In 1965, the United States government enacted legislation to
provide low-income individuals with quality health care and related
services. Initially viewed as the friendless stepchild of Medicare,
Medicaid has grown exponentially since its inception, becoming a
formidable force of its own. Funded jointly by the national
government and each of the fifty states, the program is now the
fourth most expensive item in the federal budget and the second
largest category of spending for almost every state. Now, under the
new, historic health care reform legislation, Medicaid is scheduled
to include sixteen million more people.
Laura Katz Olson, an expert on health, aging, and long-term care
policy, unravels the multifaceted and perplexing puzzle of Medicaid
with respect to those who invest in and benefit from the program.
Assessing the social, political, and economic dynamics that have
shaped Medicaid for almost half a century, she helps readers of all
backgrounds understand the entrenched and powerful interests woven
into the system that have been instrumental in swelling costs and
holding elected officials hostage. Addressing such fundamental
questions as whether patients receive good care and whether
Medicaid meets the needs of the low-income population it is
supposed to serve, Olson evaluates the extent to which the program
is an appropriate foundation for health care reform.
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