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Revised papers from the second and third of three conference held in Chicago throughout 1984-1985, and sponsored by the Project on the Federal Social Role. Includes bibliographical references and index.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Comprises 33 papers grouped under five themes: The Nature of social policy; The History of social policy; Social policy and the social services; The Political economy of social policy; and International and future perspectives on social policy.
“Keep your government hands off my Medicare!” Such comments spotlight a central question animating Suzanne Mettler’s provocative and timely book: why are many Americans unaware of government social benefits and so hostile to them in principle, even though they receive them? The Obama administration has been roundly criticized for its inability to convey how much it has accomplished for ordinary citizens. Mettler argues that this difficulty is not merely a failure of communication; rather it is endemic to the formidable presence of the “submerged state.” In recent decades, federal policymakers have increasingly shunned the outright disbursing of benefits to individuals and families and favored instead less visible and more indirect incentives and subsidies, from tax breaks to payments for services to private companies. These submerged policies, Mettler shows, obscure the role of government and exaggerate that of the market. As a result, citizens are unaware not only of the benefits they receive, but of the massive advantages given to powerful interests, such as insurance companies and the financial industry. Neither do they realize that the policies of the submerged state shower their largest benefits on the most affluent Americans, exacerbating inequality. Mettler analyzes three Obama reforms—student aid, tax relief, and health care—to reveal the submerged state and its consequences, demonstrating how structurally difficult it is to enact policy reforms and even to obtain public recognition for achieving them. She concludes with recommendations for reform to help make hidden policies more visible and governance more comprehensible to all Americans. The sad truth is that many American citizens do not know how major social programs work—or even whether they benefit from them. Suzanne Mettler’s important new book will bring government policies back to the surface and encourage citizens to reclaim their voice in the political process.
Federalism and Social Policy focuses on the crucial question: Is a strong and egalitarian welfare state compatible with federalism? In this carefully curated collection, Scott L. Greer, Heather Elliott, and the contributors explore the relationship between decentralization and the welfare state to determine whether or not decentralization has negative consequences for welfare. The contributors examine a variety of federal countries, including Spain, Canada, and the United Kingdom, asking four key questions related to decentralization: (1) Are there regional welfare states (such as Scotland, Minnesota, etc.)? (2) How much variation is there in the structures of federal welfare states? (3) Is federalism bad for welfare? (4) Does austerity recentralize or decentralize welfare states? By focusing on money and policy instead of law and constitutional politics, the volume shows that federalism shapes regional governments and policies even when decentralization exists.
Many social policies of the 1960s and 1970s, designed to overcome poverty and provide a decent standard of living for all Americans, ran into trouble in the 1980s with politicians, with social scientists, and with the American people. Here Nathan Glazer looks back at what went wrong, arguing that our social policies, although targeted effectively on some problems, ignored others that are equally important. Glazer's knowledge and judgment, distilled in this book, will be a source of advice and wisdom for citizens and policymakers alike.
Publisher Description
Social policies can transform the lives of the poor, yet subnational politics and state capacity often inhibit their success.
Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.