Combination of Parts

Nessa Behie

College of Social Work

SOWK 441

Dr. Melania Popa-Mabe

12 December 2023
 Part 1

What is the Problem?

Healthcare is an issue in the US that has long been viewed as a personal problem.

Whether it be that a person gets their insurance from their work, through the government, or by a

private company out of a person’s own pocket. According to Skuad “All but 43 countries in the

world have free healthcare or access to universal healthcare for at least 90% of their citizens”

(Skuad). One of those 43 countries is the United States. In the United States healthcare is not

seen as a right and is seen as “right to life simply means that humans have a right to live, and that

nobody can try to kill another” due to an international treaty (Mollmann, 2023). Due to this the US

is both one of the best countries for healthcare and one of the worst for those impoverished. It is

a widely known fact that one visit to the hospital can put a family in an insurmountable amount

of debt. So, who is affected?

Effected Populations

Specifically, the following are the statistics for each ethnicity on racial percentage of

uninsured (Jennifer Tolbert, 2023):

 Hispanic: 19%

 American Natives: 21.2%

 White: 7.2%

 Asian: 6.4%

 Black: 10.9%

This data does not show the income levels of families, but it does show that minority
 populations are more likely to be uninsured than white Americans. Another point this article

makes is that “financial assistance for Marketplace coverage is available for many moderate-

income people, few people can afford to purchase private coverage without financial assistance .”

(Jennifer Tolbert, 2023).

Social Theories/Macro Factors

With people being uninsured, the government has tried to change Medicare guidelines to

allow for more people to have access to affordable healthcare. The current issue is that 7 states

have not adopted these changes and may choose to continue not to. Research done by KFF

shows that those 7 states and one other has either not adopted or has adopted yet has not

implemented these changes meaning that more people are still left uninsured (Published: Jul 27,

2023). This research into policy analysis shows that those states who have not adopted are mostly

southern states with the exception of Wisconsin and Wyoming.

Intersections that cause Devaluation

From the data above, it is clear to see that any minority race is more likely to not have

healthcare insurance, or equal opportunity to healthcare due to insurance costs. Pair this with

rising inflation and you will have families struggling with medical debt due to the US only

seeing the right to life as a right and not medical care. Now if a person is both a person of color

and on the lower end of the income spectrum, they are more likely to not have proper care than a

mid to upper class white family.

An overview of countries that offer free healthcare. Skuad. (n.d.). https://www.skuad.io/blog/an-

Jennifer Tolbert, P. D. (2023, May 12). Key facts about the uninsured population. KFF.
https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/
#:~:text=Characteristics%20of%20the%20Nonelderly%20Uninsured%2C
%202021&text=The%20uninsured%20rates%20for%20Hispanic,lowest%20uninsured
%20rate%20at%206.4%25.

Mollmann, M. (2023, August 16). Health Care is a human right-and that means Universal
Access. Harvard Public Health Magazine. https://harvardpublichealth.org/equity/health-
care-is-a-human-right/

Published: Jul 27, 2023. (2023, July 27). Status of state Medicaid Expansion Decisions:
Interactive Map. KFF. https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-
expansion-decisions-interactive-map/
 Part 2

Rights-Based Approach

Key Assumptions

Rights are Universal

One of the key assumptions of the rights-based approach is that rights are universal and

should be applied to everyone regardless of race, gender, or ethnicity. This assumption allows for

the emancipation and freeing of all peoples. For example, the people of Ukraine have the right to

freedom and peace while the Russian military continues to attack them.

Helps Restore Dignity

The Rights-based approach also uses a social work tenet as one of their assumptions,

which is that people should be treated with dignity. Specifically, the rights-based approach

believes that we should help restore dignity that has been lost and allow for people to grow. One

of the ways this can happen is allowing a deaf person to make their own choices or do things for

themselves, something that some families are not willing to do.

State Officials should be held Accountable

The final assumption for the rights-based approach that I will be talking about is that state

officials should be held accountable. This assumption follows the logic that if state officials take

funding away from, or do not support legislation to help the people, then they should be held

complicit to further embedding people into poverty.

Key Tenets

Addresses Structural Injustices

fixed to ensure peoples’ rights. Some of these structural issues could be racism or sexism that

were codified into laws. Examples could be how even though homosexual couples can get

married; some states still have sodomy laws on their books making being gay still illegal. This

tenet allows for structural injustices to be rewritten and calls for antiquated laws to be upturned.

Redistribution of Resources

Another tenet of the rights-based approach is the idea that at times resources need to be

redistributed to allow for the success of everyone. This idea would allow for people to have

money needed to buy groceries or allow for the donation of food to be given to those in need.

One of the best examples on campus of redistribution is the College of Social Work’s food share

boxes that allow for students to receive a box of fresh produce with no cost to them.

Rights are Non-negotiable

The final tenet of the rights-based approach that I will be writing on is the idea that rights

are non-negotiable. This ideal is one that I have held for a long time and believe to be true. If a

person is living, then their rights should not be taken away. People have the right to food and

water to live and care for illnesses to continue living.

Needs-Based Approach

Key Assumptions

Needs should be kept away from Politics

One of the assumptions of the needs-based approach is that needs should be kept away

from politics. This assumption would allow for policies to either not be changed when needed or
to be changed without input from professionals working to meet those needs or people who have

been in need. If needs were to be kept away from politics entirely, we would not have programs

such as SNAP or TNAF to assist people with finding housing or securing food for low-income

families.

Finds more Resources

Another assumption of the needs-based approach is that the organization will continue to

find more resources to help its clients. This assumption could lead to the clients having more

opportunities for help and self-growth.

Collaboration with other Groups

The final assumption works off of the last one that groups will work together to further

resources for their clients. In social work this can look like referring a client to another agency to

better help them fully mee their needs.

Key Tenets

Needs are Assessed

The first tenet of the needs-based approach is the idea that needs should be assessed.

Many organizations use this method to ensure that care is appropriate for the patient and that if

some part of the care is not needed, it is not used. The best example of this is when a patient may

not need the Chaplin of a hospice organization, but they need the social worker to help with

some issues

Needs are met when Resources are Available

resources are available. One major example of this is when people need shelter or housing, say at

the Oliver Gospel Mission, they must be one of the first people there to ensure a bed for the night

or they will be left on the street. This tenet is seen in many policies and charities where if there is

not enough room or funding then some will go without.

Needs are Handled Individually

The final tenet discussed in this paper is the tenet of people’s needs should be handled

individually. This means that each person is given individual care for their circumstances based

on what they need in the moment. The best example from my field placement is that one patient

may need to be visited by a nurse daily while another patient may only need the nurse weekly.

Key Differences

The main differences between these two theories in my eyes are that one views people’s

basic survival needs as rights and the other views the part of what people need to survive as their

own problem and their only need. Another difference would be that the rights-based approach

calls for the government to make changes and hold themselves accountable for the people’s

distress and difficulties while the needs-based approach sees peoples problems as their own

faults and that people need help if it can be allotted by the agency servicing them.
 Part 3

Rights-Based Approach Desired Outcomes and Processes

Desired Outcomes

A desired outcome using the rights-based approach to ensuring healthcare for the US to

me would be free universal healthcare. The US on average takes in about 4.4 trillion dollars in

taxes per year, 51% of which was from private US citizens (Fiscal Data Explains Federal Revenue,

n.d.). This means that private citizens pay roughly 2.2 trillion dollars to the federal government.

In comparison, corporate income taxes only made-up 8.26 percent of the current fiscal year

(Fiscal Data Explains Federal Revenue, n.d.).

Pathway to Outcomes

My proposed solution is further investigating corporate companies to tax them at a fair

rate to increase taxes at a federal level to cover universal healthcare which has been deemed as a

human right. Through taxing billionaires and trillionaires at the same rates as the average citizen,

the American lower and middle class, the US government would have excess money to de-

privatize healthcare and allow for safe free healthcare. Many of the medical supplies and

procedures could cost less and since there would be auditing through the government, there

would be less over charging for needing medical supplies.

Needs-Based Approach Desired Outcomes and Processes

Desired Outcomes

An outcome that would be desirable using the needs-based approach would be a charity

sponsored by some of the top grossing individuals in the country, such as Elon Musk, who could

sponsor hospitals for easier tax right offs. This would allow for the needs to be kept away from
 politics and for resources to be allocated to multiple groups at once. This would also allow for

the needs to be assessed, and for resources to only be used when they are made available.

Pathway to Outcomes

I know this is a more outlandish idea, but it could allow for another star-studded gala that

would generate more money for the government to put into use in other departments. It would

attract many different celebrities and make something akin to the Met Gala, but the proceeds

would go straight to charities helping those with medical debt that are either: A) impoverished,

B) a person of color, or C) both of the categories. The appeal of positive publicity would attract

many billionaires and trillionaires to attend, furthering the profits going towards those in need.

Who defines These

Currently the United Nations defines definite human rights and one of such is the right to

healthcare. Specifically, those in poverty and the middle class see the overpriced cost of

healthcare would make the lower and middle class want the de-privatization.

Resources

Fiscal Data Explains Federal Revenue. (n.d.). Fiscaldata.treasury.gov.

https://fiscaldata.treasury.gov/americas-finance-guide/government-revenue/#:~:text=Federal

%20Revenue%20Overview&text=If%20you%20lived%20or%20worked
 Part 4
Needs-Based Approach

Pros

I personally like the needs-based approach because it does assess needs on an individual

basis because this allows for less of a “one size fits all approach” and allows tailored to the

client. I also like that it collaborates with different groups to find more resources for clients and

expand resources available for the community.

Cons

I do not like that it simply meets some needs when the resources are available. I know

that you need the resources to be able to meet needs, but there are usually ways around this.

Rights-Based Approach

Pros

I like that the rights-based approach views rights as universal and that it helps restore

dignity to people. I also like that this approach would hold state officials accountable to ensure

that tax dollars are used properly and that state officials are not being bought out.

Cons

I do not like that some of the poorer folks could be affected by redistribution of wealth

due to being “wealthier” than others and needing everything to be redistributed.

Recommendations
 I would recommend using parts of both approaches too such as holding officials

accountable while gaining a list of respectable resources to help clients in the future. There are so

many ways to combine these two amazing approaches to further the good of the common people.