Social Security and Public Welfare Chapter 12
Government’s Responsibility for Welfare • The passage of the Social Security Act in l935 affirmed the principle of government responsibility for public welfare. • The Cabinet level department responsible for public welfare is Health and Human Services (HHS). • During Reagan’s presidency there was a shift in the thinking about government’s responsibility for welfare. • Greater emphasis was placed on limiting government’s role – it should do only what people could not do for themselves.
The Social Security Act • In general, this act, with its many amendments, is the chief means by which government at the local, state and national levels provides income security to citizens. • Old Age, Survivors, Disability, and Health Insurance (OASDHI). • Medicare and Medicaid are two of its health care systems under this program.
The Social Security Act • OASDHI is a contributory system. • It is a social insurance. • Distinguishing features of OASHDI: • Provides health care • Provides income maintenance arrangements • Provides provisions for disability • Provides provisions for survivors of insured workers.
OASDHI • This program is not paid from general tax funds. • The tax burden for OASDHI is heaviest on workers currently employed. • Basically the Social Security System is a pay-as-you-go system.
OASDHI • Other characteristics of OASDHI: • The scope and coverage has been greatly broadened and extended since it was enacted. • Designed to protect people against want and need. • Taxes workers and employers to pay for it. • Don’t have to be in need to get it.
Unemployment Insurance • OASDHI and unemployment insurance are the two insurance provisions of the Social Security Act. • Unemployment insurance is a non-deterrent system. • Most characteristic of unemployment insurance is the amount of payments to workers is not the same in every state.
Aid To Families With Dependent Children (AFDC) • Families cannot qualify for AFDC where there are no children under the age of 18 (21 if in school full-time). • AFDC is often under attack because, it is believed, that it: • Encourages out-of-wedlock pregnancies • Encourages large families • Costs the taxpayer huge amounts of dollars.
AFDC • The highest percentage of children in families receiving AFDC was one child. • Steps taken to control cost for financing AFDC include: • Locating absent fathers • Collecting child support payments • Establishing paternity • Imposing liens on property • Assignment of wages
Welfare Reform • The Personal Responsibility and Work Opportunity Reconciliation Act of l996 contains all of the following features: • A requirement for states to withhold court-ordered child support payments. • That states establish JOBS programs. • Welfare clients must be enrolled in JOBS programs. • States required to provide welfare benefits to two-parent families.
General Assistance • General assistance, residual to OASDHI, is intended to aid those who cannot qualify under the federally financed SSI program for the aged, the blind, or the disabled, or AFDC or who are not covered by social insurance. • General assistance is not a popular program. • Taxes for it must be raised at the state and local levels.
Homelessness • Although experts argue over the number, estimates range from a low of 600,000 to a high of three million Americans who are without shelter in a place of their own. • Each year as many as two and a half million people are displaced by rent inflation, economic development plans, condominium development, abandonment, and arson. • Although the waiting lists for new federally funded housing units are growing, the number of units available had decreased by nearly 90 percent since l981.
Homelessness • Large numbers of homeless parents are minorities with few job skills and little experience in the work place. • A growing number of single parents, often in their teens or early twenties, with small children, are joining the ranks of homeless. • Estimates place this group at about one-fourth of those in shelters or on the streets.
Homelessness • School-age children (perhaps as many as 700,000) who move from shelter to shelter change schools frequently. • They not only have difficulty academically, they also have more chronic illnesses, and need the services of mental health specialists more often than children who live in their own homes.
Homelessness • Approximately one-fourth of the adults are alcoholics, one-fourth are drug abusers, another one-fourth have had a felony conviction or have served time in a state or federal prison. A smaller number are mentally ill. (Many fit more than one category).
Medicare • In l965 Congress legislated health insurance for the aged and disabled under the provision of the Social Security Act. • Medicare is a compulsory hospital insurance plan and a voluntary supplemental medical insurance. • The action by Congress to provide Medicare hailed the beginning of what many leaders predict eventually will become a national health insurance program providing “coverage” for virtually all Americans.
Medicare • Medicare was expanded by the l972 amendments to extend the coverage to certain disabled workers, disabled widows and widowers, and childhood disability beneficiaries. • Workers and their employers, including the self-employed, are taxed to pay for health insurance.
Medicare Reform • Senior citizens are anxiously awaiting a number of proposed reforms to the Medicare program. • One is a universal Medicare prescription drug benefit that would be affordable to both taxpayers and beneficiaries. • According to the Congressional Budget Office, $1.5 trillion dollars will be spent on prescription drugs by the Medicare population over the next 10 years.
Medicare Reform • Another concern is the spiraling cost of nursing home care and the limited coverage provided by Medicare. • The Medicare program only covers the costs of skilled nursing home care and even that coverage is limited to so many days a year. • Senior citizens who are being care for in semiskilled or personal care facilities have no Medicare benefits. • The cost of maintaining a senior citizen with Alzheimer’s Disease in a semiskilled nursing home can cost $4,000 or more a month.
Medicaid • Medical care for low-income people (Medicaid) is administered by the states. • States have the option to include persons who are able to provide for their own daily living but whose income and resources are not sufficient to meet all of their medical costs. • The main advantages of Medicaid are: • Provide hospital and medical care for poverty stricken people who have no regular income from employment. • May be used for others whose income is so low that they are unable to pay the high cost of medical and health care for themselves and their families.
Social Services and Social Work • Pubic services are available to certain categories of the population. • These services provide for children, families, and certain adults. • Until l972 service and assistance were combined under one administration. • It was assumed that services were needed for purposes of rehabilitation. • Rehabilitation meant becoming independent of assistance.
Social Services and Social Work • Assistance payments are made mainly for the benefit of dependent children, their parents (usually an unemployed mother), to the aged, the disabled and the blind, and to a few employable males and to mothers needed in the home to provide for their children. • Service patterns are widely diverse. • Approximately 1,313 services are offered in the United States.
Government and Public Welfare • There is a growing realization that government cannot solve all problems. • In some ways these failures resulted from the lack of leadership. • Since 1935 and the passage of the Social Security Act the federal government has increasingly assumed responsibility for the protection of citizens against want as an enduring principle.