Since the 1990s, researchers, scholars, and ordinary Americans are concerned with the issues that arise from being overworked. This is evident from many scholarly written literature in which authors and publishers have described their concern for a particular class in America who suffers from the issues of working time. Though time is an important factor for every citizen of the world, being indulged in continuous overwork is a serious concern mostly for middle and lower-class citizens which uphold many consequences. Let us first discuss overwork in context with those characters of the working class that are affected by the overworked and hectic schedule.
According to Nearing (1911) “Overwork is an amount of industrial activity so great that the capacity of the overworked individual is constantly decreased”. (Nearing, 1911, p. 190) That means overwork involves a daily expenditure of energy over the daily supply which results in fatigue. Excessive fatigue leads to exhaustion and exhaustion to disease and ultimately to death. Long hours and intense work both exist and constitute, in the fatigue which they produce, serious maladjustment.
Research work by Gerson & Jacobs (1998) tells us that despite the changing social trends of the American working class, the overworked American is still where he or she used to be some thirty years ago. The average length of the workweek has not changed since then and the American worker is putting in about the same amount of effort on the job with American men 42 to 43 hours per week, while American women about 36 to 37 hours per week remain at the workplace (Gerson & Jacobs, 1998).
Overwork, causes many consequences for the couples among which some are:
- Routine conflicts among the couples.
- No time to spend with the rest of the family, this creates many misunderstandings and creates communication gaps among couples and family members.
- High expectations from the family members.
- Overwork causes ill health chronic diseases.
- Increased pressure of overwork causes tension, depression, and frustration.
- Some researchers suggest that overwork causes conflicts among young couples which later transform into a high divorce rate.
Husband and wife, both earn to make both ends meet, therefore they are unable to afford any health treatment in case they require it, provided they don’t have health insurance. In case they both possess health insurance, they won’t be able to feel lucky for the reason that American health insurance does not guarantee any treatment, and in case they start treating their patients, it is chaotic. The term ‘chaotic’ has been used in context with those scenarios that take place when an ordinary American citizen arrives at the local hospitals. Doctors try their best to get bonuses from the Government on behalf of ‘clearing’ the maximum number of patients that come to them.
The most significant problem with single parent mothers or fathers is that they alone are responsible for their children’s upbringing and being overworked means they put their children at stake. Whether American families are categorized as ‘dual earners or ‘single-parent families’, reliance on women is a common factor that has affected and reduced familial support thereby increasing pressure on the working class. Some of the common consequences faced by single-parent families are:
- Lack of attention to children resulting in problem child, children belonging to single parents are mostly found to be not attentive in their studies. However, adults possess chances to fall into inappropriate social gatherings, start drugs, or indulge in drinking.
- Usually families are found hectic and chaotic.
- Health problems among which dine out and reliance on fast food are commonly seen which is not only hazardous for parents but are also not good for their children.
Single parent members of the working class no longer see themselves at the bottom of an unchanging class-based society nor feel the need to align themselves with the vehicles of working-class support. With the change in class structure, lifestyle and standards have transformed towards ease and comfort, what has not transformed is the American Health System with useless Insurance policies. Useless in a sense that a poor worker, a working-class or a middle-class citizen is not liable to afford treatment even at the cost of his life savings. From the medical perspective, there is simply no difference between a poor and a middle class as both are denied the basic treatment which is provided on behalf of the social policies of the Government.
Health Care Poverty
‘Class’ and ‘Medicine’ are two dilemmas surviving freely in the American society where one restrains the middle class from acquiring proper treatment and the other is the biggest concern for even those who work in multinational organizations and are serving their nation for years. This has raised a new issue in America named “Health Care Poverty” where both are interlinked with each other (Raiz, 2006). One cannot find the solution to these two miseries that are no doubt creating havoc in the American society, by complaining and criticizing. There is no scarcity of critics as far as American Medical sociology is concerned, as the merits and strengths of the Health Care System are never needed to be recognized if only to ensure that in some headlong effort at reform, (Ginzberg & Ostow, 1994, p. 21) we do not undermine characteristics and values that are preserved and reinforced.
Universal Medical Protection
The absence of universal medical protection is a striking feature of American life. Despite a medical system known as the most technically and scientifically advanced in the world, Americans still struggle more than citizens of other developed nations to gain access to health care. Over forty million people in the United States have no health insurance, while government and private insurers offer health plans that are limited, restrictive, or prohibitively expensive. Hospital emergency rooms have become the most expensive health providers of primary care not only for the working class but also for those who fall through the wide cracks in insurance coverage. Apart from the polls that show that a majority of Americans are ‘frustrated and angry with their health care system, the number of Americans without medical insurance is rapidly increasing.
Disease and sickness of the working class, however, even if directly caused by overwork working conditions, are not covered by workmen’s compensation and many of the illnesses common among workers are indeed related to their jobs. Poor class miners, stonecutters, and textile workers suffer from high rates of respiratory illness, especially tuberculosis. A doctor in New York City, when asked about the most frequent ailments among the working populations he treated, said that hemorrhoids and chronic constipation were common among factory operatives and that fur worker, cap makers, bakers, and hairdressers tended to suffer from tuberculosis, bronchitis, and asthma. The most prevalent illness he found among all workers was a duodenal ulcer. Reformers attributed many such medical conditions not only to specific workplace hazards but also to the long hours that left workers exhausted and unable to fight disease. (Hoffman, 1992, p. 8)
Even when society physicians known as ‘lodge doctors’ provide treatment, the quality of care is often questionable. According to sociologist Paul Starr, “the more successful doctors were generally unwilling to take such work”. (Hoffman, 1992, p. 12) The Sage study reported that most of the (benefit society) physicians feel their remuneration to be so poor that they are unable to afford to give as careful medical attention to lodge members as to the private patients. Reformers often cited the poor quality or sheer lack of fraternal medical care in arguing that voluntary societies inadequately met the needs of their constituents. Even more important to the reformers’ position was the weak financial state of most fraternal. (Hoffman, 1992, p. 12) Many voluntary societies were poor in resources and frequently ended up insolvent and unable to pay their members any benefits.
Health Insurance Initiation
The compulsory health insurance campaign brought to light a commonality of interest between manufacturing and insurance sectors intending to provide proper health coverage to the poor working class. The commercial insurance industry occupies a unique and little-examined place in the debate over social policy during the Progressive Era. Seemingly more of a white-collar business than an exploitative industry, the insurance industry was still perceived as holding sway over the lives of workers through its control of the hugely successful industrial insurance market, which sold inexpensive life insurance to wage earners. Like employers, insurance companies had a major financial stake in the defeat of compulsory health insurance.
The health insurance campaign forced business leaders to express their economic interests in more palatable ways. Whether by emphasizing the superiority of private employee benefits, the dangers of worker abuse of compulsory health insurance, or the loss of jobs that being forced to pay premiums would entail, both employers and insurance companies in opposing health insurance sought to construct their self-interest as the public interest. (Hoffman, 2001, p. 93)
The inability of benefit societies, insurance companies, and charity medicine to sufficiently protect the working class from sickness and poverty gave Progressive reformers a powerful argument in favor of compulsory health insurance. These institutions never assisted more than a minority of Americans. To those who contended that voluntary associations precluded the need for state involvement in worker protection, Progressives countered that such an inadequate patchwork system could not substitute for a more centralized plan with guaranteed benefits.
In the crescendo of complaints and criticisms of the U.S. health care system, none is more frequent or more urgent than its skyrocketing costs. As a result of steadily rising health care costs, the principal payers are under severe financial stress that is compromising their ability to perform other critical functions. Irrespective of the federal budget, the sustaining fact is that a middle-class worker is unable to afford the medical costs. Even in circumstances where he or she possesses insured medical policy, health care benefits are useless for him or her for the reason that there are selective doctors and medical staff who are aimed at “reducing” the cost of the Medical unit of U.S. Several cases are reported in which middle-class workers (patients) when send to claim their health insurance, they were not only wrongly diagnosed but also subjected to ill-treatment. The Medical unit assured them that they were perfectly healthy. Later following the symptoms of pain, when the patients arrived at a private clinic, they were diagnosed with diseases like cancer, heart strokes, and brain tumor.
Another drawback with the lower class poverty of the U.S. is increasing gaps in health insurance coverage and persistent inequities in access to health care. This is evident when a common man (worker) having an insurance policy at hand on behalf of the company sees a hospital recommended by the Insurance claim. He is confronted with two situations over here. Either he is out turned by the hospital in charge saying that they are unable to provide him treatment for the Insurance he claims does not cover the charges, or in case he smokes, the hospital staff sets him free by saying that their policy does not support smokers. If both conditions are not fulfilled they tell the worker that he is overweight or underweight and so on this continues until the patient quits visiting the hospital.
In the second situation, the hospital treats him or her and at last, proves that he or she does not need any kind of medical treatment. A majority of those without insurance are full-time employees and their dependents whose employers do not provide medical insurance benefits. Lower-class Americans have the worst health insurance coverage. Every time policymakers, corporate health benefits purchasers, or entrepreneurs try to fix something in our health care system, they run smack into its central reality: the primary producers and consumers of medical care are uniquely, stubbornly self-serving as they chew through vast sums of other people’s money. (Kleinke, 2001, p. 3)
A recent study by the Institute of Medicine revealed that due to lack of quality access to health care in America death rates among low-income populations are twice the rates of the highest income groups. So, lack of security about obtaining health insurance is a common rather basic concern for working-class Americans, where they know that if they would come across some illness during work or as a result of overwork, they would not be provided with adequate quality care. This is the reason why today’s Americans consider themselves far more vulnerable than any other underdeveloped nation and they are well aware that the problem has no solution at least for the destitute Americans. It is for this reason why today Americans like to relocate to European states where there are facilities at least as far as health is concerned.
Another dilemma that arises from health care is that as health care has become more and more expensive, insurance premiums have escalated, with the result that increasing numbers of Americans cannot afford to buy insurance. Even those working-class individuals who are somehow able to afford insurance, are not guaranteed to acquire secure health or treatment coverage.
Problems with the Medical Sociology regarding the Overworked
Historically in the United States, the provision of medical care to the poor and working-class has been handled by charitable organizations and government at the local or state level. This where on one hand secured the poor, on the other created many complexities for the organizations and Insurance Institutes. The adoption and rapid growth of the Medicaid program brought about an expanded federal role in financing this care. But, in keeping with historically assigned responsibilities, Medicaid as a program failed to assist state and local governments in their efforts to provide utmost medical security to the poor. The main problem with the Medical aid was the unstructured surety that did not attain any well-defined national policy goals. It is therefore not surprising that today when looked at from a national point of view, the medical program upholds many loopholes. Among the more significant problems with Medical sociology are the following:
- High Cost: Despite the annual high costs of Medicaid programs, the poor still suffer from chronic diseases. Why? Although state and local governments pay less than half of the cost of the program, it has been perceived as a burden by many state policymakers. As a provider of public health insurance under Medicaid, the government deals with the problem the other way which recommends that insurance agencies and Government hospitals upon conducting various tests of the patient first determine his social status. If he is poor and unable to afford health expenses, his reports are unable to detect any disease and therefore he is recommended no treatment. This way the Government not only reduces the high cost but also gets rid of the unwanted poor. High cost escorts the government to perceive the burden of the program to be greater than other states due to which the costs of such programs can be reduced by denying the poor access to essential medical services.
- Horizontal Inequity: The term ‘horizontal inequity’ has been used to refer to unequal treatment of potential Medicaid recipients across states. That is, two otherwise identical individuals could be treated very differently under the program if they happened to live in different states. According to many sources in which Government defends against blames, it suggests that since the federal-state policymakers have only indirect control over the services ultimately provided, therefore Medicaid gives states considerable latitude in determining eligibility, range of services covered, and provider reimbursement rates. (Pauly, 1980, p. 105) In response to this statement, the Government could be asked that by determining eligibility and criteria does it mean to deny those poor, who are suffering from diseases like cancer and tumors and are still uninsured according to the medical policies or if they get insurance, hospitals suggest them as ‘perfectly normal.
Today the largest Medicaid programs of the United States are blamed and are held responsible for taking the lives of thousands of Americans each year for their policies are vulnerable to the public but are highly profitable for the policymakers. Who cares!
- Chapman R. Audrey, (1994) Health Care Reform: A Human Rights Approach: Georgetown University Press: Washington, DC.
- Gerson Kathleen & Jacobs A. Jerry, (1998) “Who Are the Overworked Americans?” In: Review of Social Economy. Volume: 56. Issue: 4 p: 442
- Ginzberg Eli & Ostow Miriam, (1994) The Road to Reform: The Future of Health Care in America: Free Press: New York.
- Hoffman Beatrix, (2001) The Wages of Sickness: The Politics of Health Insurance in Progressive America: University of North Carolina Press: Chapel Hill, NC.
- Kleinke J. D., (2001) Oxymorons: The Myth of a U.S. Health Care System: Jossey-Bass: San Francisco.
- Nearing Scott, (1911) Social Adjustment: The Macmillan Company: New York.
- Pauly V. Mark (1980) National Health Insurance: What Now, What Later, What Never?: American Enterprise Institute: Washington, DC.
- Raiz Lisa, (2006) “Health Care Poverty” In: Journal of Sociology & Social Welfare. Volume: 33. Issue: 4.