America's Health Care Safety Net


Book Description

America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.




America's Health Care Safety Net


Book Description

America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.




A Safety Net That Works


Book Description

This is an edited volume reviewing the major means-tested social programs in the United States. Each author addresses a major program or area, reviewing each area’s successes and recommending how to address shortcomings through policy change. In general, our means-tested programs do many things well, but some adjustments to each could make the system much more effective. This book provides policymakers with a broad overview of the issues at hand in each program and how to address them.




Family Policy and the American Safety Net


Book Description

Family Policy and the American Safety Net shows how families adapt to economic and demographic change. Government programs provide a safety net against the new risks of modern life. Family policy includes any public program that helps families perform their four universal obligations of caregiving, income provision, shelter, and transmission of citizenship. In America, this means that child care, health care, Social Security, unemployment insurance, housing, the quality of neighborhood schools, and anti-discrimination and immigration measures are all key elements of a de facto family policy. Yet many students and citizens are unaware of the history and importance of these programs. This book argues that family policy is as important as economic and defense policy to the future of the nation, a message that is relevant to students in the social sciences, social policy, and social work as well as to the public at large. .




The Safety-Net Health Care System


Book Description

Print+CourseSmart




The Health Care Safety Net in a Post-Reform World


Book Description

The Health Care Safety Net in a Post-Reform World examines how national health care reform will impact safety net programs that serve low-income and uninsured patients. The “safety net” refers to the collection of hospitals, clinics, and doctors who treat disadvantaged people, including those without insurance, regardless of their ability to pay. Despite comprehensive national health care reform, over twenty million people will remain uninsured. And many of those who obtain insurance from reform will continue to face shortages of providers in their communities willing or able to serve them. As the demand for care grows with expanded insurance, so will the pressure on an overstretched safety net. This book, with contributions from leading health care scholars, is the first comprehensive assessment of the safety net in over a decade. Rather than view health insurance and the health care safety net as alternatives to each other, it examines their potential to be complementary aspects of a broader effort to achieve equity and quality in health care access. It also considers whether the safety net can be improved and strengthened to a level that can provide truly universal access, both through expanded insurance and the creation of a well-integrated and reasonably supported network of direct health care access for the uninsured. Seeing safety net institutions as key components of post-health care reform in the United States—as opposed to stop-gap measures or as part of the problem—is a bold idea. And as presented in this volume, it is an idea whose time has come.




America's Children


Book Description

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.




Trapped in America's Safety Net


Book Description

A “remarkable” look at the flaws of the social safety net through one family’s personal tragedy and the Catch-22 financial disaster that followed (Deborah A. Stone, author of Policy Paradox). When Andrea Louise Campbell’s sister-in-law, Marcella Wagner, was run off the freeway by a hit-and-run driver, she was seven-and-a-half months pregnant. She survived—and, miraculously, the baby was born healthy. But that’s where the good news ends. Marcella was left paralyzed from the chest down. This accident was much more than just a physical and emotional tragedy. Like so many Americans, neither Marcella nor her husband, Dave, who worked for a small business, had health insurance. On the day of the accident, she was on her way to class for the nursing program through which she hoped to secure one of the few remaining jobs in the area with the promise of employer-provided insurance. Instead, the accident plunged the young family into the tangled web of means-tested social assistance. As a social policy scholar, Campbell thought she knew a lot about means-tested assistance programs. What she quickly learned was that missing from most government manuals and scholarly analyses was an understanding of how these programs actually affect the lives of the people who depend on them. Using Marcella and Dave’s situation as a case in point, she reveals the programs’ shortcomings in this book. Because American safety net programs are designed for the poor, the couple first had to spend down their assets and drop their income to near-poverty level before qualifying for help. What’s more, to remain eligible, they’ll have to stay under these strictures for the rest of their lives, barred from doing many of the things middle-class families are encouraged to do: Save for retirement. Build an emergency fund. Take advantage of tax-free college savings. And, while Marcella and Dave’s story is tragic, the financial precariousness they endured even before the accident is all too common in America, where the prevalence of low-income work and unequal access to education have generated vast—and growing—economic inequality. The implementation of the ACA has cut the number of uninsured and underinsured and reduced some disparities in coverage, but continues to leave too many people open to tremendous risk. Behind the statistics and beyond the ideological battles are human beings whose lives are stunted by policies that purport to help them. In showing how and why this happens, Trapped in America’s Safety Net offers a way to change it. “An engaging narrative account of how social assistance programs shape real people’s lives. Campbell is authoritative and scholarly, yet warm and personal—a rare combination one sees in the likes of Oliver Sacks and Barbara Ehrenreich.” —Deborah A. Stone, author of Policy Paradox “Makes a compelling case for a stronger, more integrated, and ultimately more effective strategy for helping the millions of Americans who find themselves plummeting out of the insecure middle class.” —Jacob S. Hacker, New York Times–bestselling coauthor of Winner-Take-All Politics




Health Care Off the Books


Book Description

Millions of low-income African Americans in the United States lack access to health care. How do they treat their health care problems? In Health Care Off the Books, Danielle T. Raudenbush provides an answer that challenges public perceptions and prior scholarly work. Informed by three and a half years of fieldwork in a public housing development, Raudenbush shows how residents who face obstacles to health care gain access to pharmaceutical drugs, medical equipment, physician reference manuals, and insurance cards by mobilizing social networks that include not only their neighbors but also local physicians. However, membership in these social networks is not universal, and some residents are forced to turn to a robust street market to obtain medicine. For others, health problems simply go untreated. Raudenbush reconceptualizes U.S. health care as a formal-informal hybrid system and explains why many residents who do have access to health services also turn to informal strategies to treat their health problems. While the practices described in the book may at times be beneficial to people’s health, they also have the potential to do serious harm. By understanding this hybrid system, we can evaluate its effects and gain new insight into the sources of social and racial disparities in health outcomes.




The American Health Care Paradox


Book Description

Considers why U.S. society is believed to be less healthy in spite of disproportionate spending on health care, identifying a lack of social services, outdated care allocations, and a resistance to government programs as the problem.