Poor People's Medicine

by Engel, Jonathan

• ISBN13: 9780822336952
• ISBN10: 0822336952
• Edition: 1st
• Format: Paperback
• Copyright: 2006-02-28
• Publisher: Duke Univ Pr

Summary

Poor People's Medicineis a detailed history of the development and implementation of Medicaid since its beginning in 1965. Federally-aided and state-operated, Medicaid provides medical care to the poorest citizens of the United States. From acute hospitalization to long-term nursing home care, the nation's Medicaid programs pay virtually the entire cost of physician treatment, hospital stays, medical equipment, and prescription pharmaceuticals for the millions of Americans who fall within government-mandated eligibility guidelines. The product of four decades of contention over the role of government in the provision of health care, some of today's Medicaid programs are equal to private health plans in providing coordinated, high-quality medical care, while others continue to provide little more than bare-bones coverage to their impoverished beneficiaries.Starting with a brief overview of the history of charity medical care, Jonathan Engel presents the debates surrounding Medicaid's creation in 1965 and the compromises struck to allow federal funding of the nascent programs. He traces the development of Medicaid through the decades, as various states attempted to both enlarge the programs and more finely tailor them to their intended targets. At the same time, he describes how these new programs affected existing institutions and initiatives such as public hospitals, community clinics, and private pro bono clinical efforts. Along the way, Engel recounts the many political battles waged over Medicaid, particularly in relation to larger discussions about comprehensive health care and social welfare reform. Poor People's Medicineis an invaluable resource for understanding the evolution and present state of programs to deliver health care to America's poor.

Table of Contents

Preface	ix
Antecedents: Poverty and Early Poverty Care Programs	1	(27)
Precursors to Medicare and Medicaid	28	(16)
War on Poverty and the Genesis of Medicaid	44	(25)
Hard-to-Reach Groups	69	(23)
Redefining Health	92	(15)
Charity Care and Comprehensive Reform under Nixon	107	(16)
Health Planning and Community Medicine in the 1970s	123	(21)
Health and Welfare Reform in the Carter White House	144	(19)
Block Grants and the New Federalism	163	(21)
Recovering the Cuts, Managed Care, and Comprehensive Reform	184	(25)
Managed Medicaid, AIDS, and the Clinton Health Bill	209	(35)
Afterword	244	(9)
Notes	253	(36)
Bibliography	289	(14)
Index	303