This article describes the complex healthcare policy and financing systems in the US within a historic and political context for how the US arrived at these systems. It also provides an overview of frameworks useful for articulating how social work may have an increased influence on policies impacting the healthcare system along with specific arenas ripe for social work interventions towards healthcare system improvements. Social workers have the obligation, through the National Association of Social Workers Code of Ethics, and the requisite skills, to participate in the healthcare policy process ensuring that they not only have a place at policy making tables, but that members of communities impacted by these policies have an opportunity to assist in setting the healthcare policy agenda and programs to best serve them.
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Health Policy Overview
Heather A. Walter-McCabe
Article
Health Care Reform
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.
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Social Policy: History (1950–1980)
Mark J. Stern
Between 1950 and 1980, the United States developed a welfare state that in many ways was comparable to those of other advanced industrial nations. Building on its New Deal roots, the Social Security system came to provide a “social wage” to older Americans, people with disability, and the dependents of deceased workers. It created a health-care insurance system for the elderly, the disabled, and the poor. Using the tax system in innovative ways, the government encouraged the expansion of pension and health-care protection for a majority of workers and their families. By 1980, some Americans could argue that their identification as a “laggard” in the field of social provision was no longer justified.
