Medicaid Politics and Policy

Front Cover
Transaction Publishers, Dec 31, 2011 - Medical - 458 pages
Medicaid is a story worth telling, one rooted in American history and shaped by its culture and institutions. It has dramatic interest, heroes and heroines, triumphs and tragedies. The authors make this story come alive for the reader by providing a strong connected narrative, detailed accounts of important policy changes, and extensive use of interviews with individuals close to events. They emphasize politics and policy along with history. History is important because Medicaid has developed incrementally, layer by layer, so that almost any provision or activity needs a historical gloss to understand it. The Medicaid program has been especially subject to outside political and policy influences: the state of the economy, trends in federalism, developments in health or welfare programs, and the electoral cycle. Politics helps us understand policy outcomes. But the two go together: a knowledge of policy helps understand what is at stake, and a knowledge of politics what is possible. A central theme of the book is that Medicaid is a "weak entitlement," one less established or effectively defended than Medicare or Social Security, but more secure than welfare or food stamps. Medicaid has the flexibility to adapt (or be adapted) as well as a capacity to defend incremental and opportunistic gains. At the same time, the program lacks an effective mechanism for overall reform. It has grown enormously since its inception to become the largest health insurance system in the country, a source of perennial complaint and, most recently, of continuing crisis. The dual emphasis upon politics and policy is important to make the arcane Medicaid program accessible to the reader, and to distinguish policy grounded in facts and analysis from partisan bombast and ideology. The result is an authoritative account and reference for those seeking to refresh a perspective or to look further.
 

What people are saying - Write a review

We haven't found any reviews in the usual places.

Contents

Chapter 1
1
Chapter 2
21
Chapter 3
59
Chapter 4
95
Chapter 5
145
Chapter 6
227
Chapter 7
279
Chapter 8
323
Chapter 9
369
Chapter 10
405
Glossary
413
Bibliography
423
Index
433
Copyright

Other editions - View all

Common terms and phrases

About the author (2011)

David G. Smith is Richter Professor Emeritus of Political Science at Swarthmore College. His main teaching areas include health policy, Constitutional law and jurisprudence, American government and politics, and political theory. His writings have appeared in many professional journals, including American Political Science Review, Policy Studies Journal, and Liberal Democracy. In addition, his book, Paying for Medicare, won the Elizur Wright Award from the American Risk and Insurance Association.

Bibliographic information