CHAPTER 19 NOTES
About __16_%of America’s GDP is currently spent on Health Care
today 2013____20%___
2007 Average American spent __6__ % of its income on health Care.
Elderly and poor spent _10__ % of its income on health Care.
2007 Over _60__% of all personal bankruptcies were attributed to medical costs!
Most Americans are one diagnosis away from financial collapse.
The uninsured about __16__% --46 million
Pre Existing Conditions---lead to denial of coverage!!!!
Cancer, diabetes, overweight babies!!, acne, bunions, allergies, toenail fungus
PUBLIC POLICY: a general plan of action adopted by the government to solve a social problem, counter a threat, or pursue an objective.
This chapter focuses on: Social Security, Public Assistance, health care, education and immigration.
The above make up more than ___1__/__2___ of the national budget.
DEVELOPMENT of the AMERICAN WELFARE STATE:
I. The promotion of individual welfare through government policies is controversial
because it requires government to choose between freedom and equality.
A Recent History- social welfare expenditures have _INCREASED_ steadily in
order to provide ___MINIMUM____ living standards for
all citizens.
*__ELDERLY_____ are the principal beneficiaries
1) Great Depression- prime example
a. market forces could not help this economic decline
2) The NEW DEAL- policies to remedy the effects of the depression
(supposed to be __SHORT TERM_____ relief)
A. Composed of 2 phases
1. BOOST FARM PRICES & LOWER UNEMPLOYMENT
2. Help the Forgotten & Dispossessed / give aid to the poor
*Social Security was the Hallmark of this 2nd phase
B. The New Deal brought about a confrontation between
Democrats & Conservatives
FDR tries to “___PACK THE COURT____” add
more to the nine already there
C. Americans closely divided over New Deal policies, until those
policies become the status quo, then they grew satisfied with them
D. Poverty and unemployment remains until WWII despite
New Deal policies
*by 1939 __17%____ of the workforce was still unemployed
E. GREAT SOCIETY
programs by LBJ to redress political, social and economic inequality
a. increase educational opportunities
b. eliminate all voting restrictions
Elementary & Secondary Educational Act of 1965 was based on
the # of low income families
c. Jobs created to eliminate poverty by providing training, education,
& jobs
(__VISTA & HEAD START______)
WAR ON POVERTY- eradicate poverty in ___10__ years
POVERTY in 1964 was at 19%!
The $ ends when we go into Vietnam
By meeting minimum needs, government welfare policies
__ATTEMPT___ to promote __EQUALITY__.
President_REAGAN___ shifted emphasis in social welfare policy
from economic equality to economic _FREEDOM__.
- He kept some core _NEW DEAL____ Programs
but proposed sharp __CUTS__ in others.
- Many of the _GREAT SOCIETY____ Programs remain
in force, but the overall level of welfare spending has
declined.
President George H.W. Bush continued Reagan’s policies
1990’s produce REFORM to the American Welfare System.
President Clinton & the Republican Controlled Congress under
House leadership of Speaker Gingrich reformed welfare.
AFDC- Aid to families with Dependent Children
Reformed by TANF- TEMPORARY Assistance to Needy Families
President George W. Bush led the GREATEST Expansion of
Welfare benefits to the elderly with the passage of
Medicare Part D!
President Obama and the Democratic congress pass the
Affordable Care Act and it is found to be Constitutional by the
Supreme Court in the Summer of 2012.
Now states are opting In or Out of the Law.
- Social Insurance
Provided by the government to protect individuals against loss,
Without regard to _NEED____/___ECONOMIC STATUS__.
examples: _WORKMAN’S COMPENSATION / MEDICARE_
____SOCIAL SECURITY____ provides economic assistance to persons faced with:
- _DISABILITY____2. _UNEMPLOYMENT_
3. _OLD AGE__
Social Security is an ENTITLEMENT Program:
_Every person has a legal right to them__
Entitlement Programs consume about _1/2_ of every
dollar of government spending.
Social Security Act 1935
- provided social insurance in the form of
_Old Age & Survivor__ benefits
- __Unemployment____ insurance
3. aid to the destitute (needy families with dependent children,
the blind and permanently & totally disabled.)
1990’s4. disabled children & _Orphans____ &
vocational rehabilitation for the disabled
Social Security has expanded considerably since the 1930’s.
In 1995 it became an _Independent Government Agency!!!!!___
Full benefits now go to _67__ year olds!
The Federal Government collects taxes from employers &
__employees____ to pay benefits to persons
who are _retiring___. PAY AS YOU GO TAX!
a. is NOT a form of _SAVINGS__
b. Participation is _COMPULSORY____
c. Declining _Birth Rates_____ or
__Economic_____ depression could endanger the
benefits now scheduled to be paid to future retirees
The political system must address the issues of who pays and who
___benefits___ from social security.
By 2003 two workers will cover one beneficiary.
It used to be a lot more than that.
Annual Cost of Living Adjustments ( _COLA__) granted
by Congress _increases__ the benefits received by retirees.
2005= __2.7___%
- " _Stagflation___" during the __70__'s
meant increased social security benefits and a smaller
revenue base
- In 1983, Congress and President Reagan _increased___
Social security taxes and _reduced___ benefits
to guarantee the viability of the S.S. system in the future.
- The political risks associated with _cutbacks___
are too great to expect a major change in the way
social security works.
"Don't mess with grandma, or she won’t vote for you!"
*Reforms for Social Security have not been accepted by most Americans
In 2005 President Bush’s Social Security reform plans were not
accepted by most American-especially the _AARP___.
- _Public Assistance___ is government aid to individuals
who can demonstrate a need for that aid. It is directed toward those who lack the ability or resources to provide for themselves or their family.
Public Assistance is also known today as _Categorical Assistance_____
__Programs_.
A. They include:
1)Old age assistance for the elderly not covered by social security
2) Aid to the needy- _Blind___
3) Aid to needy families with __Dependent Children___
4)Aid to the totally & permanently _Disabled___
ADD INTO NOTES
PUBLIC ASSITANCE also includes money, tax breaks and loans given to
1) Corporations 2) Farmers 3) College students
Until __1996_, the national government distributed funds to states
in _Proportion__ to the number of people in each state with incomes below the federal __Poverty Level____
- Poverty level varies by __Family Size______
- The poverty level is calculated as __3 times____ the cost of
a minimally nutritious diet for a given number of people over a given period of time.
- Though it is an imperfect tool, the poverty level standard is useful because it allows us to measure progress against poverty.
- Critics argue that poverty level calculations should also include
__Non Cash Benefits____ other than _income__.
(food stamps-Medicare)
- The poverty rate in the U.S. has declined since the mid _1960’s_.
It was at 19% in 1964
2002 Poverty level saw _12_% of the population living in poverty.
2008 Poverty level saw _13.2_% of the population living in poverty.
2009-Poverty level saw _14.3_% of the population living in poverty.
Today, poverty is largely a predicament of the _YOUNG__ and poverty
households are headed by single moms-
2012 21.8% of people under 18 years were in Poverty
9.2% over age 65 were in poverty
“_Feminization of Poverty___”—30.9% women
2004 Family of four poverty level is anything below $_18,850.00_____
2008 Family of four poverty level is anything below $_22,050.00_____
2012 Family of four poverty level is anything below $_23,492.00_____
Congressional Digest
In 1996 Congress passed, and President Clinton signed, a welfare
reform bill that altered _61__ years of national welfare policy.
Called _TANF-Temporary Assistance for Needy Families__.
- critics of public assistance have long argued that welfare had
become a _disincentive______to work.
- The new law abolished the _AFDC-Aid to Families with dependent Children_____ program, affecting more than
_1/5_ of American families with children.
- __New Immigrants__ will no longer be eligible for
most federal benefits and services.
- Under TANF-Individual _Adult_ recipients will have
to find employment within __2__ years.
- Under federal guidelines, families can receive only _5__ years of benefits in a lifetime.
*These reforms will be phased in.
*This new law continues the devolution of power to the states.
*These reforms are intended to move the national government away
from promoting _Equal Outcomes__.
Good News about TANF- _60_% of former recipients have jobs
Less Promising News about TANF- jobs are very low in wages and there is major concern about what happens to other benefits
(__Food Stamps & Medicaid_) when transitioning out of TANF.
Many former TANF recipients still live close to the poverty level.
Check out POVERTY in the STATES charts page 647
HEALTH CARE
Despite entrenched opposition to government's intrusion in the field
of medicine, _MEDICARE___ was passed in 1965 to
provide health care to all persons over the age of ___65_____.
MEDICAID—health care for the qualifying poor
and (CHIP)—Children’s Health Insurance Program
Many Americans have NO health Insurance.
Among advanced industrialized nations, the U.S. spends the largest proportion of its economy on health care, but we still don’t live as long as many of the other nations--- chart pg 469
2002- _43.6__ million Americans have
no health insurance= 15% of population
2008- 47 million Americans have no health insurance
16% of our population
2012- __48_____ million Americans have no health insurance
__15.7___% Census Bureau
People under age 35 are less likely to have insurance
African Americans and Hispanics are more likely to be uninsured
*****
Families with incomes under $50,000 much less likely to have
insurance.
About 2/3 of Americans with Health Insurances are insured through
their employer. The remainder through government with programs
such as Medicaid, Medicare and the military.
Today Health insurance has __2___ categories:
HMO’s-__Health Maintenance Organization__
34% of Americans have this
focused on Preventative Care—Kaiser
PPO’s- __Preferred Provider Organization__
31% of Americans have this
Blue Cross/Blue Shield, Medical Mutual
Many are underinsured ---only have “catastrophic” coverage
Catastrophic Coverage- 25% of Americans has this,
but don’t have any other coverage
Access to health care depends on more than simply having insurance coverage.
1. Medicare is an _Entitlement_ program that has
massive public support from the __Elderly____.
2. Medicare costs have _increased_, the government has
required certain __incentives_ to cut costs; those
incentives may reduce_quality_ of care.
(stay time in hospitals! They make money if they can get you
out faster than the required time!)
3. After years of resistance from established _Special Interests__,
the issue of _Universal__ health care became a focal point
of the __Clinton___ administration.
4. About _15_ % of Americans under age 65 have no medical Coverage.
5. The U.S. spends more money on health care than any other
Industrialized nation!
6. The tradeoffs in the debate over health care reform involve
equality ( universal coverage & cost controls)
versus freedom ( the individual ability to choose health programs__)
V. As MEDICARE costs have __risen_____,
2002-1.55 Trillion-14% of the GDP & Growing
The fastest growing segment of Health Care today is
__Prescription Drugs___.
PART A of Medicare: is _compulsory__hospitalization insurance
It pays for care in hospitals, nursing
facilities and hospice
PART B of Medicare is Voluntary government subsidized insurance
It pays for_Doctor’s_ visits and outpatient care
It requires participants to pay a premium.
MEDICARE covers the elderly & __85_% of the program’s
beneficiaries are 65 years or older. 14% are the disabled
COST of MEDICARE- 2003 $271 Billion
Even if you receive Medicare, you can have an additional private policy.
The newest component of Medicare is the passage of the 2003-
Medicare_Prescription Drug____, Improvement,
and Modernization Act.
This provides beneficiaries with reduced priced prescription drugs
VI. MEDICAID= __AID_ to the poor/ “Workhorse” of the U.S. Health System
Created in 1965 as part of the Great Society- relatively small
Today- it is the single largest public program in the nation!
It enrolls more than 53 million people and costs $273 billion.
It ensures __1/5_ of the nation and pays for _1/3_ of all child births
Finances nearly _40___% of all long-term care expenses
Since States and the Federal Government pay for this, many _states___ have had to _reduce__ the __funding__ they provide for it.
2002MEDICAID Participants:
Children under age 21:23.1 million
Adults :10.4 million
Blind & Disabled : 7.9 million
Aged 65 & older : 4.8 million
(they may participate in this if their income falls below
a certain point along with Medicare)
2008
Children under age 21:29.8 million
Adults :16.5 million
Blind & Disabled : 9.6 million
Aged 65 & older : 6.1 million
Most recent addition to the health Care System: SCHIP
-State __Children’s Health Insurance Program______
This is an amendment to the Social Security Act
*jointly funded by the State and National Gov’t.
*requirements vary by State
* many states have cut back, but it still helps many
__children who aren’t insured______.
March 23, 2010
The Patient Protection and Affordable Care Act signed
by President Obama.
The plan is designed to provide insurance to as many
people as possible.
MANDATES---
By 2014---no more denial of pre-existing conditions
People must pay for insurance or suffer a fine
Similar to car insurance
Employers to be subject to fines if they have more than 50 employees and they don’t offer insurance.
States must set up EXCHANGES—to shop competitively for insurance.
COST of this
$940 Billion over 10 years
CBO states it should reduce deficits by $143 Billion over
10 years. (LONG HAUL)
More taxes on high health care plans “Cadillac plans”
Taxes on indoor tanning
Reforms some parts of Medicare
4/25/13 You can read through this and I will put it on the website:
VII. Elementary and Secondary Education Act of 1965:
Provided __direct__ national government ___aid__ to local school
Districts in order to improve the educational opportunities of
___economically_____ disadvantaged.
This Act began as a short bill, but today it encompasses hundreds
of pages and dozens of federal programs
*IDEA-Ideas with Disabilities Education Act added
__differences__ in student achievement between advantaged and
disadvantaged have ___declined_____ some since the 1960’s
___NATIONAL DEFENSE EDUCATION_____Act of 1958-
a response to the Cold War and Sputnik- increase our science scores
1983 “__A NATION AT RISK____”- creates
momentum by many public officials to improve the nation’s school
to keep up GLOBALLY in Math and Science
This will lead to NO CHILD LEFT BEHIND 2001 - NCLB
this law requires state’s to guarantee that all of their students are
performing at _PROFICIENT__ levels in core classes
___OF READING & MATH____ by __2014____.
Schools will have to show that they are making
Adequate Yearly Progress among all student groups
****Check out our school’s AYP score on Front white board—
newspaper article
NCLB also requires that all schools hire only _highly qualified___
teachers (HQT= you are certified in the subject you teach) in the core
subjects of reading and math.
***Today in OHIO Public Schools you can’t just teach any subject if you
are not certified. They used to allow that to happen.
NCLB leaves it up to the States to develop and define their own standards
to measure educational proficiency
Now we have RACE TO THE TOP Schools—we are one of those and get FEDERAL money but have to follow strict guidelines from the National government!!!
Today All Public Schools and some charter and private schoolsabide by all the State requirements.
Vouchers and Charter schools are controversial because they keep getting more money from their states but are not always held to the same requirements as Public Schools.
Will this lead to the end of public education?
What effects do private, charter and vouchers have on public schools and public school children?
IMMIGRATION:
Today America has 13% of the population are immigrants—38 million
Of the 13% --30% are assumed to be illegals
Immigrants tend to be among the poorest and most vulnerable in our
society.
They DO NOT have access to Food Stamps, Medicaid and TANF.
Unless they have been in the country for 5 years.
They have access to free education in public schools and
emergency room visits.
Green Card—allows legal immigrants to work and live in the U.S.
E-Verify—allows employers to check the status of an immigrant
President Obama has deported more illegal immigrants than any other president.
DREAM ACT---allows children of illegals the right to be here and no longer hide in the shadows.
Today—2013 there are bills being worked on for immigration reform.
BENEFITS and FAIRNESS:
VIII. The National government provides two types of benefits
- __Means Tested_ benefits impose an income test to qualify.
Pell grants, Medicaid, TANF
- _Non Means Tested___ benefits impose no such income tests.
An example is __Medicare_____, which provides
equal benefits to wealthy and poor Americans
- Transforming some non-means-tested benefits into means-tested
Benefits has allure during times of budget deficits.