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.