attention. This event will be described using conflict theory to explain how it reflects our society as well as what it means in terms of social control. The first part of the paper will explain the price hike, and the conflict theory will be used to explain the decisions of the CEO, and then the relationship of the healthcare institution to society.
The most recent price hike of Daraprim has sparked some debate, especially since it came at a time of presidential debates. The drug was originally priced at $13.50 and over night went up to $750 (Pollack, 2015). This drug is originally used to treat toxoplasmosis, which is a type of parasite, when untreated, this can cause harm to new born babies, people with weak immune systems like AIDS patients, as well as cancer patients (Pollack, 2015). Another drug, Cycloserine, which is used to treat tuberculosis and urinary tract infections, went from $500 to $10,800 as well (Pollack, 2015). This has sparked a lot of debate in terms of this hike being unreasonable. The CEO, Shkeli, claimed that this has nothing to do with being unreasonable or unfair, but about staying in business (Pollack, 2015).
Shkeli supported his claim by saying that the types of diseases it is suppose to treat are not very common and that it would not affect most patients (Pollack, 2015). Pollack (2015) argues however, that the decision is very profit driven and does not take into consideration the seriousness of how it affects the patients that would be affected by the hik. The reason this event was chosen was because it is a perfect example of how social control is used in our society. When looking at it through a sociological perspective, this hike in medical cost is something that would only affect those in society that cannot afford it.
Social conflict theory is a Marxist-based theory stating that the individuals and groups in society have access to different resources, these resources give them a certain standing as well as certain power within society (Allan, 2010). These resources develop social classes within society creating a market economy (Allan, 2010). The theory also argues that the more privileged groups use this power to exploit those less fortunate with no mutual benefit between the less powerful and more powerful (Allan, 2010). This has a very similar tone to classism, when comparing it to the hike in medicine. The CEO, Shkeli, has more resources that give him more power within society. He has the power to raise the medical prices at the expense of those less privileged.
As stated by Allan (2010) power is the central feature of society. By Shmkeli raising the price on Daraprim, he creates social inequality in terms of health. By only having a certain amount people having access to health resources, the quality of health is different with each class (Nathenson, 2010). Those with disadvantaged backgrounds are more likely to grow ill, or in this case not have the access to treatment (Nathenson, 2010).
The health institution has become almost a business, which its main focus is to diagnose and treat patients. With our advancement in technology, one has to wonder why we also seem to be increasing in the number of diseases. Nathenson (2010) brings up the points that the health institution is medicalizing social problems as social ones. What this means is that in order for health institutions, especially pharmacies to remain in business, there has to be diseases to treat. There are certain issues in society that are affecting people, but they are things that generally would not have to be cured medically or that is something that we define as being sick when it really is not. By increasing the cost of medicine, we are emphasizing social inequality, show stigma, and in the long run can affect the health of our citizens.
As spoken earlier about the medicalization of certain problems that are more social than medical, when we define certain things as medical illness, we bring a stigma to it (Scambler, 2006). This stigma tends to be a deviant one most of the time. Although the medicine in this paper is mostly used to treat a parasite, some other diseases such as alcoholism and mental health have a deviant stigma attached to them (Scambler, 2006). When you are an alcoholic or if you have a mental disease, others will see you differently, and as it will be discussed later, may even see you as unfit to function in society. In our society, being healthy is almost a reflection of your social class.
Although this is something that is more stereotypical, in extreme cases we can see what type of social economic class someone belongs to. The assumption is that the healthier you are the more money you are thought to have. Those in a much more privileged class would have the money to take better care of themselves than those that do not have the financial means to do so. Although as a society we feel that we have gone beyond being prejudice, there is prejudice for being a lower socio-economic class, especially since most of the people, although not all, are people of color. This is a form of social structure; this is not something biological that we know as fact. We as humans create those structures. The relationship patients have with healthcare institutions is shaped by those institutions (Gilson, 2003).
With stigma being one of the effects of social inequality in terms of healthcare, this also affects the trust that citizens have with healthcare providers. Gilson (2003) sates “healthcare provider [are] specifically expected to demonstrate impartial concern for patients’ well being” (p. 1454). When access to equal healthcare is not being distributed among all the citizens in a society, there is not trust. According to research, having trust between the healthcare institutions is important for quality interaction, but can be good for the patient; it has been known that a good relationship can be therapeutic to a patient’s well being (Gilson, 2003).
Even with trust, social inequality is evident, because patients with lower risks in terms of health tend to care less about trust than patients that are at higher risks for illness (Gilson, 2003). Healthcare providers are then expected to care about patients well being not just profits. When analyzing the action of the price hike, if a healthcare provider is raising the prices of a medicine to “stay in business”, then their concern is not the patient’s well being, but their own profits. This would affect the trust patients dependent on this drug would have with the healthcare providers. This is why professional/ethical codes are so important (Gilson, 2003).
The relationship that healthcare providers have with patients also is important in terms of influencing human behavior (Gilson, 2003). As said earlier in the paper, macro level institutional ideals and values trickle down to micro level individuals and affect our behavior in society and with other people in general. The health institution then becomes a purveyor of a wider set of societal values and norms (Gilson, 2003). If at the macro level, social inequality and mistrust are shown, then at the micro level, we see these same values. These values will be discussed later on in the paper, but the overall point of trust within health institutions is that trust-based systems offer more to society, by providing wider social value and social order (Gilson, 2003).
RELATIONTIONSHIP BETWEEN HEALTH AND WEALTH
There has been discussion regarding social inequality, stigma, and the importance of trust between the health institution of health and society. What we have not discussed is if in fact there is evidence that social inequality when it comes to health is that important. Meer et al. (2003) discussed in his research that there is evidence of a correlation between health and the amount of health you have. If you have better access to economic resources then you can have better healthcare (Meer et al., 2003). Similar to what we see in education, the name of the university plays a big role in how others see you. If I were to ask you to pick a the student that went to Harvard versus a school you have never heard about, you are more likely to pick the students that went to Harvard, just because of the name and reputation. Where a doctor went to school affects where they can find employment and how well they are know. The best doctors will be at the most expensive and prestigious medical facilities, facilities in which those with a less economic advantage will not be able to have access to. In terms of the increase in pharmaceutical pill, those with a higher economic social standing in society will not have any trouble with the increase, but those that do will have strain and be forced to pick other remedies or other facilities.
The other benefit those with a higher social economic status have, is that they can afford to live in better environments, hence illness is something they are not exposed to as often as someone that is exposed to harsher living environments (Meer et al., 2003). We see this in terms of availability of healthy food in poorer areas as well as air quality. For example, in poverty stricken areas, we see more processed, cheaper food as opposed to markets where residents can have healthy fresh food like fruits and vegetables (Meer et al., 2003). Or even the location of where they live, wealthier people can afford to live in areas with less population and therefore are not exposed to as much diseases. Through a sociological perspective, not everyone will be able to have access to such environments, and that is something that is not fixable quickly because we are a capitalist society and certain people will just have more money than others, but giving everyone equal healthcare coverage is something that can be provided to all. This is also another example of social control and social inequality. In terms of social control, this makes it a little easier for those in the healthcare institution to target certain areas. After all, similar to stigma, where you live says a lot about you. If you live in an area that is known to be unsafe, there are stereotypes and prejudices surrounding a persons living status. Pharmaceutical and other healthcare companies would have an idea of where certain diseases would be more common that others and would know where to target their sales.
Ettner (1996) also saw a correlation between health and wealth, but more see how it could also negatively impact a person’s health. Not having access to proper healthcare because of your socioeconomic status, does not just present an example of social inequality, but also can cause poor health. According to Ettner(1996), people developed depressive symptoms because of lack of access and work limitations. Research had also showed that income had a large impact on mental health as well as physical health. In the United States, I feel that because a higher socioeconomic status can offer you better benefits people work very hard to achieve this status, sometimes to exhaustion. Earlier in the paper we had discussed how not being healthy may give you a stigma among society. The healthier you were the more wealth you are thought to have. However, when you are in poor health, in not only can reflect your social standing, but it can reduce earnings because of the status that is attached to it (Ettner, 1996). Employers would not want to hire someone that is very ill.
CONCLUSION AND ANALYSIS
Medical sociology is only one part of social inequality and social control within our society. Although this is one minor event that has recently happened it is incredible to think that this one event can reflect and imply so much about our society. The institutions within society are very powerful and can reflect how we act amongst each other. One thing that we have to remember is that the much larger macro-level institutions within our society affect how micro level society values believe in and follow. If an institution believes that everyone within society is created equal and should be treated as such, then that will reflect at the individual level. However, when an institution promotes inequality and mistrust, those within those institutions and those that get affected with them will adopt those norms and values. As we discussed about stigma and unequal health access, it almost seems that being poor is almost a punishment, if you do not have the funds, then you do not have the special benefit others have.
In a way the much larger institutions can reflect socialization practices. What socialization is is a way teaching you how to think, act, and interact with each other. When we think of the CEO from the pharmaceutical company that is responsible for the increase in the pill, we can analyze it even more by stating that he was not born thinking the way he does, this is an example of socialization and the trickling down of values and norms. How he thinks is an affect of long term influence of how we see those that are poorer than most. Similarly the CEO was raised in an environment where profit was the main drive. There must be trust between those providing healthcare and those receiving it, without that trust there the patients can have negative affects in the long run. What we have seen is that social inequality is emphasized by the increase in this pharmaceutical pill.
As long as those in power continue to want to have it, we will not see that many changes within our society. Treating those from a lower socioeconomic status with stigma in terms of location and health will continue to happen until we start making changes on how we others in society. As spoken earlier in the paper, the main core of the event through a sociological perspective is that it is a much larger reflection of social inequality. Power is the major influencer, and it is the power that those in a more privileged class can use to better society for everyone instead perpetuating stereotypes and neglecting basic health.
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Ettner, S. L. (1996). New evidence on the relationship between income and health. Journal of health economics, 15(1), 67-85.
Gilson, L. (2003). Trust and the development of health care as a social institution. Social science & medicine, 56(7), 1453-1468.
Meer, J., Miller, D. L., & Rosen, H. S. (2003). Exploring the health–wealth nexus. Journal of health economics, 22(5), 713-730.
Nathenson, S. L. (2010). Critical Theory and Medical Care in America: Changing Doctor–Patient Dynamics. Sociology Compass, 4(12), 1043-1053.
Pollack, A. (2015, September 20). Drug Goes From $13.50 a Tablet to $750, Overnight. Retrieved January 5, 2016, from http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html
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