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The story of Medicaid comes alive for readers in this strong narrative, including detailed accounts of important policy changes and extensive use of interviews. A central theme of the book is that Medicaid is a "weak entitlement," one less established or effectively defended than Medicare or Social Security, but more secure than welfare or food stamps. In their analysis, the authors argue that the future of Medicaid is sound. It has the flexibility to be adapted by states as well as to allow for policy innovation. At the same time, the program lacks an effective mechanism for overall reform. They note Medicaid has become a source of perennial political controversy as it has grown to become the largest health insurance system in the country. The book's dual emphasis on politics and policy is important in making the arcane Medicaid program accessible to readersand in distinguishing policy grounded in analysis from partisan ideology. This second edition features a new preface, three new chapters accounting for the changes to the Affordable Care Act, and an updated glossary.
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. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people. 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 is an appropriate foundation for health care reform.
Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise. Many astute observers of the Medicaid debate have long claimed that “a program for the poor is a poor program� prone to erosion because it serves a stigmatized, politically weak clientele. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system. In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.
This essential guide for libraries, policy makers, and anyone concerned with health care in America has now been fully updated Readers will find updated information on long term health care spending, abortion, Medicaid and Medicare, health insurance and the uninsured, the State Children’s Health Insurance Program (SCHIP), and much, much more. New entries reflect important changes in recent years and include the Medicare Modernization Act, abstinence education, electronic health records, health savings accounts, Plan B, the President’s Emergency Plan for AIDS Relief (PEPFAR), and Project BioShield.
"Medicaid is a big deal. It is the U.S. health insurance safety net for low-income pregnant women and children, but it also affects many people above the poverty line, including disabled people in middle-class families and aged adults who, in an unsettlingly common pattern, live working class or middle class lives but lose all assets during extended nursing home stays. Now that the Affordable Care Act of 2010 (ACA) is implemented, Medicaid also covers many low-income, non-elderly, non-parent adults. The complex world of Medicaid is swirling with questions. What does Medicaid do for people? Why do people tend to support or oppose Medicaid policy? What is it like to be a Medicaid beneficiary? Will social divisions or administrative red tape eventually sink the program, or will it grow? This book helps answer these questions. Each chapter contains insights useful for practitioners and researchers alike. This book is also useful for both beginners and specialists. Each chapter introduces a key issue then takes a deep dive into the most important nooks and crannies of the program. This book also raises new questions. For those interested in answering these questions, the following chapters offer a wide range investigative techniques that future Medicaid researchers could employ. Warning: the work will not be easy. Medicaid is complex and constantly changing. Yet whether readers want to understand ongoing changes or create changes of their own, they are likely to find much of the information they need in the chapters that follow"--
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.
"Medicaid is a big deal. It is the U.S. health insurance safety net for low-income pregnant women and children, but it also affects many people above the poverty line, including disabled people in middle-class families and aged adults who, in an unsettlingly common pattern, live working class or middle class lives but lose all assets during extended nursing home stays. Now that the Affordable Care Act of 2010 (ACA) is implemented, Medicaid also covers many low-income, non-elderly, non-parent adults. The complex world of Medicaid is swirling with questions. What does Medicaid do for people? Why do people tend to support or oppose Medicaid policy? What is it like to be a Medicaid beneficiary? Will social divisions or administrative red tape eventually sink the program, or will it grow? This book helps answer these questions. Each chapter contains insights useful for practitioners and researchers alike. This book is also useful for both beginners and specialists. Each chapter introduces a key issue then takes a deep dive into the most important nooks and crannies of the program. This book also raises new questions. For those interested in answering these questions, the following chapters offer a wide range investigative techniques that future Medicaid researchers could employ. Warning: the work will not be easy. Medicaid is complex and constantly changing. Yet whether readers want to understand ongoing changes or create changes of their own, they are likely to find much of the information they need in the chapters that follow"--
Featuring analysis of healthcare issues and first-person stories, Policy & Politics in Nursing and Health Care helps you develop skills in influencing policy in today’s changing health care environment. 145 expert contributors present a wide range of topics in policies and politics, providing a more complete background than can be found in any other policy textbook on the market. Discussions include the latest updates on conflict management, health economics, lobbying, the use of media, and working with communities for change. The revised reprint includes a new appendix with coverage of the new Affordable Care Act. With these insights and strategies, you’ll be prepared to play a leadership role in the four spheres in which nurses are politically active: the workplace, government, professional organizations, and the community. Up-to-date coverage on the Affordable Care Act in an Appendix new to the revised reprint. Comprehensive coverage of healthcare policies and politics provides a broader understanding of nursing leadership and political activism, as well as complex business and financial issues. Expert authors make up a virtual Nursing Who's Who in healthcare policy, sharing information and personal perspectives gained in the crafting of healthcare policy. Taking Action essays include personal accounts of how nurses have participated in politics and what they have accomplished. Winner of several American Journal of Nursing "Book of the Year" awards! A new Appendix on the Affordable Care Act, its implementation as of mid-2013, and the implications for nursing, is included in the revised reprint. 18 new chapters ensure that you have the most up-to-date information on policy and politics. The latest information and perspectives are provided by nursing leaders who influenced health care reform with the Patient Protection and Affordable Care Act of 2010.
Fully updated in this new edition, Health Care Politics and Policy in America combines a historical overview of U.S. health policy and programs with analysis of current trends and reform efforts. The book -- shows how health policy fits into the larger social, economic, political, and ideological environment of the United States; -- identifies the roles played by both public and private, institutional and individual actors in shaping the health care system at all levels; -- considers the trade-offs inherent in various policy choices and their impacts on different social groups; -- takes account of the dynamic impact of technological change on health care capacities, costs, and ethics. This edition includes expanded discussion of equity issues and whether there is a "right" to health care, and a new chapter on the issue of medical liability. The concluding chapter brings the story of health care policy up to the end of the millennium, with particular attention to the managed care revolution and reaction to it. The book equips readers with the basic tools for drawing more informed judgments in the ongoing debate about health care policy in the United States.
Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.