hi everyone this week we're going to be looking a little bit about health and health care we're also going to be looking at gerontology we'll be focusing more on that in the next lecture an area that's kind of interdisciplinary coming together from sociologists from epidemiologists from people who study the process of Aging in the biological components and things like that so we're not going to really get into that today we're going to be focusing in on how sociology views health and health care obviously in sociology we're not going to get into the biology we're not biologists we're not going to try to understand on a molecular level or a genetic level of this particular virus or that particular bacteria or something like that you know we saved that for experts in that field what sociology focuses on more is what are the implications in society that the presence or an absence of a particular virus or bacteria have um you know and a lot of different opinions on this both from an economic and a political and a social and a religious and so all these different social institutions have an impact on our health and that's what a sociologist would view not just simply whether you get sick but if you get sick can you access health care did you have health insurance if you get sick what does that do to everybody in your family what about that loss of income what about you see there's so many different things that are connected and that's what we focus on obviously there is experts in biology and Immunology and virologists and so forth that are looking at those areas in geneticists and they're far more qualified to understand the genetic structure of a particular virus or something like that what we look at is how does this all come together as part of the physical and the mental and the social what about people that are getting exercise are they going to have a stronger immune system what about people that have access to food and healthy food and and money so they can buy those things that they need you know for sanitation or for gloves or masks or whatever we end up having to do in society versus those people that don't have access to it how does that shape their health if it was just simply the bacteria or the virus well then we could isolate it we could treat it or we couldn't treat it and we'd respond but there's so many other factors that play into whether somebody gets sick whether they don't get sick um how badly they get sick how are they going to be able to provide for themselves and the list goes on and on and on that's what we look at so we view Health as kind of a holistic Viewpoint now I know you're going to hear the term holistic medicine and you typically look at it from a naturopathic kind of that they've used that a lot um but holistic actually means that you treat the entirety of the person which means their environment their mental health their emotional health their physical health their social life you know it's the entirety of health and that's how we view it in sociology okay if you think about it doesn't Society kind of shape our perception don't we judge our health in relative terms if you have health care and health insurance and you've had it your entire life don't you have a different expectation of your level of Health than you would if you have never had health insurance or Access to Health Care let me see if I can give you an example here in the United States we get sick and I know we're social distancing right now but under normal circumstances we get a sniffle we run over you know students will run over to the healthcare clinic and you should you know by all means if you have health insurance that allows you to go over to the health clinic on campus or to your own doctor whatever yeah go absolutely that is the ability that we have here in this country so we Define as I'm sick as I've got a sore throat and I got a stuffy nose I'm sick can't go to class call out from work use my sick leave what not now let's say you lived in a country where the nearest clinic or doctor is 150 200 miles away you have no means to pay for that even if you could get over there what would you define as being sick at that point sniffles a cough no you got to go out and you got to get enough food to feed your family for the day you're not sick until you literally are taken to the doctor because you can't get out of bed then you'd say oh I'm sick I need to stay in today I'm not trying to say one's better one's worse what I'm trying to say is the view that we have that expectation that's what we mean by its relative it's relative like relative and absolute poverty kind of the same thing someone who's middle class feet can feel poor compared to the upper class but somebody who is absolute poverty where life is threatened relative to the poor say in the United States there's still a light year's distance between those it's kind of the same thing when we're looking at health and health care okay we also pronounce healthy is what we deem to be morally good a healthy lifestyle that when we start putting healthy a healthy framework of Mind a healthy mentality a healthy way of viewing things a healthy uh fear of God a healthy which again if you do more power to you but when we start adding that word it's healthy then we can say something else is unhealthy and if it's unhealthy we can condemn it because nobody wants something unhealthy you see when we start calling something unhealthy because we've called other things healthy then we can add in judgments and when we add in judgments then it creates a value structure well that's not a bad virus that's not a bacteria that's a social response to what we Define as being healthy and unhealthy and that's what sociology looks at we also look at how technology and health standards I've got to move a little quicker for you guys have changed over time you know um you you look at the response that we had to uh the flu in the in 1918 and most people are now familiar with this I find it fascinating that most people if you'd ask them you know when was the Spanish Flu most people would have said the Spanish Flu over in Spain in Europe what wasn't that part of the bubonic play and all that stuff and now we're very very well aware of this because Society shapes our understanding of health and health care and so those standards have changed over time just that awareness the ability to have at our fingertips all this access to information that you didn't have back then so you remember back in night what you don't remember but back in 1918 we had social isolation too people were shut down people were you know separated trying to stop this pandemic at the time was just known as an epidemic because it was in when country pandemic means it's across the globe epidemic means it's within one region so at any rate so you have this epidemic that was going on back then and people were practicing social distancing to try to keep other people because we did we'd quarantine we'd isolate and then they said oh no we're over we're over and so they started coming out of public they started coming out in public and about two weeks later they had this huge upswing after the initial onset and the second onset killed more people than we lost in all of World War One because their standards had changed in that short period of time now look at the standards from then until now it's cheap well in some ways it's kind of the same but in other ways it's changed exponentially sorry I'm going off on a tangent but you get the idea by now and then Health also relates to social inequality as well which I'm going to come back to here in just a moment basically in a nutshell if you have health care you're more well has nothing to do with who you are it has to do with your social status people that have health health insurance and Health Care Access to Health Care are going to do better off over time than those people who don't so when we're looking at it if we start to compare for example uh the leading cause of deaths in the 19 early 1900s versus the early 2000s we see a complete different picture well this doesn't mean that that that that it's just the virus of the bacteria the disease has changed obviously influenza pneumonia back in the early 1900s well most people have forgotten or don't realize it was the number one killer in the United States you get the flu or you can and it evolves into pneumonia you're dead Okay not everybody died but the vast majority of people died today we're very fearful with coronavirus but overarchingly look how far down on the other side of the list it is over on this other side it's way down the list why because of vaccines because of immune resistance and and herd immunity because it has a social impact technology treatments I mean there was no such thing as Theraflu in the 1900s to reduce its impact which allowed the body to fight it off in a variety of other things so it isn't so much that it's just and obviously there's been mutations of the virus and bacterias out there but it isn't just that it's also the response and the technology and how we interact I mean for example tuberculosis it's not even on the list anymore we have a vaccination from it and it's always fascinating to me about all these people that are running around anti-vaxxers and so forth can you imagine what life would be like if we didn't have vaccinations people are fearful of like the flu vaccine and know what makes me sick and everything could you imagine having the Spanish Flu every year what it would be like if we didn't have vaccinations now that's one Viewpoint there are people and it's perfectly valid for them to have their viewpoints against the vaccinations if that causes more illness actually statistics show no it really doesn't and and people forget that they don't think about that well not being able to think or thinking about that is a social interaction that social in and of itself you see so everything that we do has an impact on health and Health Care stomach and intestinal diseases now we have liver disease and cirrhosis heart disease has gone up what's changed capitalism go go personality got to work at any cost we work on vacations I'm working 10 12 hours a day try to answer emails and I come up with lectures then I handle this and I have meetings with people across the world and all this other stuff that's going on boom that creates that Dynamic that heart attacks have gone up through the roots roof cancer has gone way up it used to be way down the list on the other side now it's number two well what's changed well air pollution for one uh additives to food that could be a cause driving in our car that's a carcinogen people say yeah well driving under cars but did you know that it's easier you you breathe in more carcinogens driving your car even on the inside of your car every 100 miles or so that if you smoked a half of a cigarette you'd be breathing in more carcinogens but nobody's saying get rid of your car people say well no that's not true that's not okay about this one I'm not an advocate for cigarettes okay I quit smoking fortunately I still Vape but I quit smoking and I'm thankfully Vape allowed me to um so let's say you go out and just to look at look at it from a kind of factual perspective for a moment this is how social just tries to see this stuff because it's easy to get swayed one way or another by social influence so let's say you went out to your car in the garage and you sat out there and you smoke cigarette after cigarette after cigarette after cigarette after cigarette for two three four hours Non-Stop would you be high yeah would you be dizzy yeah would you be sick probably and then your oxygen levels would come up and you'd be fine now go sit in your garage turn on your car what happens you're dead We're Not Gonna Get rid of cars because we need to get from one place to another but you see but cars are actually more of a pollutant than cigarettes we got rid of cigarettes on campus okay cool that's great for Everybody's Health I agree while we're walking behind a diesel truck doing yard maintenance breathing in all those fumes see that's what a sociologist would look at we don't make the decision but we look at how does that get defined as somehow different one's a necessity one's an option let's get rid of the option and let's demonize that you see that's a social interpretation the fact is we're doing more of your cancerous type activities we have more additives to food pollution as I said that may be a factor may be a factor lung disease gone up accidents have gone up quite a bit new interactions didn't happen before but in an industrialized Society you're around a lot more mechanization HIV now and AIDS now on the list suicide now on the list that wasn't on the list it's not that it wasn't a killer but it didn't exist to the point of being the top Killers what about diphtheria disease of the infancy um um all these different things that diphtheria you got inoculated when you were born against that that's why it doesn't exist polio basically doesn't exist uh um chickenpox smallpox mumps all these things you have a much stronger uh response system if you are exposed some of it we have almost basically eradicated out of most industrialized societies that's a social influence so it isn't just the biology and sociology this is a really fascinating area if you think about it because we study all the implications all the different factors that would cause these shifts and these changes rather than just simply if it exists or doesn't why what is the impact what is the effects and this area is called social epidemiology I've mentioned that term already this is how health and disease are distributed throughout the entirety of this society's population now I'm going to be posting a little video please take the time to watch that as well I'm going to post that right underneath apparently I put that other video in the middle of my lecture on the last lecture and YouTube says they contacted me there's somebody violated a copyright or something like that hence the links to the videos in YouTube so people get credit I don't want to take anybody's credit um but it's a little video uh Hans wrestling who unfortunately is not with us anymore he was one of the leading Global epidemiologists out there and he looks at changes in 200 countries over 200 years to really get an impact of how we in epidemiology and sociology would be looking at that distribution and the direct impact now he's looking at access to health care and economic life as a direct impact on our life expectancy and it is night and day difference and so it's just another really quick example it's about five minutes long please take the time to watch that but it will bring to light and he does it is really kind of unique way with data animating the data in a three-dimensional plane which is really cool there's a lot of people that he works with to create this um and it gives you an idea of all these different social factors having an impact on our lifespan on our health on the the just the ability to lead a happier longer healthier life as well as other issues out there that is limiting someone's access to a happier healthier life that's what epidemiology looks at how it's distributed throughout a uh population and how health and Health Care access is distributed and what impacts does that have on various different social institutions if you're going to look at age and sex and this I can go through fairly quickly age and sex for example you know if a mortality rate is virtually non-existent obviously accidents in use of the two exceptions but if you remember from the earlier lecture we had a high-end for mortality rate in any pre-industrialized societies those that are still currently pre-industrialized still have a very high infant mortality rate is it because babies are healthier in certain countries well no not biologically but yes because of well-baby care prenatal care prenatal vitamins that were taken by the mother um Access to Health Care testing inoculations all these different factors that come together that basically ensure once a child is born it's going to live past being a year old and probably well into adulthood so that's had a huge impact where before that didn't have women typically fare better than men well why is that especially when you look at all of history now we are seeing it shift and it changed anybody that still thinks that health is not as much Social as it is biological all we have to do is look at women entering into the workplace a good thing equality absolutely please don't get me wrong but we're also noticing is women are entering into the workplace over the last 30 35 40 well now 40 years and more and more into type A personality kind of jobs well all of a sudden because that previously known masculine type a behavior that's what we used to call it masculine Behavior it's just human behavior but you know how we associate you know based on gender roles one to be more masculine so competitiveness and aggressiveness well now women are in those fields they're in the managerial or CEO or CEO CFO position what's happening out there women are dying of heart attacks and other heart complications and problems in the past we called it a man's disease we thought only men suffered heart attacks at this High rate oh we're starting to realize or have been realizing for quite some time something sociologists and other epidemiologists have known it's type of Lifestyle not biology because now that women are in positions of power and in that type A personality jobs and so forth huh there are rates of heart attack have gone up proportionally to where they're almost equal to men the fastest growing killer of women is heart disease today so age and sex is impacted both in our lifestyle it's impacted to our access to health care as well as the biology we're not discounting biological input obviously but it's a lot more social than just simply the biological remember that social biological model I mentioned way back at the beginning of the semester we have a predisposition biologically but then isn't it predominantly shaped by Society that's the sociological perspective of course other other people may disagree with that but I'm here to teach you the sociological perspective look at social class and race you know infant mortality rates are twice as high for disadvantaged groups um the poorest in the United States suffer from diseases that only strike children in in least industrialized societies because they're industrialized access is the equivalent if you look at people that are industrialized societies their life expectancy is greater than those at least industrialized societies if we said that your average lifespan is going to be 58 years old while you're sitting here watching this video what would you be doing differently would you be getting married quicker would you start having children quicker would you uh work or would you put off going to work because you have such a short life um by comparison 58 years nothing to sneeze at but what about if you have the expectation of 78 or 82 or 85 years of age doesn't it just add that extra 20 30 years it says well life is just I I got plenty of time I can have a kid at 40 and I'm still going to be around to see that kid at 18 and graduate high school what do you do if your kid is going to be you know 18 if you have the child at 30 you know by the time you're 48 you've only got eight ten more years on average these are just averages it just puts a whole different picture 58 you're not even ready for retirement in the United States for another 10 years you know well you might be ready for it but you know the average has gone up so much at least another seven years that's the United States compared to other industrialized societies there's other societies that live longer than the United States Japan for example that they have a longer life span than the United States that has a definitive uh connection and then you look at Access to Health Care you look at economic income based on uh uh people's ethnicity and race as having less access because of the blocks and and historical discrimination has been in place that isn't given the same opportunities the same security the same access to certain groups this isn't just the United States this is globally some individuals just simply have uh due to economics a better Access to Health Care well if you can go to the doctor when you get the sniffles or a sore throat you're less likely that that sniffles your sore throat escalating to become pneumonia and putting your life at risk versus somebody that's waiting until it's gone to the point they're having difficulty breathing and then they go into the hospital then they rack up a 2-3 or maybe they put off going to the hospital simply because they don't want to get hit with a two three four thousand dollar bill let me put it to you a different way could you imagine if you were a parent and you had your child and let's say you had a really good job that provided you with Healthcare I mean you work for it but you have health insurance your child gets a little fever you rush them off to Urgent Care Emergency Room in a second could you imagine being that parent of a child when you don't even have health insurance and your child starts running a fever and you have to make that decision should I run them in to The Urgency Care of the emergency room and get hit with a two thousand dollar bill that's going to go to collections because I can't pay for it or put my kid into a lukewarm bath and try to bring down their fever first see if that one could you imagine having to make that decision that's the impact of economics that's the impact of Health Care and I think sometimes people particularly those in power those in the government don't really understand because they don't have to make that choice they never have they don't have to look at their child and say can we afford to get health care for my child is my child's sick when you look at it from that framework you can't tell me that Health Care is just biology it is so much more social than that and I'm not saying all politicians are that way by any means please don't get me wrong I'm just saying if you are well to do you don't see it that way you never had to see it that way so you have no frame of reference it's kind of like saying a foremost authority on cancer is the foremost authority on cancer but if they really understand cancer they understand it better than almost anybody on the planet as far as the molecular structure as far as the response in the body as far as how it attacks the body as far as what the body's going to do and the response to the medication in response to disease the life expectancy and so on you are the foremost expert in the world but do you really truly 100 understand cancer no because you've never had it you can't see it through those eyes any more in the person just because they've had it is an expert on cancer it works both ways just because you have something doesn't mean you're an expert on it but an expert doesn't always understand what it's like to look through the eyes of someone who has it sociologists are aware of this and that's what I'm trying to bring out with social class race age sex all these different factors it's easy to sit and judge when you have the ability to judge that's social I'm not saying it's wrong I'm not saying it's bad that people have health care not at all people always go to it either or and it just is is so well it's a response oh so if you say the people who have health insurance don't understand what it's like to not so we should take away their health no I've never said take away their Health Service they probably worked really hard for it and more power to them I would love to just be able to give the same thing to other people or have them and the opportunity to work for it that's the sociological perspective it's not an either or it's a looking at it in a constructive critical way without trying to say critique I mean in in a negative sense and say one is better one is worse than the other we don't do that in sociology but we do look at the realities of that Division and that unequality is inequality no matter how you no matter how you shape it the problem is that it becomes even more social because people try to shave it to live achieve a particular agenda so my point is if after all this you're not seeing that illness health health care is as much Social as it is biological than you're missing the whole point obviously it really is and that's sociology in a nutshell and that's how sociologists use it okay so hopefully you're starting to get an idea of that even the way we practice medicine has changed I mean we used to have home visits we used to go to the doctor that probably gave you know helped uh birth us and then while we were growing up and then in our young hood and then probably birthed our kids you know before they retired or passed on um and then we got really distant really distance where um the best medical care is very clinical and very cold and so forth well we're starting to realize and including not only from people that work in the area of medicine but also because of sociologists that the mind the emotions the body are all interconnected when people are stressed out their health suffers when people feel scared their health suffers their blood pressure Rockets up their their immune system doesn't function properly and so the whole medical field starting to change and to really focus on as I said earlier view the person in a holistic sense kind of the same way social soldiers view health and Health Care look at treating the entirety of the person so today instead of just simply hi what are your symptoms what can I help you with oh well I've had the sniffles I've had a sore throat okay well perhaps maybe some more just for some vitamin C get plenty of fluids get rest come see me if things get worse now it could be where did you go how often you get sunlight how often do you exercise what what's your diet like what are all these do you have allergies let's look at that possibility is you know a response immune system responds to the environment that you're living in and so forth I mean people used to move to the valley here to get away from allergies now we've brought in so many other plants and that aren't indigenous to this area and so much other uh pollution because of the growth of this city now we're one of the allergy hubs it's not because the desert itself changed we changed it so we look at change we look at the entirety of that person in medicine how how is that person's interaction with your environment how what is today being different from yesterday what is the exercise et cetera et cetera and then we've also kind of started to view patients as people I remember when I was younger and I'm not that old but um when I was younger I would go into the doctor and they wouldn't even look up from the chart I was just a number on a chart a name on a chart they would even look at me it's hi how you doing today what can I do for you and this would be a doctor that I've been to for like three four years hey what can I do for you okay great great because they thought that distance was a good thing but how do they treat the entirety of a person if they don't even look up today you'll notice a lot more they'll come in and they'll be looking at your Charter they'll look at it really quickly to see just the last little bit of your history to kind of get them caught up on you because they see a lot of people it's a tough job and then they set it down and they look you in the eye and say hi why are you here today or they remember who you are you know my primary care physician Knows My Name knows that I have kids we've talked about his kids you know but I've been going to them for a number of years and it helps with the PHD kind of treats me like a peer but he also treats everybody else in his office very much the same way that the environment has changed you notice it isn't all just Stark and white walls and clinical and sterile and everything else you know I mean of course we still have that in an operating Arena however doctors offices have Bays they have artwork on the walls you got a little TV there because they found that people's blood pressure comes down people are nervous to go in someplace and then the nurse takes your blood pressure it's going to be higher than if you're calm and you're relaxed let's get a resting heart rate let's get what it would be like if you were in your home did you know that home visits are starting back up again with doctors and I'm not talking about just simply online I'm talking about physical doctor well not right now with everything that's going on but overarchingly you know coronavirus period notwithstanding there were more doctors that were starting to home visits again because that's where people are more comfortable in the past as well doctors actually really kind of frowned on on patients thinking they knew something or or coming in and self-diagnosing and no doubt let me do my job you know and they have that kind of God complex today with so many patients and health insurance such as hmos Health Management organizations that have really taken over the healthcare health insurance limit how much they're going to be paid per patient and so oftentimes they only have two to three minutes per patient because the requirements and and the quotas that they have to get through to maintain their standing with Medicare Medicaid or or other forms of welfare insurance providers and so forth otherwise they're dropped so they actually really really strongly prefer somebody that that is at least aware of what their symptoms are instead of coming in and say well last night I was over my friend Jenny's and then about 10 o'clock I said well no first at about seven o'clock we had dinner well no before we had that we had Drake you know who doesn't have time for all that so they're actually favoring a person that will come in and say well last night I was at my friend's Jenny's for dinner about 10 o'clock I got my first symptoms so my obsessed stomach about 11 o'clock I went in the bathroom and I threw up by one in the morning I felt like I was gonna die and it was coming out both sides not to be gross the doctor is going to appreciate that because they're really what they're doing is listening to Keith terms they're not going to know Jenny and and what time you in and who you met up with and everything else they're listening for those key terms well an informed patient not trying to self-diagnose and I know what I have but understands what they have can put it into key terminology they appreciate you going to see the doctor you should have a list of this is what time this is what time this is what time this is what time and a list of your symptoms they will appreciate that today versus in the past you're usurping their Authority that's a shift in practicing medicine and just simply a much more personalized uh treatment as I said with the artwork and the walls calming I'll never forget uh being in the birthing center for my first child before my son was born and I walked into the the birth room you know thinking it was going to be like you know pull the curtain and you got those lines of women and ah you know and all this stuff you know um like when I was a kid and I was born nah it was like walking into a living room with a bed there's a couch there's a coffee table there's a TV on the wall there's a little kitchen that there was a bathroom and we weren't you know high on the list I didn't have great health insurance I had the bare minimum health insurance and there was this bed here and then when it came time for my wife at the time to give birth the wall opened up to turn into Transformer room and all the equipment came out of the wall and out of the bed and disturbs came up and she gave birth within five minutes after giving well maybe ten it just felt fast because I'm looking at my kid and holding my brand new kid um but as soon as the baby was born within about 10 minutes and they take my son off for the apgar test and everything it'll look like a living room again and there's my wife with all the you know change clothes or the with a blanket over her just like I just gave birth and fortunately it was a very fast delivery but it was like oh my God you know because they found that birth mothers in an environment like that are more likely to recover a recover recuperate so quickly that they're out within 24 hours and they go home instead of the typical three day stay in the hospital that it used to be I mean it used to be like a major medical procedure to give birth not that it isn't for some people but just that calmness that that support structure that they have there that or that has a big impact and the ability to provide medicine so that's been a huge shift why because we understand the social implications of medicine not just the medicine itself because we're not saying the medicine doesn't exist how we give medicine how we treat somebody that has much of as much importance as the treatment itself in some in some instances now when it comes to health insurance I've mentioned it a few times I'm not gonna try to explain every single but you get a little a lot of misinformation out there uh particularly in the United States where we're screaming about socialized medicine socialized medicine it's gonna create socialism and so forth and so on no it is a socialized program and yes even societies that are free-market economies such as Denmark have socialized medicine their people get the king of Denmark came to Harvard University Harvard to correct Harvard students that they weren't a socialist society they are a free market economy that has more social programs than what we do and so we're one of the few industrialized Societies in the United States right or wrong that does not have socialized medicine wait don't we have Medicare Medicaid that is socialized medicine we already have it and you know but socialized for all becomes the whole argument and everything else um and I'm not going to get in and try to solve that argument or or both sides you can look that up for yourself we have what's called basically a two-tiered system okay so two tiered simply means that you have government provided health insurance for those that can't afford it we have public uh that is the public health insurance then we have Private health insurance as well now the most most majority of the people in the United States have Private health insurance about 85 percent have at least access to Private health insurance and about 35 percent there is a little overlap that's why the numbers don't add up to 100 folks there is a little overlap because sometimes the health insurance that a person has is so minimalistic that they're also supplemented by Medicaid sometimes people while they're still on the job but they qualify for Medicare have a little bit of an overlap between Medicare and their other insurances where they have two Insurance spots set primary Insurance to secondary insurance on you know your doctor's forms things like that so that's why there's a little bit of an overlap there two-tiered simply means that it's not one or the other a single-tiered or single-payer system is when the government pays for predominantly all the health care necessity all right so if you can get by without having a secondary or Private health insurance that the government pays for it or what we would call in the United States socialized medicine that's a single-payer single tier system we really don't use single tiered we just use single-payer and then you may hear two-tiered or two-payer system two parents have thrown people though so we say two-tiered private and public okay United States is two-tiered China for example um is basically single-payer Because unless you're very very wealthy and can access some other health care or privatized Health Care everybody has access to health care social reunion uh the Russian now um has has uh unilateral health care but again they're starting to get access to if you can afford it to Private health care interestingly enough is these societies become more industrialized privatized Health Care starts to rise up which is an Essence part of capitalistic free market economies um Sweden has uh compulsory health care for everybody Great Britain has health care for everybody Canada has health care for everybody Japan has health care for everybody however doctors in Japan operate privately in Sweden in Great Britain and Canada you can also buy private insurance so it is a Single Payer everybody has the basics but if you need more or you want more or can afford more or like in Canada sometimes there's a wait for certain procedures but if you have private insurance then you go to a private hospital and you don't have to wait but everybody single pair means everybody has at least the basic health care provided for um we in the United States don't have that again I'm not going to get into right wrong but there's a lot of misunderstanding about what that is and they think oh because we have socialized medicine I mean Germany has socialized medicine and yet they're a free market economy um Great Britain is a free market economy but they have a lot more social programs and so you hear all that argument between you know capitalism and socialism that you looked at previously similar fact is you're almost always going to have a mix of the two people who say the United States doesn't well then we wouldn't have Medicaid and Medicare oh and uh public education that's the social program oh yeah and the fire uh uh firefighters and police officers that socialized protection um you know we have a lot more social in this country and I'm not sociologists are not a big believer because you'll never have a fully socialist society it's virtually impossible you can't because it it as I said in the earlier lectures you reduce any any um and I'm kind of going back to that a little bit just for your own knowledge it reduces any incentive you know if everybody gets paid the same amount why would somebody go to school to become a doctor if they're going to make the same as a bus driver I talked about this in class before this whole Corona thing um but at the same time you're always going to have those that need taken care of okay even in a fully capitalistic Society can't just say oh some of our populists is going to die if they get sick there are some people like the elderly or the invalid or somebody who's disabled or challenged or something like that that is or the children they can't provide for themselves so you're going to need some social programs it's it's inevitable so you're never going to have all of one or the other okay um at least according to Sociology at any rate I digress I'm going off a little bit of a tangent there hopefully been following this lecture today