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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.
Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.
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.
The contemporary American political landscape has been marked by two paradoxical transformations: the emergence after 1960 of an increasingly activist state, and the rise of an assertive and politically powerful conservatism that strongly opposes activist government. Leading young scholars take up these issues in The Transformation of American Politics. Arguing that even conservative administrations have become more deeply involved in managing our economy and social choices, they examine why our political system nevertheless has grown divided as never before over the extent to which government should involve itself in our lives. The contributors show how these two closely linked trends have influenced the reform and running of political institutions, patterns of civic engagement, and capacities for partisan mobilization--and fueled ever-heightening conflicts over the contours and reach of public policy. These transformations not only redefined who participates in American politics and how they do so, but altered the substance of political conflicts and the capacities of rival interests to succeed. Representing both an important analysis of American politics and an innovative contribution to the study of long-term political change, this pioneering volume reveals how partisan discourse and the relationship between citizens and their government have been redrawn and complicated by increased government programs. The contributors are Andrea Louise Campbell, Jacob S. Hacker, Nolan McCarty, Suzanne Mettler, Paul Pierson, Theda Skocpol, Mark A. Smith, Steven M. Teles, and Julian E. Zelizer.
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.
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
Winner of the Lillian Smith Book Award Winner of the Los Angeles Times Book Prize Finalist for the National Book Award The Nation's "Most Valuable Book" “[A] vibrant intellectual history of the radical right.”—The Atlantic “This sixty-year campaign to make libertarianism mainstream and eventually take the government itself is at the heart of Democracy in Chains. . . . If you're worried about what all this means for America's future, you should be.”—NPR An explosive exposé of the right’s relentless campaign to eliminate unions, suppress voting, privatize public education, stop action on climate change, and alter the Constitution. Behind today’s headlines of billionaires taking over our government is a secretive political establishment with long, deep, and troubling roots. The capitalist radical right has been working not simply to change who rules, but to fundamentally alter the rules of democratic governance. But billionaires did not launch this movement; a white intellectual in the embattled Jim Crow South did. Democracy in Chains names its true architect—the Nobel Prize-winning political economist James McGill Buchanan—and dissects the operation he and his colleagues designed over six decades to alter every branch of government to disempower the majority. In a brilliant and engrossing narrative, Nancy MacLean shows how Buchanan forged his ideas about government in a last gasp attempt to preserve the white elite’s power in the wake of Brown v. Board of Education. In response to the widening of American democracy, he developed a brilliant, if diabolical, plan to undermine the ability of the majority to use its numbers to level the playing field between the rich and powerful and the rest of us. Corporate donors and their right-wing foundations were only too eager to support Buchanan’s work in teaching others how to divide America into “makers” and “takers.” And when a multibillionaire on a messianic mission to rewrite the social contract of the modern world, Charles Koch, discovered Buchanan, he created a vast, relentless, and multi-armed machine to carry out Buchanan’s strategy. Without Buchanan's ideas and Koch's money, the libertarian right would not have succeeded in its stealth takeover of the Republican Party as a delivery mechanism. Now, with Mike Pence as Vice President, the cause has a longtime loyalist in the White House, not to mention a phalanx of Republicans in the House, the Senate, a majority of state governments, and the courts, all carrying out the plan. That plan includes harsher laws to undermine unions, privatizing everything from schools to health care and Social Security, and keeping as many of us as possible from voting. Based on ten years of unique research, Democracy in Chains tells a chilling story of right-wing academics and big money run amok. This revelatory work of scholarship is also a call to arms to protect the achievements of twentieth-century American self-government.