1. Health Care Policy Chapter 11

2. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 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

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

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

5. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 2007, Brooks/Cole, a division of Thomson Higher Education  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

6. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 2007, Brooks/Cole, a division of Thomson Higher Education Major Health Programs  Medicare The largest health care program, part of the social insurance system, designed for people eligible to receive Social Security benefits

7. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 2007, Brooks/Cole, a division of Thomson Higher Education  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

8. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 2007, Brooks/Cole, a division of Thomson Higher Education  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

9. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 2007, Brooks/Cole, a division of Thomson Higher Education  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

10. Social Welfare Policy and Social Programs: A Values Perspective, by Elizabeth Segal Copyright 2007, Brooks/Cole, a division of Thomson Higher Education Other Services  Disability Insurance – part of Social Security program, covers those who paid in  Supplemental Security Income – disability benefits for low-income people

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

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