This entry provides an overview of the state of health care in the United States. Service delivery problems such as access and affordability issues are examined, and health care disparities and the populations affected are identified. A discussion of two primary government-sponsored health care programs—Title XVIII (Medicare) and Title XIX (Medicaid), and the Patient Protection and Affordable Health Care Act—are reviewed along with various health care programs and major existing service delivery systems. Ethical conflicts in providing health care, and new directions and challenges are discussed, along with future roles for social workers.
Vikki L. Vandiver
Since the mid-1980s, managed care has been one approach used to address the economic crisis in the American health-care system. This entry overviews managed care from the perspective of policy, procedure, practice, and system. Specifically, emphasis is given to understanding the emergence and history of managed care, multiple definitions, how it works, and examples of managed care plans, key legislation, existing research, its future, and implications for social-work practitioners.
Kenneth S. Carpenter
Bertram Beck (1918–2000) was a social worker who contributed to juvenile delinquency prevention and held many leadership positions in social work organizations. At Fordham University he was instrumental in creating the managed care institute and the religion and poverty institute.
Patricia A. Fennell and Sara Rieder Bennett
There is a paradigm shift occurring in medicine, from models focused on treating acute illnesses to those concerned with managing chronic conditions. This shift coincides with the higher prevalence of chronic illnesses resulting from factors such as lower mortality from formerly fatal illnesses and an aging population. The chronically ill do not fare well in an acute care model, and as a result, it has become imperative to develop new models effective for these chronic conditions. These new care models will require comprehensive, coordinated case management, an activity in which social workers can play a significant role.
Lonnie R. Snowden
This entry describes the extent of the mental health problem in the United States, trends in treatment rates, and evidence that public recognition of mental illness and related interventions is increasing both in the United States and internationally. Emphasis is given to the structure of the mental health system's major sectors, to the key roles that social workers play, and to the challenges they face, outlined at the conclusion of several sections, in providing effective and quality care against the complex backdrop of this system.
Cynthia Moniz, Stephen H. Gorin, and Terry Mizrahi
National health care reform in the United States, from its introduction into the public policy agenda at the turn of the 20th century through policy debates and legislative proposals more than a century later, has achieved limited success with universal coverage for health and mental health services. Opposition to government-sponsored health care has always been present. The extent of the opposition has depended on the type of reform proposed and the era in which it occurred. Medicare and Medicaid reform in the 1960s greatly expanded access and coverage for older adults and low income individuals and families. But, the first true effort to reach universal coverage occurred with the passage of the Affordable Care Act in 2010.