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Unequal Coverage

Unequal Coverage
Author: Jessica M. Mulligan
Publisher: NYU Press
Total Pages: 316
Release: 2018
Genre: Medical
ISBN: 1479848735

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"The Affordable Care Act set off an unprecedented wave of health insurance enrollment as the most sweeping overhaul of the U.S. health insurance system since 1965. In the years since its enactment, some 20 million uninsured Americans gained access to coverage. And yet, the law remained unpopular and politically vulnerable. While the ACA extended social protections to some groups, its implementation was troubled and the act itself created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. Unequal Coverage documents the everyday experiences of individuals and families across the U.S. as they attempted to access coverage and care in the five years following the passage of the ACA. It argues that while the Affordable Care Act succeeded in expanding access to care, it did so unevenly, ultimately also generating inequality and stratification. The volume investigates the outcomes of the ACA in communities throughout the country and provides up-close, intimate portraits of individuals and groups trying to access and provide health care for both the newly insured and those who remain uncovered. The contributors use the ACA as a lens to examine more broadly how social welfare policies in a multiracial and multiethnic democracy purport to be inclusive while simultaneously embracing certain kinds of exclusions"--Publisher's website.


Unequal Coverage

Unequal Coverage
Author: Heide Castañeda
Publisher: NYU Press
Total Pages: 328
Release: 2017-12-26
Genre: Medical
ISBN: 1479834408

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The Affordable Care Act’s impact on coverage, access to care, and systematic exclusion in our health care system The Affordable Care Act set off an unprecedented wave of health insurance enrollment as the most sweeping overhaul of the U.S. health insurance system since 1965. In the years since its enactment, some 20 million uninsured Americans gained access to coverage. And yet, the law remained unpopular and politically vulnerable. While the ACA extended social protections to some groups, its implementation was troubled and the act itself created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. Unequal Coverage documents the everyday experiences of individuals and families across the U.S. as they attempted to access coverage and care in the five years following the passage of the ACA.It argues that while the Affordable Care Act succeeded in expanding access to care, it did so unevenly, ultimately also generating inequality and stratification. The volume investigates the outcomes of the ACA in communities throughout the country and provides up-close, intimate portraits of individuals and groups trying to access and provide health care for both the newly insured and those who remain uncovered. The contributors use the ACA as a lens to examine more broadly how social welfare policies in a multiracial and multiethnic democracy purport to be inclusive while simultaneously embracing certain kinds of exclusions. Unequal Coverage concludes with an examination of the Affordable Care Act’s uncertain legacy under the new Presidential administration and considers what the future may hold for the American health care system. The book illustrates lessons learned and reveals how the law became a flashpoint for battles over inequality, fairness, and the role of government. More books on the health care debate


Unequal Treatment

Unequal Treatment
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 781
Release: 2009-02-06
Genre: Medical
ISBN: 030908265X

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Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.


Communities in Action

Communities in Action
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
Total Pages: 583
Release: 2017-04-27
Genre: Medical
ISBN: 0309452961

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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.


Understanding Racial and Ethnic Differences in Health in Late Life

Understanding Racial and Ethnic Differences in Health in Late Life
Author: National Research Council
Publisher: National Academies Press
Total Pages: 184
Release: 2004-09-08
Genre: Social Science
ISBN: 0309165865

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As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.


Fragmented Democracy

Fragmented Democracy
Author: Jamila Michener
Publisher: Cambridge University Press
Total Pages: 239
Release: 2018-03-22
Genre: Political Science
ISBN: 1108245323

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Medicaid is the single largest public health insurer in the United States, covering upwards of 70 million Americans. Crucially, Medicaid is also an intergovernmental program that yokes poverty to federalism: the federal government determines its broad contours, while states have tremendous discretion over how Medicaid is designed and implemented. Where some locales are generous and open handed, others are tight-fisted and punitive. In Fragmented Democracy, Jamila Michener demonstrates the consequences of such disparities for democratic citizenship. Unpacking how federalism transforms Medicaid beneficiaries' interpretations of government and structures their participation in politics, the book examines American democracy from the vantage point(s) of those who are living in or near poverty, (disproportionately) Black or Latino, and reliant on a federated government for vital resources.


Uneven & Unequal

Uneven & Unequal
Author:
Publisher:
Total Pages: 72
Release: 1994
Genre: Health insurance
ISBN: 9780939253357

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Inequality for All

Inequality for All
Author: William Schmidt
Publisher: Teachers College Press
Total Pages: 289
Release: 2015-04-17
Genre: Education
ISBN: 0807771082

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Inequality for All makes an important contribution to current debates about economic inequalities and the growing achievement gap, particularly in mathematics and science education. The authors argue that the greatest source of variation in opportunity to learn is not between local communities, or even schools, but between classrooms. They zero in on one of the core elements of schooling—coverage of subject matter content—and examine how such opportunities are distributed across the millions of school children in the United States. Drawing on data from the third TIMMS international study of curriculum and achievement, as well as a six-district study of over 500 schools across the United States, they point to Common Core State Standards as being a key step in creating a more level playing field for all students. William H. Schmidt is University Distinguished Professor at Michigan State University and co-director of the Education Policy Center. Curtis C. McKnight is emeritus professor of mathematics at the University of Oklahoma.


Uneven Odds, Unequal Outcomes

Uneven Odds, Unequal Outcomes
Author: Nandini Krishnan
Publisher: World Bank Publications
Total Pages: 197
Release: 2016-06-28
Genre: Social Science
ISBN: 1464807876

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Perceptions of eroding living standards and low life satisfaction are widespread in the Middle East and North Africa region today, along with pessimism about prospects for economic mobility. Conventional measures of economic well-being offer little in the way of explanation †“ in most countries in the region, extreme poverty is low and declining and economic inequality is lower than in other parts of the world. This book investigates possible reasons for this disconnect, focusing on the role played by inadequate and unequal access to opportunities to realize one’s aspirations for economic mobility. The inability of most countries in the region to meet the aspirations of citizens is closely linked to persistent weaknesses in the labor markets where the pace of job creation has been chronically below levels required to absorb the growing and increasingly better educated population. A high degree of segmentation in the labor markets also puts the youth and women in the region at a particular disadvantage. While labor markets are critical for mobility, opportunities and life paths can diverge even earlier in life if access to basic services in health, education and infrastructure are unequally distributed among children in their formative years. This book documents sharp disparities in the quality of services available to children of varying birth circumstances in the region. Although the most intense debates in development coalesce around inequality of income or wealth, the notion of inequality of opportunity has an intuitive appeal that can bridge ideological differences. By drawing attention to the notion of equality of opportunity to create a level playing field for all sections of society, the book highlights the need to critically examine the social contract and governance structures that guide the delivery of services and are instrumental for implementing necessary reforms to make labor markets more dynamic and equitable.


Borders of Belonging

Borders of Belonging
Author: Heide Castañeda
Publisher: Stanford University Press
Total Pages: 382
Release: 2019-02-26
Genre: Social Science
ISBN: 1503607925

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Borders of Belonging investigates a pressing but previously unexplored aspect of immigration in America—the impact of immigration policies and practices not only on undocumented migrants, but also on their family members, some of whom possess a form of legal status. Heide Castañeda reveals the trauma, distress, and inequalities that occur daily, alongside the stratification of particular family members' access to resources like education, employment, and health care. She also paints a vivid picture of the resilience, resistance, creative responses, and solidarity between parents and children, siblings, and other kin. Castañeda's innovative ethnography combines fieldwork with individuals and family groups to paint a full picture of the experiences of mixed-status families as they navigate the emotional, social, political, and medical difficulties that inevitably arise when at least one family member lacks legal status. Exposing the extreme conditions in the heavily-regulated U.S./Mexico borderlands, this book presents a portentous vision of how the further encroachment of immigration enforcement would affect millions of mixed-status families throughout the country.