Erma Agus Setiyaningsih 2011120031 American Culture and Society Studies Final Exam Paper

Discrimination of Health Care System in America and Indonesia: A Similarity During the period of Barack Obama under his party Democrat, the concern of health care in the United States of America keep increasing day by day. There are a lot of ways done to achieve a better system of health care so that every pupils in America could feel that the government guarantees their health. In this case, one of the ways is increasing tax for wealthy person. It is hoped that by doing so, the wealthy citizen could help those who are unable to pay for their own health care. It is the most ideal situation which seems so perfectly planned and has perfectly good purpose done by the government. In the other hand, I would like to see deeper on the implementation of health care in actual condition of America with its multi race ecosystem. In the research written by Fauci (2001), it stated that there is a racial disparities inside the circle of America health care system. The racism issue happened ever since pre civil war until the period of civil right movement. Moreover, the racism issue seems like to be more obvious even after civil right movement. One of the specific example in this case is the data which shows that African-American people have difficulties and a longer period of time in getting a kidney to be transplanted than white European American people. Health care system during pre-civil war highlighted on an obvious racism issue because slavery is still there at the period and cause the slave to depend the health care to the master. However, after civil right movement, the problem seems to stay still and unsolved because a lot of factors such as

lack of health insurance owned by African American, lack of medical equipment and lack of African American doctors. The effect which comes after the factors caused is the lack of treatment received by African American. In this case, specific examples stated several things such as the birth of African American baby who is less likely to be healthy, the higher possibility of African American to have disease and less likely to be treated based on the factors listed and many other disadvantages. Talking about health insurance, people in the United States are ought to pay for their health insurance and the data shows that African American are more likely to live without their health insurance because they simply cannot afford it. This economic problem is always become an excuse of health care organization to clean their hand with. Sometimes, they denied that health care is not equally given because of economic problem instead of racism. However, the fact listed above that African American has longer period of waiting to be kidney recipients, I believe can be one of the prove that the discrimination exist. Another proved that can be justified is the fact coming from one of the article on American Nurses Association is that African American has life chance six years shorter than European American. Besides, not only talk about African American, another colored citizen such as Chinese and Vietnamese also have to suffer from cancer threat more than whites. In another case, I would like to look back on the prevention of health itself. Health care is meant to be there for those who has suffer from sickness. However, a sickness will always has cause behind it. Unhealthy environment can be one on the list of causes. In this case, it is not includes to the duty of health care to be fully responsible but I thought that there must be some notice coming from health care to prevent this kind of situation. The situation that I mean is rely on the research from Shavers and Shavers (2008) which stated that 70% of African American should live in a place with problem of federal air pollution standard 2002 rather than European American which only come to the rate of 58%.

In my analysis, if the research has speak about the fact that more African American is exposed to unhealthy environment, they will be more likely to require health treatment rather than whites. Unhealthy environment will naturally cause sickness despite of all the unhealthy habit of human. Thus, it will make them need health care more than whites. In the other hand, the other party which has duty to take care of this matter seems not to be fair enough in treating citizen of America. They are all the citizen of multicultural America but they receive different types of treatment in case of health care. In this case, because of social sentiment of past issue of racism and also another factors such as economic and social issues, African American cannot get the equal access to health care. Still discussing about the fact that minorities are more likely to require health care more than whites because of the environmental factors, I also would like to highlight about the comparison between doctor visits for whites and for other colors. In this case, Randall (2002), has stated that the number of doctor visits for whites is more than the visits for other colors. I believe that it is perfectly correlated with the fact that colored or minorities receive less treatment from health care institution itself. Randall also points out that the enthusiasm of treatment given by doctors for whites is more rather than for colored. In the other part of the world, the place that I live now, there is also discrimination of health care treatment received for several types of person. In Indonesia, there are no specific issue on race since I believe they are truly multicultural and have no problem about which skin color is better than the other. However, slightly similar to United States, Indonesia discriminate person who is able to achieve good health care treatment based on the economical status. Previously, I have stated that America has tried to avoid using the term racism in defining the discrimination of health care and using the term economic problem instead. Here, discrimination based on economic factors is obviously become the main issue which actually backlashing the idea of health care is guaranteed by the government motto. In

Jakarta, the central of Indonesia, citizen are given a card of health insurance for poor family to get access of proper health treatment when they are sick. It is actually goes in the same line with another region which applied this kind of health card to assure poor people get equal right to be healthy even they do not have money. However, looking back for the case of Jakarta, the problem started to appear. I believe that the ideal situation set by the government by providing the privilege card for health for poor family has perfectly good purpose. They are trying to get away from the issue of health care discrimination issue based on economic problem. It just perfectly the same as Obama has set the increase of tax to optimize health care system but the implementation cannot goes as smooth as the plan since discrimination based on race still happen here and there. In Jakarta, the number of poor people who are trying to get treatment are end up making problem to the hospital since they do not have enough facility and capacity to keep them all. I would like to pick one issue which become a trend in media. A twin baby who have to lose one of the pair and send one of them to the grave because of hospital cannot accept them due to room limitation. However, that is only a problem out of the discrimination issue and more to the practical issue of the card. In another part of the issue, the doctors and also private hospitals are back off from the program due to the patient exploding. In this case, the health care service coming from doctors are also cannot integrate and be in line with what the government planning. I believe that the back of is not merely because the lack of facility but also the money problem. The logic that possibly applicable to this case is that since they are private hospitals, the worker is not civil servant. Thus, they do not have any specific duty to do community service such as assuring the citizen to be healthy. Benefit are believed to be less than the disadvantages. Thus, I think it caused them to back off. Moreover, the patients who keep exploding to the hospital is poor people who will distract them in taking care of the wealthier person who will bring income for them.

There is a popular phrase in Indonesia about health care and economic issues. The phrase is Poor people cannot get sick. This phrase illustrate that poor people have no right to bother themselves to get sick because medicine will cost money and it will get them into trouble to get it. I believe that the term still exist because there are a lot of people who are sick but come from poor family cannot get the proper access of health care which guaranteed by the government. If anyone in Indonesia watch TV program which shows reality life of Indonesian which far from wealthy condition. You might have chance to see that there are a lot of people who are far away from being assured in a matter of health care since they do not have money to pay for it. Similarity of discrimination issues in health care system of both America and Indonesia is not on who is the subject of discrimination. It is not about whether it is racially based or economically based. The similarity that lies here is that there is a chain of capitalist system who control people who have capability to access health care to be more treated than those who are not. Equality is not there and there are still a lot of people who have to suffer and even die because they cannot afford health care for themselves. Equality should be reinforced from the very first place if we want to change the solution. Government should work well with health care organization to assure that their plan of distributing health care equally will be in line with the person in charge of the field which is health care organization.

Resources: Cara A. Fauci, Racism and Health Care in America: Legal Responses to Racial Disparities in the Allocation of Kidneys, 21 B.C. Third World L.J. 35 (2001), http://lawdigitalcommons.bc.edu/twlj/vol21/iss1/3 Shavers, V. & Shavers, B. (2006). Racism and Health Inequity among Americans. Journal Of The National Medical Association. Vol. 98, No. 3. Bethesda, Maryland and Washington, District of Columbia. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2576116/

Randall, V. (2002). Institutional Racism in US Health Care. University of Florida Journal of Law and Public Policy. pp. 45-91. Retrieved from http://academic.udayton.edu/health/07humanrights/racial01c.htm American Nurses Association (ANA). (1998). Discrimination and Racism in Health Care. American Nurses Association. Retrieved from http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positionsand-Resolutions/ANAPositionStatements/Position-StatementsAlphabetically/Copy-of-prtetdisrac14448.html Hapsari, E. (2013). Orang Miskin Dilarang Sakit?. Republika Newspaper. Retrieved from http://www.republika.co.id/berita/kolom/fokus/13/03/01/miz9wg-orang-miskindilarang-sakit Sinar Harapan. (2013). Orang Miskin Dilarang Sakit. Tajuk Rencana Sinar Harapan. Retrieved from http://www.shnews.co/detile-19898-orang-miskin-dilarang-sakit.html Hess, J. (2013). Hospital Heads Warns of Racism in U.S. Health Care System. Mississippi Public Broadcasting. Retrieved from http://mpbonline.org/News/article/hospital_head_warns_of_racism_in_u.s._healthca re_system