© 2016,2014,2011 Pearson Education, Inc. All rights reserved. 17 Politics and Social Welfare.

© 2016,2014,2011 Pearson Education, Inc. All rights reserved.

17

Politics and Social Welfare


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


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


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


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


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

FIGURE 17.1: America’s poor: The rate and number

17.1

FIGURE 17.2: Who’s entitled? 17.1


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


Poverty in the United States

Temporary Poverty

Persistent Poverty

Family Structure

The “Truly Disadvantaged”

17.2


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


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

Homeless in America 17.2


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


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


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


Entitlements

Eligibility criteria Age, income, retirement, disability, unemployment, etc.

New Deal, FDR (1930s)

Great Society, Johnson (1960s)

17.3


Origins of federal welfare programs 17.3


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


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


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


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


FIGURE 17.3: Aging of America: Growing Number of Social Security Beneficiaries

17.4


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


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


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


Politics and Welfare Reform

Conflict Over What Causes Poverty

Politics of Welfare Reform

17.5


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

TABLE 17.1: Public opinion: What causes poverty?

17.5


Politics of Welfare Reform

Liberal and conservative consensus Mothers should work Transitional assistance necessary

TANF Successor to AFDC Block grants to states

17.5


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


Health Care in America

Health of Americans

Access to Care

Coverage Gaps

Health Care Costs

Managed Care Controversies

Medicare

Medicaid

SCHIP

17.6


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


Campaigning for Obamacare 17.6


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


FIGURE 17.4: Health coverage and the uninsured in 2008

17.6


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


Health Care Costs

15% of GDP

Incentives for patients

Incentives for providers Fear of lawsuits Paid by procedure

17.6


Managed Care Controversies

Preferred provider organizations (PPOs)

Health maintenance organizations (HMOs)

Problems Administrative costs Medical decisions made by insurance company

employees

17.6


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


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


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


Obama’s Health Care Transformation

Individual Mandate

Employer Mandate

Medicaid Expansion

Health Insurance Exchanges

Taxes

No “Public Option”

Costs

17.7


Individual and Employer Mandates

Individuals must purchase health insurance

Employers with 50+ works must provide health insurance

Tax credits for small employers

17.7


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


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


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


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?


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


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


Other challenges to the law:

State Compliance with Medicaid Expansion

IRS Enforcement

State Participation in Exchanges

“Rationing” Care

No Tort Reform

17.8


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


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


Why is the U.S. the only developed country without universal health care? What objections do Americans have to universal health coverage? Do you expect to see universal coverage in your lifetime?

Discussion Question 17

© 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.