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Lecture 9 american social protection and welfare 2016

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This lecture proposes an overview of the American welfare policy. It covers the different insurance schemes and the latest developments including Obamacare and Trump's proposed reforms.

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Lecture 9 american social protection and welfare 2016

  1. 1. Welfare Policy “Welfare is hated by those who administer it, mistrusted by those who pay for it and held in contempt by those who receive it.” —Peter C. Goldmark, Jr.
  2. 2. Eight Categories of Welfare Programs and Total Costs, 2002 Medical Aid: $282 billion, 54% Cash Aid: $102 billion, 20% Food Aid: $39 billion, 7% Housing Aid: $36 billion, 7% Education Aid: $30 billion, 6% Other Services: $22 billion, 5% Jobs and Training Aid: $8 billion, 2%
  3. 3. Social Security  Old-Age and Survivors Insurance: retirement pensions to which all Americans over 65 are entitled  Disability Insurance / Unemployment Insurance / Health insurance  Medicare: Medical care for the over 65
  4. 4. Welfare: social protection for the poor  Medicaid: medical coverage for the poor.  Food Stamps (Vouchers that can be exchanged for food)  Housing Assistance  Temporary Assistance for Needy Families (most often single mothers with children)
  5. 5. Food Stamps  Paid by the U.S. Department of Agriculture  Provides food for low-income people, and subsidies to farmers.  49 million Americans on food stamps
  6. 6. Health Programs  Unlike Britain or France the US has no national free healthcare system  Americans required to purchase insurance privately or through employer, or else pay for treatment upfront.  2 programs: Medicare Medicaid
  7. 7. Medicare  Helps pay hospital and medical costs  Anything not paid by Medicare is often paid through supplemental insurance as medical costs rise the elderly are paying more for their health care  There is no long-term care provision for in-home assistance
  8. 8. Medicaid  Pays for health care for: low income families with children low income elderly people with disabilities  65 million Americans received Medicaid in 2014
  9. 9. An Imperfect safety net  People can buy individual insurances but these are very expensive. (15% of the population without coverage).  However when illness strikes, people postpone treatment.
  10. 10. Unequal health  American medicine the most sophisticated and innovative in the world.  But reflects growing inequalities  Disparities resulting from Income & race
  11. 11. Physical Health by Income group Gallup 2010
  12. 12. Access to health care by income group
  13. 13. African Americans  infant mortality rate is 2.4 times higher than that of white infants  30% higher death rate for all cancers  Seven times more likely to die from HIV / AIDS  Five times more likely to develop glaucoma
  14. 14. Hispanics and Latinos  twice more likely to die from diabetes  20% of new cases of TB  Higher rates of high blood pressure and obesity
  15. 15. American Indians & Alaskan Natives  Diabetes rates that are twice the national average  Disproportionately high death rates from unintentional injuries and suicide
  16. 16. Soaring Costs  Prices regularly increasing (15% a year)  Malpractice suits  Insurance policies more expensive.
  17. 17. Reasons Why People Sue TheirReasons Why People Sue Their DoctorsDoctors  Advised to sue by influential otherAdvised to sue by influential other 3232  Needed moneyNeeded money 2424  Believed there was a cover-upBelieved there was a cover-up 2424  Child would have no futureChild would have no future 2323  Needed informationNeeded information 2020  Wanted revenge, licenseWanted revenge, license 1919 Percent ExpressingPercent Expressing ConcernConcern Source - Hickson, 1992
  18. 18. Soaring Costs (drugs)  Drugs are 3 times higher than in Britain and 6 times higher than in Brazil  The United States leaves pricing to market competition
  19. 19. Soaring Demand  Population aging & higher life expectancy.  By 2030 the baby boomers will be retiree  Medicare and social security place an increasing burden on workers.  Possible solutions are to increase the retirement age...
  20. 20. 2010 Obamacare  First major US healthcare.  Aims to extends health insurance to the 15% of US population without coverage.  Subsidies to make coverage affordable.  Requirement on businesses to offer employees healthcare plans  More control on insurance companies  Young people are allowed to remain on their parents’ plans until the age of 26.
  21. 21. Why does Trump want to repeal Obamacare?  President Trump has called Obamacare an “incredible economic burden”  He proposes a return to free market principles for the health care sector.
  22. 22. Welfare and Public Opinion Why do Americans hate welfare? Welfare associated with racial prejudice. Americans value autonomy self-reliance and self- help The poor are regarded as responsible for their fate. Welfare is thought to be a wasteful program encouraging laziness and fraud. An insult to the American work ethic