This article looks at the way Texans view healthcare. It surprised the author that many Texans who hand the means decided to remain uninsured. This study looked at why, and the importance or lack of importance of social class.
Sherry Ortner's definition of social classes in the USA:
While movement is theoretically possible between classes, being a particular social class influences the way one thinks and talks about themselves and others and how they act. The differences that stem from this result in the perpetuation of social class. In other words, there is a "sharing of culture" within social classes
- Lower Class-
- working class
- do not own the means to production
- earn a living through some type of manual labor
- poorest
- often non-white, although the majority of poor are white
- strong element of racism plays into the PERCEPTION of the lower class
- Lower Middle Class-
- working class
- do not own the means to production
- earn a living through some type of manual labor
- Upper Middle Class-
- act as administrators and managers, and do not work in manual labor
- more wealth than lmc
- Upper Class-
- WASPs who have old money
- owners of the means to production
There is no middle class according to Ortner, it is an attractive cultural ideal without merit-- it is the way that most people "identify" and why we may think that America is a classless society.
- the denial of classes leads to the condemning of those whose personal failings are seen as their fault rather than the result of structural inequality.
- only nation not to produce health statistics by social class
- health policy neglects class disparities and instead focuses on race
- dog whistle politics and racism are said to undermine class solidarity and prevent more generous social welfare policies
- some argue that upper class owners of medical services and insurance companies were the real beneficiaries when the single payer system was cast aside in favor of a hybrid that worked within the existing system.
texas and ACA
- before ACA Texas boasted the highest level of uninsurdes and almost 25% or 7 million people.
- texans are knowm for their sense of Texan identity and their loyalty to the state.
- Second largest state with the second largest population.
- political rhetoric
- cost millions of jobs
- raised healthcare costs
- caused people to lose their insurance
- provides support to people that don't deserve it
- still by 2016- decrease in uninsured to 18% (still double the national average)
- coverage gap can be attributed to income levels.
- did not expand access
- coverage for middle and upper class went down 43% in cost. For poor and lower middle class only about 15%.
- coverage gap bu INCOME
- Anna (lower class)
- no knowledge of ACA or how to get it
- receiving stigmatized indigent care
- feeling that she is under surveillence
- no internet or computer so hearing mostly texas govt. rhetoric
- does not qualify for unexpanded medicare
- Beth (lower middle class)
- got insurance coverage through the market place that was subsidized by her husband's employer and the govt.
- was still not a supporter and felt stigmatized for getting Obamacare
- found it too difficult to figure out the marketplace when husband became self employed and Texas did not support a navigator system to help individuals
- Cate: Upper middle class
- tax penalties led to resentment
- chose before not to get healthcare insurance
- want to be free not to have it
Onus of care on WOMEN who took responsibility for finding insurance and caring for their families whether parents or spouse and children. All had forgone employment opportunities which could have offered them health insurance (employment based).
Social Class and Differeneces in Health Coverage
- ability to gain coverage through ACA
- all concerned about "accidents" which made them feel vulnerable without coverage
- Anna
- felt marginalized
- never really part of the healthcare system
- had any untreated ailments and poor health
- uniformed about ACA
- cited STRUCTURAL BARRIERS that prevented her from getting health insurance
- Beth
- felt irresponsible for not having health insurance
- also felt guilty about obtaining healthcare through obamacare
- too complicated a process and cost too high
- Cate
- personal CHOICE to forgo insurance coverage
- Independence and self reliance as texan and neoliberal values
- Also not able to get employer based insurance
- felt capable of managing her own risk, believed stereotypes about the other uninsured but not herself
Complained but did not take action to change anything even though they felt that it should all be overhauled. LACKED THE CLASS CONSCIOUSNESS to join to take action because of the neoliberal perspective and stereotypes about race (dog whistling) and immigration.
All the same age from the same area but had differenr class-based experiences.
People without health insurance are much more likely to suffer health issues and premature death
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