© 2016,2014,2011 Pearson Education, Inc. All rights reserved. 17 Politics and Social Welfare.
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Transcript of © 2016,2014,2011 Pearson Education, Inc. All rights reserved. 17 Politics and Social Welfare.
© 2016,2014,2011 Pearson Education, Inc. All rights reserved.
Learning Objectives
Assess the importance of social welfare policy
Characterize the extent of poverty in the United States and identify correlates
17.1
17.2
17
© 2016,2014,2011 Pearson Education, Inc. All rights reserved.
Learning Objectives
Outline the major social welfare programs in the United States
Explain the reasons for and consequences of the political strength of older Americans
17.3
17
17.4
© 2016,2014,2011 Pearson Education, Inc. All rights reserved.
Learning Objectives
Analyze the role of politics in welfare reform
Compare the United States and other nations on health care expenditures and measures of health care and describe the nation’s major health care programs
17.5
17.6
17
© 2016,2014,2011 Pearson Education, Inc. All rights reserved.
Learning Objectives
Describe the key provisions of the Patient Protection and Affordable Care Act (PPACA) of 2010
Describe the challenges to “Obamacare” and the Supreme Court decision upholding it
17.7
17.8
17
© 2016,2014,2011 Pearson Education, Inc. All rights reserved.
Power and Social Welfare
Who gets what from government? Redistributor of income Transfer payments Social Security 60% of government spending
Poverty line $22,350 for family of four 50 million Americans (15%)
Means-tested spending Less than 1/3
17.1
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17.1 What percentage of the U.S. population lives in poverty, according to official calculations?
a. 15%
b. 30%
c. 5%
d. 7%
17.1
© 2016,2014,2011 Pearson Education, Inc. All rights reserved.
17.1 What percentage of the U.S. population lives in poverty, according to official calculations?
a. 15%
b. 30%
c. 5%
d. 7%
17.1
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Poverty in the United States
Temporary Poverty
Persistent Poverty
Family Structure
The “Truly Disadvantaged”
17.2
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Temporary vs. Persistent Poverty
Most poverty is not long term
Half of poor remain poor for 5 years Social welfare policy is safety net for other half Persistent poor need intensive interventions
17.2
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Family Structure and the “Truly Disadvantaged”
Single mothers poorest
Urban poverty Societal problems concentrated in inner cities Changing job market may be to blame
17.2
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17.2 Which type of household is most likely to be poor?
17.2
a. Two adults with no children
b. One man with children
c. One woman with children
d. A single man or woman with no children
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17.2 Which type of household is most likely to be poor?
a. Two adults with no children
b. One man with children
c. One woman with children
d. A single man or woman with no children
17.2
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Entitlements
Social Security
Unemployment Compensation
Supplemental Security Income (SSI)
Family Assistance (TANF)
Food Stamps (SNAP)
Earned Income Tax Credit (EITC)
Medicaid
17.3Social Welfare Policy
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Entitlements
Eligibility criteria Age, income, retirement, disability, unemployment, etc.
New Deal, FDR (1930s)
Great Society, Johnson (1960s)
17.3
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Origins of federal welfare programs 17.3
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Social Security
Unemployment Compensation
Supplemental Security Income (SSI)
Family Assistance (TANF)
Food Stamps (SNAP)
Earned Income Tax Credit (EITC)
Medicaid
17.3Examples of social welfare programs
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Social Security
Unemployment Compensation
Supplemental Security Income (SSI)
Family Assistance (TANF)
Food Stamps (SNAP)
Earned Income Tax Credit (EITC)
Medicaid
17.3Examples of social welfare programs
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17.3 Which social welfare program provides benefits to disabled people?
a. Social Security
b. Family Assistance (TANF)
c. Supplemental Security Income (SSI)
d. Food Stamps (SNAP)
17.3
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17.3 Which social welfare program provides benefits to disabled people?
a. Social Security
b. Family Assistance (TANF)
c. Supplemental Security Income (SSI)
d. Food Stamps (SNAP)
17.3
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Senior Power
Aged in the Future
Generational Compact
Rising Dependency Ratio
Social Security Taxes
Cost-of-Living Increases
Wealthy Retirees
“Saving” Social Security
17.4
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Aged in the Future and the Generational Compact
Baby boomers Born from 1945-1960 Current population growth from immigrants Retiring now, living longer
Trust fund Get back what you pay Reserves earn interest Current payments go straight to paying benefits
17.4
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FIGURE 17.3: Aging of America: Growing Number of Social Security Beneficiaries
17.4
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Rising Dependency Ratio and Social Security Taxes
Dependency ratio From 10:1 to 2:1
Social Security tax is 12.4% Half paid by employer, half by worker
17.4
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Cost-of-Living Increases, Wealthy Retirees, and “Saving” Social Security
COLAs based on CPI
Increase in retirement age from 65 to 67
Increase in Social Security taxes
17.4
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17.4 Why do older Americans have relatively high political power?
a. They vote
b. They are increasing as a percentage of
the population
c. They are politically active
d. All of the above
17.4
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17.4 Why do older Americans have relatively high political power?
a. They vote
b. They are increasing as a percentage of
the population
c. They are politically active
d. All of the above
17.4
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Politics and Welfare Reform
Conflict Over What Causes Poverty
Politics of Welfare Reform
17.5
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Conflict Over What Causes Poverty
Beliefs vary widely
Some blame individual motivation
Some blame the economy
Some blame social welfare programs Impetus for welfare reform
Chicken and egg question
17.5
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Politics of Welfare Reform
Liberal and conservative consensus Mothers should work Transitional assistance necessary
TANF Successor to AFDC Block grants to states
17.5
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17.5 What do Americans think is a main cause of poverty?
a. Medical bills
b. Poor public schools
c. The welfare system
d. Drug abuse
17.5
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17.5 What do Americans think is a main cause of poverty?
a. Medical bills
b. Poor public schools
c. The welfare system
d. Drug abuse
17.5
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Health Care in America
Health of Americans
Access to Care
Coverage Gaps
Health Care Costs
Managed Care Controversies
Medicare
Medicaid
SCHIP
17.6
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Health of Americans
Public health and sanitation improvements Immunizations Clean water Sewage disposal
Causes of death linked to lifestyle Smoking, lack of exercise, poor diet
Improvements in lifespan linked to lifestyle, not health care
17.6
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Access to Care
Extending coverage to all Americans
15% have no insurance 45+ million people
Consequences of lack of medical insurance Going without care Denial of care Cost shifted to others Impoverishment
17.6
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FIGURE 17.4: Health coverage and the uninsured in 2008
17.6
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Coverage Gaps
Inadequate coverage is major problem
Deductibles
No coverage for vision, dental, hearing aids, routine exams, long-term care, catastrophic illness Need for nursing home care growing
17.6
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Health Care Costs
15% of GDP
Incentives for patients
Incentives for providers Fear of lawsuits Paid by procedure
17.6
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Managed Care Controversies
Preferred provider organizations (PPOs)
Health maintenance organizations (HMOs)
Problems Administrative costs Medical decisions made by insurance company
employees
17.6
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Medicare
Elderly and disabled
Acute, not long-term care, expenses
Part A – hospital coverage
Part B – 80% of outpatient charges Premium deducted from Social Security benefits
17.6
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Medicaid and SCHIP
Low-come persons
Administered by states
Recipients generally on welfare
Costliest public assistance program 45% state-funded/55% federally-funded
State Children’s Health Insurance Program (SCHIP) Families with incomes 200% of poverty line
17.6
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17.6 Which of the following is not a requirement of Medicare eligibility?
a. U.S. citizen for at least 10 years
b. Eligible for Social Security
c. If younger than 65, disabled
d. 65 or older
17.6
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17.6 Which of the following is not a requirement of Medicare eligibility?
a. U.S. citizen for at least 10 years
b. Eligible for Social Security
c. If younger than 65, disabled
d. 65 or older
17.6
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Obama’s Health Care Transformation
Individual Mandate
Employer Mandate
Medicaid Expansion
Health Insurance Exchanges
Taxes
No “Public Option”
Costs
17.7
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Individual and Employer Mandates
Individuals must purchase health insurance
Employers with 50+ works must provide health insurance
Tax credits for small employers
17.7
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Medicaid Expansion and Health Insurance Exchanges Incomes up to 133% of poverty level
States must fund States can choose not to comply
Federal govt. will create exchanges Plans must meet federal requirements Subsidies High-risk pools
17.7
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Taxes, No “Public Option,” and Costs
Variety of new taxes
Public option rejected by Congress Fears of “socialized medicine”
How much will Obamacare cost? CBO says $1 trillion Obama says cut waste and abuse
17.7
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17.7 Why doesn’t Obamacare include a public option?
a. Fears of “socialized medicine”
b. There was no initiative to include one
c. Critics charged that a public option
would be too expensive
d. It does include a public option
17.7
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a. Fears of “socialized medicine”
b. There was no initiative to include one
c. Critics charged that a public option
would be too expensive
d. It does include a public option
17.717.7 Why doesn’t Obamacare include a public option?
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Challenges to “Obamacare”
Constitutionality of the Individual Mandate
State Compliance with Medicaid Expansion
IRS Enforcement
State Participation in Exchanges
“Rationing” Care
No Tort Reform
17.8
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Constitutionality of the Individual Mandate
Every American must obtain health insurance Supported by insurers Spreads risk in larger pool
Supreme Court rules 5-4 Not legal under Commerce Clause Legal as a tax
17.8
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Other challenges to the law:
State Compliance with Medicaid Expansion
IRS Enforcement
State Participation in Exchanges
“Rationing” Care
No Tort Reform
17.8
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Other challenges to the law:
State Compliance with Medicaid Expansion
IRS Enforcement
State Participation in Exchanges
“Rationing” Care
No Tort Reform
17.8
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17.8 Which of the following is not a challenge that has been made to Obamacare?
17.8
a. Constitutionality of individual mandate
b. Constitutionality of penalty for states
opting out of Medicaid expansion
c. Constitutionality of tort reform
d. None of the above
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17.8 Which of the following is not a challenge that has been made to Obamacare?
a. Constitutionality of individual mandate
b. Constitutionality of penalty for states
opting out of Medicaid expansion
c. Constitutionality of tort reform
d. None of the above
17.8