The politics of Medicaid / Laura Katz Olson.

Includes bibliographical references (p. [371]-405) and index.

1. The Medicaid story. The political economy of welfare medicine -- Devolution of power -- The (many) hands in the till -- The disregarded stakeholders: low-income households -- Social location: gender and race -- Public opinion and partisan politics -- Overview and organization of the book -- 2. The launching of Medicaid: 1965 to 1980. National health care: early failures -- The Social Security Amendments of 1965: Medicare and Medicaid -- Medicaid: more than a welfare program? -- Cost shifting: paying welfare medicine's bill -- Stemming the cash flow -- National health care strikes again -- Disillusionment -- Reimbursement and provider participation -- The powerful stakeholders -- Combating fraud -- Quality of care -- Conclusion: emerging questions -- 3. From Reagan to Clinton: the low-income health program on trial. Welfare medicine on the defensive -- Congress, mandates, and expansionary politics -- Devolution: fiscal crisis in the states -- The states strike back -- Confrontation: the emergence of the "new right" -- The end of welfare as we know it -- Resumption of expansionary Medicaid politics -- Conclusion: the ebb and flow of welfare medicine -- 4. Welfare medicine in the twenty-first century. Destabilizing Medicaid -- Welfare medicine in the states -- Expanding coverage -- Dismantling the program -- Children first -- Conclusion: smokescreens and mirrors -- 5. Better than nothing? Who gets what, when, how, and where. Who is covered? barriers to participation -- Impediments to obtaining services -- Restricted benefit packages -- Welfare medicine: universal problem solver -- Conclusion: good enough? --

6. Long-term care: Medicaid's eight-hundred-pound gorilla. Long-term care in the United States -- The middle class as stakeholders -- The growth of home-and community-based services -- Hidden costs: informal caregivers -- Déjà vu: counting on the marketplace -- Conclusion: reckoning with long-term care -- 7. Quality of care: does welfare medicine measure up? Second-rate care -- Skimping on services: managed care -- Serving frail elders and the disabled -- Gaming the system -- Program integrity -- Conclusion: disregarding the poor -- 8. The energizer bunny: Medicaid and the health economy. The Medicaid medical industrial complex -- Economic engine for the states -- Conclusion: stakeholders and welfare medicine -- 9. The buck stops where? Tug-of-war: paying the bill -- Medicare and welfare medicine -- Combat within and among the states -- Encumbering the poor -- Dodging responsibility: the private sector -- Conclusion: paying the bill -- 10. Conclusion: Medicaid and the future of health care in the United States. Welfare medicine: promise and performance -- Devolution: the fiscal and political incapacity of states -- The U.S. health care system: broken and dysfunctional -- If it's broke, fix it: the need for national health care.

Olson unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. She helps readers of all backgrounds understand the entrenched and powerful interests that have swollen costs and held elected officials hostage.