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Application of the Copenhagen School

Theories in National Health Care

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Introduction

            Issues on national health care address varying concerns on how the government can effectively deliver its services to the people by making it accessible, efficient and effective.  In observing the national health care policies across different societies, it is apparent that some systems work best in which health care is given to the citizens according to the allocation of the government’s resources whereas some nations face the challenge across various components, from making health care accessible to the isolated areas to the issue of costs.

            Clark and Mceldowney mentioned that when it comes to explaining how health care is better in some nations, the authors pointed out the following factors that play a hand in certain successes: the economic, the social and political conditions.  Although the approaches of governments to these factors differ depending on the implemented set of priorities to the capacity of the government to attend to the health care needs of its citizens, national health policies can be observed to be constantly on the process of reforms in order to come up with the right formula that serves best the people without taxing the government’s capabilities in order to deliver this service.

            In this regard, the Copenhagen School theory, particularly the framework of security studies and international relations, is seen as a potential platform that can serve as a working model in the formulation of effective national health care policies.  Although this particular school of thought addresses security concerns, the association with health care can be initially seen in its intent to address similar issues which include economic, social and political conditions.  The next sections discuss how national health care can be therefore reformed according to this particular framework.

On National Health Care

            The mode of provision for health care can be initially considered political in a sense that the nation’s system can already determine how health care is going to function as a public service, as a right, and at the same time, as a capitalist venture which includes corporations providing products and services in this industry.  Although it can be argued it is an economic issue, decisions when it comes to health care strategy remains to be subject to certain political decisions.  For instance, in the United States, the country spends a significant percentage of its national budget on health care; according to the Office of the Actuary in the Centers for Medicare & Medicaid Services, the government allocated $2.26 trillion on health care.  This amount alone already allows each citizen of the United States an amount of $7,439 for 2007.  However, despite this huge budget, health care in the United States is not universal because usually, those who are covered by insurance are either those covered through their employers or through their individual purchases of insurance premiums; the government’s provision for health services which are accessible, efficient and effective to the people has been lacking.

            Such can be compared to the performance of other nations where health care is universal.  According to a document by the World Health Organization, other nations such as United Kingdom and Canada offer universal health care, in which case, this reflects an application of the functions of a welfare state.  Although this is the case, the health care system has brought convenience to a lot of people although the service in itself is compensated through taxation, among others.  Less developed nations, in this regard, has had this challenge for several decades in which the country does not have enough wealth that can enable the government to bring forth accessible and efficient health services to everyone.

              Although health care alone, as previously mentioned, can be regarded as among the rights of the citizens, according to Chapman, such approach may be problematic.  As the author explained (35):

“The language of rights is useful in highlighting the inequities and inadequacies of our current system, and in organizing public support for reform in general. It is also useful in helping to define the broad parameters of a system that can assure a right to health care. However, in determining the myriad details in the design of this system, it may not prove useful as an operational guide, for it raises as many questions as it answers. How much health care? What quality health care? What is the responsibility of individuals for their own health?”

              Apparently, in this case, the lack of ability to bring sufficient health care services to the people is based on the economic and political factors that can be deemed to be conflicting with the social rights.  In order for an effective plan to be formulated, it is therefore important to use a framework that can be utilized to come up with the solutions addressing the true issues of national health care challenges.

The Copenhagen School

            The Copenhagen School generally refers to schools of thought that have emerged from Copenhagen in Denmark.  What makes the Copenhagen School distinctive not just as a set of theories from the Danish capital is that these theories can be considered as greatly influential; hence, their significance in their respective fields has been apparent.  These “schools of theory” are as follows:

Quantum Physics or the Copenhagen School in Quantum Physics
Minimalist Theology or the Copenhagen School in Biblical Exegesis
The Copenhagen School of Security Studies
The Copenhagen School in Linguistics
These theories are not related to each other except that they share the common of origin in which these schools of thought come from Copenhagen.

The Copenhagen School of Security Studies

            The Copenhagen School of Security Studies is known among international relations circles.  As Hyde-Price cited O’Weaver, et al., “Survival for a society is a question of identity, because this is the way a society talks about existential threats: if this happens, we will no longer be able to live as ‘us’” (38).

            What makes the theory on security of the Copenhagen school is that this movement addresses collective identity and political affiliation; hence, in this theory, there is an emphasis on the societal aspects of security.  Furthermore, as Hyde-Price pointed out, this theoretical framework has helped focus on the “problem of ethnonational conflict and drawn attention to the all-too-frequent lack of fit between states and societal collectivities in the modern world” (38).

            However, true to a number of theories, Hyde-Price also highlighted the weaknesses of this framework.  One of the flaws of this theory is how it failed to address distinctions such as those between society and society groups, especially when it comes to how these groups express their respective identities.  In the aspect of security, this is especially important as countries hold different and conflicting social groups, such as for instance, the conflict within the states of Yugoslavia which was also evident through the conflicts among its socio-cultural groups.

            Hence, although the Copenhagen School is seen to deeply touch on identity as its distinctive feature as seen in its propositions on theories in security, identity is also a weakness because it does not address how identity is related to interests.  The latter is significant as this result to a set of actions that become consequential to the society and the context of security as well.

            This school has also identified how security functions in a country, and that is through the implementation of clusters.  Hence, such concerns are addressed according to each cluster as per region, which is believed to be the best means to cover security since crossing distances just to extend security services do not work best in the interest of each region or social cluster.  This is to say, for instance, that if security is not proliferated enough to cover an entire nation in which the distribution is by means of establishing regional centers, the tendency is that having too much reliance on few “centers” such as those in the big cities or capitals can bring more problems to more isolated communities that need security support.

            Another issue in this school in addition to societal security is securitization.  Securitization comes from “to securitize an issue means to take it out of the normal realm of political discourse and to signal a need for it to be addressed urgently and with exceptional means” (Hyde-Price, 38).  From this, security is also perceived as more than a threat or a problem but also as existential threats to a referent object by a securitizing actor who thereby generates endorsement of emergency measures beyond rules that would otherwise bind” (Hyde-Price, 38).

Application of the Copenhagen School to National Health Care

            From the previous discussion on the specific Copenhagen School in security studies, there are a few points that can be gathered as the prevailing concepts of this field:

The role of society and identity as a means to determine the kind of service formulated to the needs of the people
How regional clusters can help in the distribution of services which can make the services more accessible to those who need it
A more constructive yet perspective adopted when it comes to assessing the threats and problems of the issue
The intent to take out the politics in the issue and to address it mostly based on the necessity to come up with the best treatment possible
It can be said that the

            The application of these concepts can then be regarded to promote a functional foundation for national health care policies.  Apparently, these concepts can be used as important forces that can give way to the formation of national health care strategies that are going to be more accessible, effective and efficient.

Society and Identity in Health Care: Addressing the Issue of Demand

            One of the identified concepts in the Copenhagen School is the role of society and identity in the theory.  In health care, these two factors can be considered critical as they define the people who are in need of these services.

            Health care systems generally focus on the beneficiaries of the system; with people demanding certain services according to certain trends, national policies determine what kind of services can the country afford and at the same time, make sure that certain issues are addressed.  In the context of society and identity in health care, a critical consideration is how health care is defined according to the demands of the people it serves; this is to say that health care strategies are specifically designed according to the social profiles of the society which, in a collective perspective, already conveys the presence of identity (Moon).

            How this contributes to the design of an effective national health care strategy is based on the evaluation on the needs of that particular society which can differ.  For instance, there have been recent studies on the differences in health profiles according to different races (Ovretveit).  This factor alone can be deemed to already influence the health care strategy especially among multicultural societies such as the United States.  In addition to this, there is also the fact of the increasing number of the ageing population; with this, it is apparent where the demand is going to rise and what kind of medical and health interventions are going to be on the rise as well.

            In addition to the social profile, there is also the need to identify other important aspects such as the socio-economic considerations which can create an input in terms of potential demand with the patient having limited access to resources.  From this, depending on the economic standing of the society, the government is able to determine a workable health policy that redirects resources to those in need, especially if such demand is on the rise among a significant portion of the population.

Regional Clusters to Effectively Distribute Health Care: Addressing Accessibility

            One of the main challenges in health care is how it can be made more accessible to areas that are remote from city or regional centers.  Although there are the common community-based health services, usually, the kind of services and resources that these community centers have are not sufficient.  In addition, in relation to addressing the health care needs of a society as based on its needs according to its profile, community health care should also reflect such strategy.  This is to say that, for instance, there is a common dengue outbreak in a particular community, the health center for this community should have sufficient access to skills and resources in order to respond to this problem and at the same time, have the means to transport patients to bigger hospitals for more dire cases.

            In this theory and application, the establishment of regional centers or clusters enables communities to have better access to health care.  Through these clusters and centers, the government can strategically allocate resources according to prevailing health care needs as defined by the health profile of the region.

Threat Assessments

            In order for national governments design an effective health care policy, it is important to adapt a strategic approach especially when it comes to the distribution of health care resources.  Threat assessments can be considered a common approach in strategic frameworks, and in the cited framework of security issues, threat assessments serve its purpose in making sure that the potentiality of risks is addressed.

            When it comes to the health care industry, threats come in many forms.  First, there is the aspect of the health concerns such as outbreaks or other diseases that may be hard to treat for the practitioners, especially if the disease leads to a number of people contracting them.  Second, there is of course the issue of resources both human, supplies and funding; the threat comes in the form of decline of these resources which is always possible.  Third, there is the threat of external factors such as the entry of politics into the services or even how an economic crisis can also affect health services, thereby making it less accessible, efficient and effective.

            In this case, the role of threat assessments is that this enables the government to foresee any possible obstacles that can create serious threats in the implementation of effective health care that it can deliver to the people.  Such assessments will therefore serve as fundamental intelligence or information that can help the government in determining certain strategies and approaches that can be effective in the creation of a health care framework.

Taking the Politics Out of Health Care

            The political forces surrounding health care is inevitable.  As health care services are supported by budget allocations, in addition to the inputs of the private sector such as insurance firms, health institutions and pharmaceutical companies, each of these actors aim to place themselves at a winning position in the industry and in the market.  In a way, the potential challenge is how the government is able to balance the demands and expectations of these actors without jeopardizing the welfare of the people.  In addition, there is also the advocacy of interest groups such as the church and human rights groups who may conflicting views not only when it comes to health care but also certain procedures that they deem unethical or procedures that should be pushed for.

            Hence, it is important to take the politics out of health care although this maybe considered a huge challenge considering the role of politics in making things happen, especially at the national setting.  In this case, what makes this work depends on the leadership that steers health care into more of a social concern rather than the political.

Conclusion

            The Copenhagen School can be regarded to provide a working framework that can benefit the formulation of effective health care strategies and policies that can be used by nations.  National health care should therefore emphasize its accessibility, efficiency and effectiveness, especially with the amount of people who are highly dependent on the government to provide them with critical services, especially concerning their health.  Hence, the government is tasked to come up with national health policies that do not only address the problems but also the needs of its people.  From the framework utilized, which is based on the concepts of the Copenhagen School of security, it is apparent that such application is relevant and the concepts behind this theory can also work in setting a platform that can improve health care policies.

Cited Works / Bibliography

Chapman, Audrey, (Ed.)  Health Care Reform: A Human Rights Approach.

Washington, DC: Georgetown University Press, 1994.

Clark, Cal ; Mceldowney, Rene.  “The Performance of National Health Care Systems:

A “Good News, Bad News” Finding for Reform Possibilities”.  Policy Studies Review, 17(2000): 133.

Crichton, Anne, Robertson, Ann, Gordon, Christine ; Ferrant, Wendy.  Health Care: A

Community Concern?  Calgary: University of Calgary Press, 1997.

Flood, Colleen.  International Health Care Reform: A Legal, Economic, and Political

Analysis.  London: Routledge, 2000.

Havighurst, Clark ; Richman, Barack.  “Distributive Injustice(s) in American Health

Care”.  Law and Contemporary Problems, 69(2006): 7+.

“Health Systems Resources”. World Health Statistics 2008: Global Health Indicators.

World Health Organization (2008).

Hyde-Price, Adrian.  “Beware the Jabberwock!”: Security Studies in theTwenty-First

Century”.  Europe’s New Security Challenges.  Eds. H. Gärtner, A. Hyde-Price & E. Reiter.  Boulder, CO: Lynne Rienner, 2001.

Kleinke, J.D.  Oxymorons: The Myth of a U.S. Health Care System.  San Francisco:

Jossey-Bass, 2001.

Lesnik, Juniper.  “Community Health Centers: Health Care as It Could Be”.  Journal of

Law and Health, 19(2004): 1+.

Moon, Graham.  Society and Health: An Introduction to Social Science for Health

Professionals.  Eds. G. Moon & R. Gillespie.  London: Routledge, 1995.

“National Health Expenditures, Forecast summary and selected tables”, Office of the

Actuary in the Centers for Medicare & Medicaid Services, 2008.

Ovretveit, J.  (1998). Evaluating Health Interventions.  Buckingham: Open University

Press.

Rushefsky, Mark & Patel, Kant.  Politics, Power & Policy Making: The Case of Health

Care Reform in the 1990s.  New York: M. E. Sharpe, 1998.

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