This is part of a series of lectures in American civilization for 1st year students of English. The lectures covers the main issues related to American social and health care programs Under the different administrations.

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. According to the federal government,
how many Americans are poor?
In 2010, 46.2 million
Americans lived in poverty—
that’s 15.1% of the U.S.
population.

4. 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

5. 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)

6. Medical Aid Programs
• Medicare
– anyone aged 65 or older who was at one time
covered at work by Social Security is eligible
• Medicaid
– only low-income people are eligible for this
type of assistance

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. 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. 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. Unequal health
• American medicine the most sophisticated
and innovative in the world.
• But reflects growing inequalities
• Disparities resulting from
– Income &
– race

12. 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

13. Hispanics and Latinos
• twice more likely to die from diabetes
• 20% of new cases of TB
• Higher rates of high blood pressure and
obesity

14. American Indians & Alaskan Natives
• Diabetes rates that are
twice the national
average
• Disproportionately high
death rates from
unintentional injuries
and suicide

15. Soaring Costs
• Prices regularly increasing (15% a year)
• Malpractice suits
• Insurance policies
more expensive.

16. 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

17. 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

18. 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...

19. Other welfare programs: AFDC
• Aid to Families with Dependent Children
– Temporary Assistance to Needy Families
– Provides income to families with
dependent children
– Generally single parent families
– About 95% of single parents are women

20. AFDC: A Flawed System?
The system did not do enough to encourage
work
By rewarding unwed mothers and pregnant
teens, responsible for the breakdown of the
family
The system fostered dependency
In 1996, AFDC was replaced by the more
restrictive Temporary Assistance for Needy
Families (TANF) program

21. Food Stamps
• Paid by the U.S. Department of Agriculture
• Administered by state welfare departments
• Provides food for low-income people, and
subsidies to farmers.
• 49 million
Americans on
food stamps

22. “Suppose the budgets of your state and local
governments have to be curtailed, which of
these parts would you limit most severely?”
Public welfare programs 39%
Food stamps 35%

23. Welfare and Public Opinion
Why do Americans hate welfare?
Welfare has become a code word for race, tapping
into latent 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 that
encourages laziness and fraud.
An insult to the American work ethic