Biopolitics of U.S. Health Care
Author: Andy Tang, Undergraduate Student, University of Washington School of Public Health
The hepatitis B virus (HBV) is 100 times more infectious than HIV, infecting over 350 million people worldwide. Over half of the deaths in the United States resulting from chronic HBV infection occurs among the Asian Pacific Islander (API) population1. This November, I attended the National APAMSA Hepatitis B Conference through which I learned about the epidemiology, pathology, prevention and treatment of HBV as well as policy efforts to combat this deadly but preventable disease. Doctrines of biopolitics and neoliberalism contribute to the lack of access of health care for the poor and populations with limited English proficiency. The U.S. health care system represents a form of biopower that perpetrates discrimination of HBV in API populations.
Why can’t the 1 out of 10 HBV-positive Asians attain health care coverage? Health insurance companies do not cover pre-existing conditions, which can be seen as an example of America’s aberrant system of health coverage . Issues of private versus public sector health insurance, legal citizenship versus cultural citizenship, as well as racialization of ethnic minorities and the poor are critical issues that leave vulnerable populations marginalized. In the United States, our nation’s health coverage is a “two-tier hierarchy of health care.” (Becker, 9) This includes the private sector, used by the middle and upper classes, and the public sector, used by the poor. This is a model of discrimination based on social class and status, which mediates a relationship of power within the healthcare system. Lack of treatment for chronic illnesses comes with the lack of insurance, resulting in greater health care costs in the long term. The gap between the privileged and the marginalized continue to widen and is imperative that change is implemented for equal rights for all human beings.
Biopolitics and neoliberalism are foundations which govern the systematic control of health insurance in the U.S. Private and public health insurance lays good groundwork for this analysis. Those who are employed are seen as productive bodies have easier access to high quality health insurance. Those who do not work (e.g.: the disabled and elderly) are seen as unproductive bodies and have poor health insurance. By providing subpar public insurance for those deemed as unproductive bodies, the government is passively favoring those who do not work and contribute to the economy. Neoliberalism places an emphasis on individual responsibility and promotes a lack of government intervention in both economic and social policy. Neoliberal tactics allow the government to not take responsibility for inequalities in healthcare and places responsibility on the citizens. The lack of health care coverage leads to dehumanization and provincialism. A change in this system would save human lives at the front end versus the back end. Through participating in a national dialogue with HBV awareness advocates, I have unraveled explanations of cross-cultural phenomena. Although I am at an early phase of my training, I am fortunate to be able to help translate and build bridges to find commonalities for unexplained health disparities.
2. Becker, Gay, 2007, The Uninsured and the Politics of Containment in U.S. Health Care, Medical Anthropology, 26:
Filed Under: Marginalized Populations in Healthcare
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