Poor People’s Medicine is a detailed history of Medicaid since its beginning in 1965. Federally aided and state-operated, Medicaid is the single most important source of medical care for the poorest citizens of the United States. From acute hospitalization to long-term nursing-home care, the nation’s Medicaid programs pay virtually the entire cost of physician treatment, medical equipment, and prescription pharmaceuticals for the millions of Americans who fall within government-mandated eligibility guidelines. The product of four decades of contention over the role of government in the provision of health care, some of today’s Medicaid programs are equal to private health plans in offering coordinated, high-quality medical care, while others offer little more than bare-bones coverage to their impoverished beneficiaries.
Starting with a brief overview of the history of charity medical care, Jonathan Engel presents the debates surrounding Medicaid’s creation and the compromises struck to allow federal funding of the nascent programs. He traces the development of Medicaid through the decades, as various states attempted to both enlarge the programs and more finely tailor them to their intended targets. At the same time, he describes how these new programs affected existing institutions and initiatives such as public hospitals, community clinics, and private pro bono clinical efforts. Along the way, Engel recounts the many political battles waged over Medicaid, particularly in relation to larger discussions about comprehensive health care and social welfare reform. Poor People’s Medicine is an invaluable resource for understanding the evolution and present state of programs to deliver health care to America’s poor.
PRODUCT DETAILS
Publisher: Duke University Press Pub. Date: 1st February 2006 Catalog: Book Media: Paperback Number Of Pages: 344 Ean: 9780822336952 Isbn: 0822336952
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USER REVIEWS
Good, solid history of Medicaid ~ Written on Oct 24, 2009. 1 out of 1 users found this review helpful.
This is a history of Medicaid, from its inception in 1965 down to the second administration of George W. Bush. Actually, it starts before the start of Medicaid itself; it has a very good introduction which covers the prior history of charity medicine in America. All in all, it is a good, solid history. Engel knows the subject, he has done his research and he tells the story reasonably well. I would not call it a good read, compared to entertaining fiction or narrative history, but, as social science goes, it reads pretty well.
The theme of the story is ambivalence. As Engel very accurately describes, America has always been ambivalent about government funded medical care for the poor. On the one hand, no one wants the poor not to receive medical care. On the other hand, the country is committed to free enterprise, and does not want government-funded poor people's medicine to be used as a wedge to push toward full socialized medicine. (This is majority feeling. There are those, of course, who feel exactly the opposite, and have over and over tried to use poor people's medicine precisely as a way to slowly nudge the country toward a single payer system.)
Because of this ambivalence, Medicaid has never been what either ideological extreme would like it to be. Instead, it has been a fairly typical American welfare state enterprise, big enough to prevent the poor from suffering want but not so big as to overtly threaten the status quo. Engel is enough of a liberal to wish that the program was more to the left, but he is also enough of a pragmatist to acknowledge that the program does a great deal of good and does, in fact, reflect what the majority of Americans really want.
All in all, a good solid history. If you want to know the history of Medicaid, you need to read this book.
(1 customer reviews)
