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Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.
America's Children is a comprehensive, easy-to-read analysis of the relationship between health insurance and access to care. The book addresses three broad questions: How is children's health care currently financed? Does insurance equal access to care? How should the nation address the health needs of this vulnerable population? America's Children explores the changing role of Medicaid under managed care; state-initiated and private sector children's insurance programs; specific effects of insurance status on the care children receive; and the impact of chronic medical conditions and special health care needs. It also examines the status of "safety net" health providers, including community health centers, children's hospitals, school-based health centers, and others and reviews the changing patterns of coverage and tax policy options to increase coverage of private-sector, employer-based health insurance. In response to growing public concerns about uninsured children, last year Congress voted to provide $24 billion over five years for new state insurance initiatives. This volume will serve as a primer for concerned federal policymakers and regulators, state agency officials, health plan decisionmakers, health care providers, children's health advocates, and researchers.
Tobacco control leaders were extremely proud of the movement's achievements in the state of Minnesota. In sharing their perspectives and experiences with Mark Wolfson, they found a way of making sure that the story would get told. His training in social movements had given him an appreciation of the importance of understanding the social infrastructure on which movements are built, and Minnesota had built heavily on the infrastructure of health care and public health. What became apparent is that the struggle against the tobacco industry in Minnesota involved a close, collaborative relationship between government (or "state") actors and the leaders of the tobacco control movement. Wolfson develops both of these themes: building on the infrastructure of health, and state-movement interpenetration, to understand the emergence, growth, and outcomes of the tobacco control movement in Minnesota. He focuses on the advantages and constraints associated with these two related themes. He goes beyond the case study method to assess the generalizability of the pattern, and whether the same sort of movement can be used by other states in North America, and even in other countries and their social movements. How has the tobacco control movement become such a significant and successful force in shaping public policy, social norms, and the habits of millions of Americans? In this first such detailed study by a sociologist, Wolfson documents how the movement has grown over nearly three decades by building an infrastructure of health organizations and health professionals, and by fostering relationships with government. Rich in survey data, extensive interviews, and archival sources, this text is essential reading for courses in social problems, social movements, and public health. The general reader will also find it engaging, given the issues of tobacco use as an addiction and a social problem.