ISBN-10:
0765809575
ISBN-13:
9780765809575
Pub. Date:
01/31/2003
Publisher:
Taylor & Francis
Welfare Medicine in America: A Case Study of Medicaid / Edition 1

Welfare Medicine in America: A Case Study of Medicaid / Edition 1

by Rosemary A. Stevens, Rosemary Stevens

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Overview

Welfare Medicine in America: A Case Study of Medicaid / Edition 1

The present study was undertaken for three reasons: Medicaid is a vital program-in the early 1970s it provided care for over one tenth of the American population. It is a huge program-in the same period it consumed over nine billion dollars of public funds. And Medicaid is, in many ways, the most direct involvement with the provision of medical care undertaken by either the federal government or the states. But until the publication of this book, Medicaid had not been studied in depth or in a systematic way. Welfare Medicine in America is the complete history of Medicaid. The authors carefully examine the program's historical antecedents, its strengths, and its weaknesses. In part one, "The Coming of Medicaid," the hows and whys of the establishment of Medicaid are discussed, as are the basic provisions of the program. In part two, "The Euphoric Demise: July 1965-January 1968," the focus is on how Medicaid is administered in the states. In part three, "The Storm: January 1968-July 1970," specific amendments to Medicaid, the costs involved, and other health programs are examined. And in part four, "Benign Neglect: July 1970-June 1973," the role of the courts in administering Medicaid, and its future, are the primary subjects. This history of Medicare, however, goes beyond the specific government program itself and offers a paradigm for inquiring into the problems of medical care in general and the nature and limitations of public medical services. Welfare Medicine in America is a profound analysis of Medicaid and welfare systems, and will be of great use to policymakers, students of welfare and government, and to those working within the medical profession.

Product Details

ISBN-13: 9780765809575
Publisher: Taylor & Francis
Publication date: 01/31/2003
Edition description: W/a New Introduction by Rosemary Stevens
Pages: 429
Product dimensions: 6.00(w) x 9.00(h) x 0.96(d)

About the Author

Robert Stevens is master of Pembroke College, Oxford, and serves as counsel to the law firm Covington & Burling, where his practice involves international commercial law and competition law. He has also taught at Yale and Tulane Universities, and has authored many articles and books, including studies of social legislation and the legal profession in the United States and the United Kingdom.

Rosemary A. Stevens is a DeWitt Wallace Distinguished Scholar in social medicine and public policy at Weill Cornell Medical College, and Stanley I. Sheerr professor emeritus in the history and sociology of science at the University of Pennsylvania. Her writings have appeared in Harvard Business Review; Journal of Health Politics, Policies and Law;and American Journal of Public Health. In addition she is the author of numerous books, including The Public-Private Health Care State: Essays on the History of American Health Policy. Rosemary A. Stevens is a DeWitt Wallace Distinguished Scholar in social medicine and public policy at Weill Cornell Medical College, and Stanley I. Sheerr professor emeritus in the history and sociology of science at the University of Pennsylvania. Her writings have appeared in Harvard Business Review; Journal of Health Politics, Policies and Law;and American Journal of Public Health. In addition she is the author of numerous books, including The Public-Private Health Care State: Essays on the History of American Health Policy.

Table of Contents

Introduction to the Transaction Editionxi
Acknowledgmentsxxix
Prologuexxxiii
List of Acronymsxl
Part IThe Coming of Medicaid
Introduction1
1.Competing Welfare Philosophies and the Provision of Medical Care5
The Welfare Heritage5
The Social Insurance Tradition8
1935: The Freezing of Theories10
Income Security and Health Care13
Government and Medical Care15
2.Public and Political Concern with Medical Care19
The Philosophies Conged19
Vendor Payments Become the Order of the Day21
Medical Care and Geriatric Politics24
Kerr-Mills26
Kerr-Mills Is Implemented31
3.The Federal Role: An Aphilosophical Expansion42
Other Federal Programs42
The Fall of Kerr-Mills45
Medicare48
Medicaid and Federal Health Care51
4.Basic Provisions of Medicaid57
The Structure of State Programs as Outlined in Public Law 89-9758
Who Is Eligible under Title XIX?61
What Was Provided under Title XIX?65
General Considerations68
Part IIThe Euphoric Demise July 1965 - January 1968
Introduction73
5.Implementation75
The Federal Response76
The State Legislatures Act80
Sacramento81
Albany84
6.The Beginning of Disillusion91
The First Crisis: The Backlash in New York92
Problems in State Administration: New York and California Contrasted96
Medicaid: The Other States99
7.Facilis Descensus Averno108
New York Revisited109
California Revisited112
Reaction and Response in Washington114
The Social Security Amendments of 1967117
Part IIIThe Storm January 1968 - July 1970
Introduction129
8.The Scene in Washington131
General Implications of the 1967 Amendments131
Medicaid and Other Health Programs133
Information, Interests and Expectations134
Meanwhile, Back in HEW ...137
Federal Administration: A Case Study of the Nursing Home Industry139
The Congressional Reactions143
Beginning the Nixon Administration145
9.The Scene at the State and Local Level156
The Effect of the 1967 Amendments156
California160
New York162
New York City: The Impact of Decisions in Albany166
New York City: Regulating Providers169
The Bellin Blitz171
General Issues173
10.Costs, Successes, and Scapegoats183
Cost Estimation184
The Hospitals186
Nursing Homes188
Physicians190
The Fine Sport of Fee-Hunting194
Recipients198
Variation or Discrimination?200
11.Reassessments212
The Role of the Senate Finance Committee212
The Competing Approaches215
The McNerney Reports216
The Story of FHIP221
The Supply and Demand Debate226
Health Maintenance Organizations228
Part IVBenign Neglect July 1970 - June 1973
Introduction235
12.Federal Administration237
New Broom Newman237
Nursing Homes241
Early and Periodic Screening245
And May We All Participate?248
Most Recent Developments251
13.The States260
Skyrocketing Costs261
Excessive Utilization, Near Fraud, and Fraud264
The Providers' View of Administration265
The Administrative Response in the States267
The States and the Courts269
The Recipients' Viewpoint271
14.New York, California, and Illinois282
New York: The Same Old Story282
The California Scene: History Does Repeat Itself287
California as Innovator290
Illinois: A Clash of Giants293
Illinois: The Winter of Our Discontent295
15.The Courts and the Congress305
Role of the Courts305
Equal Protection308
The Congressional Role315
The Battle Commences: New Perspectives on Basic Philosophies316
16.Congress and the Future327
"Once More Unto the Breach, Dear Friends"327
The Warriors: National Health Insurance332
"These Wounds I Had on Crispin's Day"335
P.L. 92-603: Medicaid Provisions337
Epilogue349
Appendix363
Index373

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