health care policy chapter 11. social welfare policy and social programs: a values perspective, by...

Health Care Policy

Chapter 11

Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth SegalCopyright 2007, Brooks/Cole, a division of Thomson Higher Education

Early Health Care

Historically, health care initiatives centered around public health and sanitation

Public legislation to provide for health care was slow in coming, and was not legislated nationally until the Social Security Act of 1935

Early efforts were meager, and it was not until 1965 and passage of MEDICARE and MEDICAID that the federal government was involved in health care policy


Health Insurance Coverage

Most health insurance coverage is through employment, with government programs available to people who are poor and the elderly

In 2004, 45.8 million people lacked health insurance coverage


Mental Health Care

Although often treated separately, mental health care is an important part of health care policy in the U.S.

Early care was primarily in the home, or in almshouses when families were destitute

State institutions were developed in the mid-1880s


By 1946 the federal government became involved through creation of the National Institute of Mental Health

Passage of the Community Mental Health Centers Act in 1963 was meant to provide treatment and services within communities


Major Health Programs

Medicare

The largest health care program, part of the social insurance system, designed for people eligible to receive Social Security benefits


Medicaid

Medical care and services for low-income individuals, mandated by the Social Security Act in 1965

While Medicaid covers poor families and children, almost 70% of costs are for elderly people and people with disabilities


SCHIP

State Children’s Health Insurance Program, enacted in 1997, provides funds for uninsured children in families whose incomes are too high to qualify for Medicaid, but below 200% of poverty level


Immunization

Preventive services for children Guard against childhood diseases such

as measles, mumps, pertussis, rubella and polio

$1 saves $16 in medical care that would be needed if such diseases were not prevented


Other Services

Disability Insurance – part of Social Security program, covers those who paid in

Supplemental Security Income – disability benefits for low-income people


Community Mental Health Centers

Provide care for people with mental illness

Goal is to keep people in their communities, without institutionalization

While centers provide needed services, many go untreated due to shortages of resources and underfunding of the policy


Critical Issues in Health Care Today

Lack of health insurance coverage

High cost of medical care

Emerging health concerns HIV/AIDS Substance abuse Alzheimer’s disease Diabetes

health care policy chapter 11. social welfare policy and social programs: a values perspective, by...

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