Poor People s Medicine

Author: Jonathan Engel
Publisher: Duke University Press
ISBN: 0822387638
Format: PDF
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Poor People’s Medicine is a detailed history of Medicaid since its beginning in 1965. Federally aided and state-operated, Medicaid is the single most important source of medical care for the poorest citizens of the United States. From acute hospitalization to long-term nursing-home care, the nation’s Medicaid programs pay virtually the entire cost of physician treatment, medical equipment, and prescription pharmaceuticals for the millions of Americans who fall within government-mandated eligibility guidelines. The product of four decades of contention over the role of government in the provision of health care, some of today’s Medicaid programs are equal to private health plans in offering coordinated, high-quality medical care, while others offer little more than bare-bones coverage to their impoverished beneficiaries. Starting with a brief overview of the history of charity medical care, Jonathan Engel presents the debates surrounding Medicaid’s creation and the compromises struck to allow federal funding of the nascent programs. He traces the development of Medicaid through the decades, as various states attempted to both enlarge the programs and more finely tailor them to their intended targets. At the same time, he describes how these new programs affected existing institutions and initiatives such as public hospitals, community clinics, and private pro bono clinical efforts. Along the way, Engel recounts the many political battles waged over Medicaid, particularly in relation to larger discussions about comprehensive health care and social welfare reform. Poor People’s Medicine is an invaluable resource for understanding the evolution and present state of programs to deliver health care to America’s poor.

The Politics of Medicaid

Author: Laura Katz Olson
Publisher: Columbia University Press
ISBN: 0231521596
Format: PDF, Mobi
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In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state, most notably with regard to nursing home coverage. Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program has advanced health care in the nation.

The Political Life of Medicare

Author: Jonathan Oberlander
Publisher: University of Chicago Press
ISBN: 9780226615967
Format: PDF, ePub, Docs
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In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.

American Therapy

Author: Jonathan Engel
Publisher: Penguin
ISBN: 1440629781
Format: PDF
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From Freud to Zoloft, the first comprehensive history of American Psychotherapy Fifty percent of Americans will undergo some form of psychotherapy in their lifetimes, but the origins of the field are rarely known to patients. Yet the story of psychotherapy in America brims with colorful characters, intriguing experimental treatments, and intense debates within this community of healers. American Therapy begins, as psychotherapy itself does, with the monumental figure of Sigmund Freud. The book outlines the basics of Freudian theory and discusses the peculiarly powerful influence of Freud on the world of American mental health. The book moves through the emergence of group therapy, the rise of psychosurgery, the evolution of uniquely American therapies such as Gestalt, rebirthing, and primal scream therapy, and concludes with the modern world of psychopharmacology, cognitive-behavioral therapy, and highly targeted short-term therapies. For a counseled nation that freely uses terms such as “emotional baggage” and no longer stigmatizes mental health care, American Therapy is a remarkable history of an extraordinary enterprise.

Boomerang

Author: Theda Skocpol
Publisher: W. W. Norton & Company
ISBN: 9780393315721
Format: PDF, ePub, Docs
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How did the debate on health reform turn into the most concerted attack on government in recent American history?

The Transformation of American Liberalism

Author: George Klosko
Publisher: Oxford University Press
ISBN: 0199973423
Format: PDF, ePub
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With the passage of the Social Security Act in 1935, the US government ushered in a new era of social welfare policies, to counteract the devastation of The Great Depression. While political philosophers generally view the welfare state to be built on values of equality and human dignity, America's politicians, beginning with Franklin D. Roosevelt, argued on different grounds. From the beginning, Roosevelt based his defense of the welfare state on the individualist, or Lockean premises inherent in America's political culture. As a result, he not only encouraged the United States' commitment to individualism, but also contributed to distinctively harsh American stigmatization of welfare recipients. In The Transformation of American Liberalism, George Klosko explores how American political leaders have justified social welfare programs since the 1930s, ultimately showing how their arguments have contributed to notably ungenerous programs. Students of political theory note the evolution of liberal political theory between its origins and major contemporary theorists who justify the values and social policies of the welfare state. But the transformation of liberalism in American political culture is incomplete. Individualist values and beliefs have exerted a continuing hold on America's leaders, constraining their justificatory arguments. The paradoxical result may be described as continuing attempts to justify new social programs without acknowledging incompatibility between the arguments necessary to do so and American culture's individualist assumptions. An important reason for the striking absence of strong and widely recognized arguments for social welfare programs in American political culture is that its political leaders did not provide them.

Caring for America

Author: Eileen Boris
Publisher: Oxford University Press
ISBN: 0199939055
Format: PDF, ePub, Docs
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In this sweeping narrative history from the Great Depression of the 1930s to the Great Recession of today, Caring for America rethinks both the history of the American welfare state from the perspective of care work and chronicles how home care workers eventually became one of the most vibrant forces in the American labor movement. Eileen Boris and Jennifer Klein demonstrate the ways in which law and social policy made home care a low-waged job that was stigmatized as welfare and relegated to the bottom of the medical hierarchy. For decades, these front-line caregivers labored in the shadows of a welfare state that shaped the conditions of the occupation. Disparate, often chaotic programs for home care, which allowed needy, elderly, and disabled people to avoid institutionalization, historically paid poverty wages to the African American and immigrant women who constituted the majority of the labor force. Yet policymakers and welfare administrators linked discourses of dependence and independence-claiming that such jobs would end clients' and workers' "dependence" on the state and provide a ticket to economic independence. The history of home care illuminates the fractured evolution of the modern American welfare state since the New Deal and its race, gender, and class fissures. It reveals why there is no adequate long-term care in America. Caring for America is much more than a history of social policy, however; it is also about a powerful contemporary social movement. At the front and center of the narrative are the workers-poor women of color-who have challenged the racial, social, and economic stigmas embedded in the system. Caring for America traces the intertwined, sometimes conflicting search of care providers and receivers for dignity, self-determination, and security. It highlights the senior citizen and independent living movements; the civil rights organizing of women on welfare and domestic workers; the battles of public sector unions; and the unionization of health and service workers. It rethinks the strategies of the U.S. labor movement in terms of a growing care work economy. Finally, it makes a powerful argument that care is a basic right for all and that care work merits a living wage.

Medicare and Medicaid at 50

Author: Alan B. Cohen
Publisher: Oxford University Press, USA
ISBN: 0190231548
Format: PDF, ePub, Mobi
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For fifty years, Medicare and Medicaid have stood at the center of a contentious debate surrounding American government, citizenship, and health care entitlement. In Medicare and Medicaid at 50, leading scholars in politics, government, economics, health policy, and history offer a comprehensive assessment of the evolution of these programs and their impact on society -- from their origins in the Great Society era to the current battles over the Affordable Care Act ("Obamacare"). These highly accessible essays examine Medicare and Medicaid from their origins as programs for the elderly and poor to their later role as a safety net for the middle class. Along the way, they have served as touchstones for heated debates about economics, social welfare, and the role of government. Medicare and Medicaid at 50 addresses key questions for understanding the past and future of health policy in America, including: · What were the origins for these initiatives, and how were they transformed over time? · What marks have Medicare and Medicaid left on society? · In what ways have these programs produced innovation, even in eras of retrenchment? · How did Medicaid, once regarded as a poor person's program, expand its benefits and coverage over the decades to become the platform for the ACA's future expansion? The volume's contributors go on to examine the powerful role of courts in these transformations, along with the shifting roles of Congress, public opinion, and state governors in the programs' ongoing evolution. From Lyndon Johnson to Barack Obama on the left, and from Ronald Reagan to George W. Bush on the right, American political leaders have tied their political fortunes to the fate of America's entitlement programs; Medicare and Medicaid at 50 helps explain why, and how those ongoing debates are likely to shape the future of the Affordable Care Act.

Changing Poverty Changing Policies

Author: Maria Cancian
Publisher: Russell Sage Foundation
ISBN: 1610445988
Format: PDF, Kindle
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Poverty declined significantly in the decade after Lyndon Johnson’s 1964 declaration of “War on Poverty.” Dramatically increased federal funding for education and training programs, social security benefits, other income support programs, and a growing economy reduced poverty and raised expectations that income poverty could be eliminated within a generation. Yet the official poverty rate has never fallen below its 1973 level and remains higher than the rates in many other advanced economies. In this book, editors Maria Cancian and Sheldon Danziger and leading poverty researchers assess why the War on Poverty was not won and analyze the most promising strategies to reduce poverty in the twenty-first century economy. Changing Poverty, Changing Policies documents how economic, social, demographic, and public policy changes since the early 1970s have altered who is poor and where antipoverty initiatives have kept pace or fallen behind. Part I shows that little progress has been made in reducing poverty, except among the elderly, in the last three decades. The chapters examine how changing labor market opportunities for less-educated workers have increased their risk of poverty (Rebecca Blank), and how family structure changes (Maria Cancian and Deborah Reed) and immigration have affected poverty (Steven Raphael and Eugene Smolensky). Part II assesses the ways childhood poverty influences adult outcomes. Markus Jäntti finds that poor American children are more likely to be poor adults than are children in many other industrialized countries. Part III focuses on current antipoverty policies and possible alternatives. Jane Waldfogel demonstrates that policies in other countries—such as sick leave, subsidized child care, and schedule flexibility—help low-wage parents better balance work and family responsibilities. Part IV considers how rethinking and redefining poverty might take antipoverty policies in new directions. Mary Jo Bane assesses the politics of poverty since the 1996 welfare reform act. Robert Haveman argues that income-based poverty measures should be expanded, as they have been in Europe, to include social exclusion and multiple dimensions of material hardships. Changing Poverty, Changing Policies shows that thoughtful policy reforms can reduce poverty and promote opportunities for poor workers and their families. The authors’ focus on pragmatic measures that have real possibilities of being implemented in the United States not only provides vital knowledge about what works but real hope for change.

The Economics of Medicaid

Author: Jason J. Fichtner
Publisher: Mercatus Center at George Mason University
ISBN: 0989219364
Format: PDF, ePub, Mobi
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Medicaid, originally considered an afterthought to Medicare, is today the largest health insurance provider in the United States. Under the Affordable Care Act, the Congressional Budget Office projects Medicaid enrollment to increase nearly 30 percent by 2024 and federal spending on the program to double over the next decade. For the states, Medicaid is already the largest single budget item, and its rapid growth threatens to further crowd out other spending priorities. In this collection of essays published by the Mercatus Center at George Mason University, nine experts discuss the escalating costs and consequences of a program that provides second-class health care at first-class costs. The authors begin with an explanation of Medicaid’s complex state-federal funding structure. Next, they examine how the system’s conflicting incentives discourage both cost savings and efficient care. The final chapters address the pros and cons of the most mainstream Medicaid reform proposals and offer alternative solutions. This book offers a timely assessment of how Medicaid works, its most problematic components, and how—or if—its current structure can be adequately reformed to provide quality care for those in need at sustainable costs. Contributors include: Joseph Antos, American Enterprise Institute Charles Blahous, Mercatus Center at George Mason University Darcy Nikol Bryan, MD, practicing physician James C. Capretta, Ethics and Public Policy Center Robert F. Graboyes, Mercatus Center at George Mason University June O’Neill, Baruch College, CUNY Nina Owcharenko, Heritage Foundation Thomas Miller, American Enterprise Institute