Politics of Medicaid

ISBN-10: 0231150601

ISBN-13: 9780231150606

Edition: 2010

Authors: Laura Katz Olson

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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 and has become a formidable force of its own. Funded jointly by the national government and the states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every participating state, most notably with regard to nursing home coverage.Laura Katz Olson, a longtime 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 plan. 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 that have woven themselves into the program and are instrumental both in fostering its swelling costs and holding elected officials hostage to their demands. Addressing such fundamental questions as whether patients receive good care or whether Medicaid truly meets the needs of the population it supposedly serves, Olson evaluates the true extent to which this program has advanced health care in the United States.
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Book details

List price: $37.95
Copyright year: 2010
Publisher: Columbia University Press
Publication date: 6/22/2010
Binding: Hardcover
Pages: 416
Size: 6.25" wide x 9.25" long x 1.00" tall
Weight: 1.628

Introduction: The Medicaid Story
The Political Economy of Welfare Medicine
Devolution of Power
The (Many) Hands in the Till
The Disregarded Stakeholders: Low-Income Households
Social Location: Gender and Race
Public Opinion and Partisan Politics
Overview and Organization of the Book
The Launching of Medicaid: 1965 to 1980
National Health Care: Early Failures
The Social Security Amendments of 1965: Medicare and Medicaid
Medicaid: More Than a Welfare Program?
Cost Shifting: Paying Welfare Medicine's Bill
Stemming the Cash Flow
National Health Care Strikes Again
Reimbursement and Provider Participation
The Powerful Stakeholders
Combating Fraud
Quality of Care
Conclusion: Emerging Questions
From Reagan to Clinton: The Low-Income Health Program on Trial
Welfare Medicine on the Defensive
Congress, Mandates, and Expansionary Politics
Devolution: Fiscal Crisis in the States
The States Strike Back
Confrontation: The Emergence of the "New Right"
The End of Welfare as We Know It
Resumption of Expansionary Medicaid Politics
Conclusion: The Ebb and Flow of Welfare Medicine
Welfare Medicine in the Twenty-first Century
Destabilizing Medicaid
Welfare Medicine in the States
Expanding Coverage
Dismantling the Program
Children First
Conclusion: Smokescreens and Mirrors
Better Than Nothing? Who Gets What, When, How, and Where
Who Is Covered: Barriers to Participation
Impediments to Obtaining Services
Restricted Benefit Packages
Welfare Medicine: Universal Problem Solver
Conclusion: Good Enough?
Long-Term Care: Medicaid's Eight-Hundred-Pound Gorilla
Long-Term Care in the United States
The Middle Class as Stakeholders
The Growth of Home- and Community-Based Services
Hidden Costs: Informal Caregivers
D�j� Vu: Counting on the Marketplace
Conclusion: Reckoning with Long-Term Care
Quality of Care: Does Welfare Medicine Measure Up?
Second-Rate Care
Skimping on Services: Managed Care
Serving Frail Elders and the Disabled
Gaming the System
Program Integrity
Conclusion: Disregarding the Poor
The Energizer Bunny: Medicaid and the Health Economy
The Medicaid Medical Industrial Complex
Economic Engine for the States
Conclusion: Stakeholders and Welfare Medicine
The Buck Stops Where?
Tug-of-War: Paying the Bill
Medicare and Welfare Medicine
Combat Within and Among the States
Encumbering the Poor
Dodging Responsibility: The Private Sector
Conclusion: Paying the Bill
Conclusion: Medicaid and the Future of Health Care in the United States
Welfare Medicine: Promise and Performance
Devolution: The Fiscal and Political Incapacity of States
The U.S. Health Care System: Broken and Dysfunctional
If It's Broke, Fix It: The Need for National Health Care
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