Exploration of Social Justice, Unit 2

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Capella University *

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SWK5002

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Health Science

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Oct 30, 2023

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1 Exploration of Social Justice: Healthcare Access Tyler McAndrew Capella University SWK5002: Social Welfare History, Policy, and Practice Dr. Spigner October 2023

Healthcare Access Introduction Healthcare access in the United States is an ongoing problem deeply intertwined with mechanisms and forms of discrimination and oppression. This assignment aims to explore the various forms of oppression and discrimination affecting healthcare access. The exploration of social justice will analyze their impact on the United States, discuss ethical concerns guided by the NASW Code of Ethics, assess current enacted policies, and compare advocacy methods. Mechanisms and Forms of Discrimination and Oppression Various mechanisms and forms of discrimination and oppression influence healthcare access disparities in the U.S. Economic discrimination creates barriers for individuals from lower income brackets to access healthcare. Documented files show ethnic and racial disparities do exist in accessing healthcare. Gender-based discrimination affects healthcare access as well. Women may face disparities in reproductive healthcare, and transgender individuals encounter discrimination when seeking gender-affirming care. Geographic barriers are another discrimination mechanism, disproportionately affecting rural and underserved areas. It is also crucial to explore language barriers as a substantial barrier to healthcare access for non-English-speaking individuals. This can result in miscommunication and reduced access to essential information. A study by Perez et al. (2009) emphasized the importance of language- concordant healthcare to address disparities effectively. Another barrier to explore is disability discrimination. Discrimination against people with disabilities not only extends to physical accessibility, but also to the insensitivity of healthcare providers. The study by Haffer et al. (2016) found that healthcare providers often lack training in providing care to individuals with disabilities

Healthcare Access Ethical Problems Associated with Healthcare Access In line with the NASW Code of Ethics, ethical problems associated with healthcare access disparities include issues related to social justice and the dignity and worth of individuals. Ethical considerations should address the right to healthcare, nondiscrimination, and equitable access. The implications for social work practice involve advocating for vulnerable populations to ensure they receive the care they deserve. Positive client outcomes are likely to be achieved by addressing socially determining factors of health, providing culturally competent care, and reducing healthcare disparities. The NASW Code of Ethics highlights the need to promote social and economic justice. Ensuring equity in healthcare access aligns with social work's commitment to these principles (Reamer, 2014). Autonomy and informed consent are sometimes ethical problems associated with healthcare access. Ethical considerations in healthcare access should include respecting individual autonomy and obtaining informed consent. Currently Enacted Policies Several local, state, and federal policies aim to address healthcare access disparities. After the U.S. Congress passed the bill in 2010, the Affordable Care Act (ACA) took effect in 2014 (Vitalarie, 2014). Medicaid expansion is a policy component of the ACA. Another currently enacted policy addressing social justice in healthcare access includes the Children's Health Insurance Program (CHIP), addressing healthcare access for children. Also, the Mental Health Parity and Addiction Equity Act (MHPAEA), which allows the mentally ill easier healthcare access and to receive equal treatment for disorders (Ku, 2015). CHIP, a collaborative effort between federal and state governments, offers healthcare coverage for children from low-income families. This program serves as a vital component in

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Healthcare Access mitigating healthcare disparities among children. Becoming policy in 2008, MHPAEA is a key policy for social justice within healthcare access. The MHPAEA guarantees that insurance plans offer parity in coverage, ensuring that substance abuse and mental health disorder treatments receive the same level of benefits as medical and surgical services. The policy has played a pivotal role in diminishing bias against individuals with substance abuse disorders and mental health challenges, enhancing their access to mental health services. The Effectiveness of Policies The ACA allowed low-income people to purchase insurance coverage through health insurance marketplaces and Medicaid. Increases in insurance coverage translated to improved access to healthcare services. More people had access to regular medical check-ups and preventive care. Before the ACA, many individuals delayed medical care due to cost concerns. With expanded coverage, fewer people reported delaying or forgoing essential healthcare treatment. With the help of CHIP, it is now easier for children to access essential healthcare services, encompassing well-child check-ups, immunization, and required medical treatments. As a result, this has led to enhanced health outcomes for children who might not have otherwise received consistent healthcare services, as detailed in the study by Dubay and Kenney (2003). The implementation of MHPAEA has resulted in higher usage of mental health and addiction services, implying that individuals are more inclined to seek treatment when it is covered on par with other healthcare services. Policy Constraints Policy constraints in addressing healthcare access disparities include political resistance, budget constraints, and the complexity of the healthcare system. Political challenges and

Healthcare Access resistance are significant constraints in achieving comprehensive healthcare reform. An article by Rosenbaum (2017) discusses the political complexities surrounding healthcare policy changes such as political divide, repeal efforts, divisive public opinion, and legal challenges from states and special interest groups. Advocacy Methods Advocacy methods for healthcare access problems involve a combination of mobilization, lobbying, and community organizing. The strengths include raising awareness, influencing policy decisions, and uniting communities. Challenges may include opposition from powerful interest groups and limited resources. To address these challenges, advocates can strengthen coalitions, leverage social media, and engage in sustained efforts. An article by Kogut (2019) reveals how lobbyists often try grassroots mobilization. “Grassroots” efforts are fundamental in political policy. “Grassroots” mobilization occurs when a lobbyist or group rallies the public to show strong support for a particular policy, encouraging other lobbyists to change their vote. The Conclusion In conclusion, healthcare access disparities in the United States are rooted in various forms and mechanisms of oppression and discrimination. Ethical concerns guided by the NASW Code of Ethics emphasize the need for equitable access and nondiscrimination. While policies are in place, their effectiveness could improve, and challenges persist. Advocacy methods are vital in driving change, but overcoming barriers requires persistent efforts and creative strategies.

Healthcare Access References Haffer, S. C., Cheang, D., Karp, S., & White, S. (2016). Public health gerontology competencies for the medically trained social worker. Gerontology & Geriatrics Education, 37(4), 344- 359. Kogut, B. (2019). The power of grassroots advocacy: Grassroots lobbying. Forbes. https://www.forbes.com/sites/benjaminlakers/2019/06/16/the-power-of- grassroots- advocacy-grassroots-lobbying/?sh=1ebf33e51f47 Ku, L., & Brantley, E. (2015). How Medicaid and CHIP can support population health: Important lessons for the future. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2015/aug/how- medicaid- and-chip-can-support-population-health-important Perez, L. M., Martinez, J., & Ponce, M. (2009). The impact of immigration on the need for safety-net services: An examination of utilization patterns in California. Social Science & Medicine, 69(6), 1012-1018. Reamer, F. G. (2014). Social work and social justice: Concepts, challenges, and strategies. Columbia University Press. Rosenbaum, S. (2017). Repealing the Affordable Care Act—Implications for Access to Care. New England Journal of Medicine, 376(4), e6. Vitalari, A. (2014). The Affordable Care Act: Implications for Cancer Survivorship. American Journal of Nursing, 114(6), 53-60.

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