Chapter 19 Government

8/12/2019 Chapter 19 Government

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Erica VenzorAshley Vu


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- Americas health policy paradox: spend moreon our national resources on health than anyother industrialized country but are far from thehealthiest- Dont have a government -run health caresystem nor do we have a private one


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Although were generally healthy we lagbehind other countries in some key healthcare categoriesChances of a baby dying in the U.S. is morethan 50% higher than those in Japan


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Not cheap-1 trillion annuallyHealth expenditures- 1/7 th (14%) of GDP, not only arethey high but they increase faster than any othergood or service we purchase.Spend almost 3x as much as we did in 1983 and

spend only about again as much on food andhousingCosts soar on not only private but public side ofhealth care and some reasons theyre so high is: 1. Overbuilt medical care facilities

2. New drugs and technology 3. Treatments -Huge gigantic wheel


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Inequalities are serious problem in AmericaGain access to health care in a variety ofways. Today many go with HealthMaintenance Organization (HMO)


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More than 43 million people are without health insurance1999=15.5% were without health insuranceOften linked to a job; 61% of Americans get their healthinsurance from the workplaceEven if some have opportunity of to a group healthinsurance plan they cant take it Closely tied to race and income; 1/3 Hispanics wentwithout insurance in 1999, 21% African American andAsian familiesDiscrepancies to health care is reflected in the health ofdifferent groups

Advances in technology help but at the same time arentavailable to everyoneEven for those who have it dont have the full package


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Differs from other democracies in one important way: roleof governmentNational , state, and local pay for 46% of countrys totalhealth billFederal government pays for much of nations medical billthrough the Medicare program, Medicaid, and health carefor veteransHarry S. Truman was first president to call for nationalhealth insurance and was strongly opposed by the AMACongress went ahead to rectify the special health careproblems of elderly by adopting Medicare; have Part A andBLike SS, Medicare is running out of contributions to theMedicare Trust Fund


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Equality of care and on costs have taken a backseat to technological advanceNeeded procedures are very expensiveOne reason for uneven government and private

health care policies involves a representation ofinterestsElderly most powerful voting and lobbying forcesin politicsOne group that is increasingly active in healthcare policymaking is businessAnother major player in health care policymakingis the insurance companies


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Clinton made health care reform centerpiece of hisfirst administrationMain concern was guaranteeing health care coveragefor everyonePaying for it would have necessitated either broad-based taxes, or a requirement that employers providehealth insurance or pay a premium into a public fundTo contain costs, the administration would haverequired states to set up large consumer groupscalled health alliances to collect premiums, bargainwith health plans, and handle paymentsHarry and Louise ads - Theres got to be a betterway


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Health care issues remained high on agendaPublic opinion surveys show that people thinkthe nations health care system need a greatdeal of reformCost of medical care in general andprescription drugs in a particular confrontedCongress as the century turned


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Politics infuses itself into the debate over theenvironment


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Early 60s environmental protection notprominent in federal policy1970 Environmental Protection Agency(EPA) created and charged with administeringall the governments environmentallegislation Administers policies dealing with toxic wastes Largest federal independent regulatory agency


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1969 - National Environmental Policy Act(NEPA): law that is the centerpiece of federalenvironmental policy in the US. Established the requirements for environmental

impact statementsRequires govt and agencies to detail possible effectsof a policyDoesnt necessarily stop unsound activities


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Charges Dpt. Transportation with theresponsibility of reducing automobileemissions1990 Congress reauthorized Clean Air Act Significantly increased controls on cars, oil

refineries, chemical plants, and coal-fired utilityplants


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1972 Water Pollution Control Act Control pollution in lakes and rivers1973 Endangered Species Act Required govt to actively protect species listed as

endangered regardless of surrounding economiceffects


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Govt constantly in argument over what form of energycountry should be producingCoal = Americas most abundant fuel U Coal = thedirtiestOil = cleaner U oil = possible oil spillsNuclear power = most controversial energy source Radiation leaks and accidents in late 1960s enough to cause

environmental concern Reduced nuclear power industry No new plants built in US after 1978Each source of energy poses potential risks to theenvironment. Interest in conservation, renewable energysupplies, and alternative fuels has increased.1992 energy bill encourages development of renewableenergy sources and alternative clean fuels.


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Global Warming: scientists say earth iswarming at a rapid rate Potential adverse affects on environmental, social,

and economic situations

No technology to control carbon emissions; mustburn less fuel or find alternative energy to reducegreenhouse gases

1997, Kyoto, Japan 150 nations met and agreed torequire 38 industrial nations to reduce greenhouse

gas emissions below the level in 1990 by the year2010Opposite argument from fear that cutting greenhousegases will be too costly


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1980 - Congress established the Superfund(created by taxing chemical products) to dealwith toxic waste Est. that those who polluted the land were responsible

for paying to clean it up. Essentially eliminated haphazard dumping of toxic

wastes, but has been less successful in cleaning upexisting waste due to endless rounds of litigation.

EPA finds unpredicted difficulties at timesDamage at some sites is so serious they may be beyond

clean up.No place to store nuclear wastes, such as that from nuclearreactors and the production of nuclear weapons.


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Environmental concerns vs. equally legitimateconcerns about foreign trade, economic growth, and jobs.Much pollution due to production of cars, electricity,and food and consumer products (occupations)

Big change in recent years increasing presence ofnew interest groups that complain about pollutionand want govt solution 1960s and 1970s increasing number ofenvironmental interest groupsEnvironmental movement has changed somedirections Argues employment, economic growth, and international

competitiveness must be part of policymaking equation Local groups have started resisted planned development


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A. Democracy and Health Care andEnvironmental Policy High-tech issues limit public participation in a

democracy

Hard to include public in reasoned political debate Issues with high technology often so complex, they

involve many different levels of govt Policymaking for technological mostly relies on

groups as opposed to individual citizens


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B. The Scope of Government and Health Careand Environmental Policy Americans demand govt to play a greater role in

high-technology issues, so scope of the federal

government has grown in response Tension between demands for government services

and protections and a concern about thegovernment providing those services andprotections.

Documents

Chapter 19 Government