Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform

By Karen Seccombe; Kim A. Hoffman | Go to book overview

Chapter 7
Facing Reality

Social and economic policies are health
policy. When governments or other agen-
cies make decisions that are going to have
an impact on people's lives, they need to
understand the impact that could have on
their health
.

–Kaplan et al. 2005

Social policies can have profound consequences for the health of the population. The passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) in 1996 is often viewed as a defining moment in the history of social welfare in the United States and, as we have shown, affects health in varied ways. However, welfare reform policy does not exist in isolation. The political and fiscal attack on our welfare system has deep and historic roots that reflect American sentiment about poverty generally and poor women in particular. Americans tend to view public relief programs with suspicion, believing the programs discourage work incentives and motivation. Many people believe that families in need of welfare are lazy and content to live off the [public dole.]

A culture of public resentment grew and pushed legislators more than a decade ago to implement radical welfare reforms, resulting in the erosion of one of our most vital national safety nets. With limited exceptions, lifetime

-163-

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Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Figures and Tables vii
  • Acknowledgments ix
  • Chapter 1: Introduction Access to Health Care and Welfare Reform 1
  • Chapter 2: Health Status and Health Changes 28
  • Chapter 3: Insurance Coverage 63
  • Chapter 4: Other Access and Barriers to Health Care 90
  • Chapter 5: Do Families Get the Health Care They Need? 114
  • Chapter 6: Worry, Planning, and Coping 136
  • Chapter 7: Facing Reality 163
  • Appendix 185
  • Bibliography 191
  • Index 205
  • About the Author 213
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