Exam 2 Flashcards
Reconciliation
Procedure through which fiscal bills that do not increase long-term deficits can circumvent the filibuster (only majority needed)
* Used to pass ACA in 2010
Supplemental Security Income (SSI)
Under Nixon, national government takes over state-run programs, expanded administrative responsibilities of the robust Social Security Administration to add compensation for disabled, working-age people
AARP
Large interest group (~38 million members) representing Medicare recipients
Dependency Ratio
Measures the relationship between supply and demand on the Social Security system (dependents : workers)
Single-payer System
Health care financing approach where only one source pays providers (ex. UK NHS)
* Praised for simplicity, criticized as “socialized medicine”
401(k) Plan
An employer-sponsored, defined-contribution plan
* Established in 1978 through changes in tax code
* Cheaper for employers than defined-benefit, very popular
American Association for Labor Legislation
In early 1900s argued that compulsory health insurance would enhance worker security
* Operated at the state level
* Campaign was defeated state after state, unified and defined interests of opposing groups (business, insurance, medical profession)
Medicare + Choice
Medicare Part C or “Medicare Advantage”
* Established by the Balanced Budget Act of 1997
* Opened Medicare to private plans
Pay-as-you-go System
Money contributed in payroll taxes today is distributed to current retirees
“Doughnut Hole”
Medicare Prescription Drug Improvement and Modernization Act of 2003 (Medicare Part D) created an intentional gap in prescription drug coverage ($2,250-$5,100 annual)
* Addressed as part of the ACA
Defined-benefit Pensions
Promise a predetermined amount at fixed intervals untile death, based on length of job tenure and earnings (employer assumes risk)
* Characterized by vesting, common in unions
“Harry and Louise” Ads
Ads in response to Clinton’s Health Security Act, heightened public uneasiness
* Later returned in support of Obama’s ACA
Individual Mandate
Provision in the ACA stating that all citizens must have health insurance coverage
* Very polarizing (constitutionality)
* Supported by AMA because access to new customers
Health Care Exchanges
Provision under the Affordable Care Act, allows people and small businesses to shop for insurance
* Can be administered at the state level (ex. MNsure)
* Appeals to conservative beliefs in competition
Health Security Act
Health reform proposal under Clinton in 1992, goal was to provide universal health coverage without mention of taxes
* Managed competition within a budget, coverage via employer contributions
* Stalled in committee, never voted on
National Health Service
Single-payer system in the UK in which the government employs many medical personnel, runs hospitals, and plays a key role in medical education
Townsend Movement
Social movement that pressured the federal government to act on impoverished elderly during Great Depression
* Led by Dr. Francis E. Townsend, unemployed doctor in Long Beach, CA
* Proposed the Townsend Old Age Revolving Pension Plan
Payroll Tax
Determines eligibility for Social Security (roots of “deservedness” of benefits, highlights path-dependence)
* 6.2% up to $160,200
* Secure source of funds
Greenspan Commission
Appointed in 1981 to reform Social Security, report was the basis for the amendments in 1983
* The “Gang of Nine” reached a secret agreement in 1983, excluded most ideological members of the Commission, passed reform by 12-3 vote
Defined-contribution Pensions
Benefits are determined by how much is contributed and how much interest is earned (ex. 401(k))
* Contributions by employers/workers
* Do not promise a specific level of benefits
Medicare Prescription Drug Improvement and Modernization Act of 2003
- “Medicare Part D”
- Established the “doughnut hole” in coverage for prescription drugs annually from $2250 to $5100
Townsend Old Age Revolving Pension Plan
- Proposed by Dr. Francis Townsend in during the Great Depression
- $200/mo. for retired citizens which they need to spend within 30 days
- Financed by national sales tax, promote economic growth and reduce poverty among elderly
Jacob Hacker
Described path dependence in policy development when discussing private pension plans
Illustrated the strong opposition to health care reform taken on by doctors and the private health care industry
Argues that preconditioning, along with group politics and the suffering economic context justify the passage of the ACA
Christopher Howard
Argues against the conventional wisdom of the power of the AARP interest group, states that many of its members do not follow the political standing of the group
Martha Derthick
Described the history of the Social Security Administration as a competent and strong body
Béland and Waddan
Argued that the “deservedness” discourse of Social Security helped to establish its strict path dependence and the notion of the “third rail”
Charles Phelps
Holds that the health care industry is entirely for profit, and the provisions of employer health insurance in reality cut into the salaries of employees
Jill Quadagno
The classical liberal political culture in the US largely prevents large-scale changes to health care from occurring, outlines the numerous veto players and points in the policymaking process
Quadagno also outlines the relevant stakeholders and prospects for reform given the strong opposition
Lawrence Jacobs
Argues that an unmovitvated voting population and highly motivated private interest helps to preserve the status quo in the US health care system
Asks why the ACA was able to succeed where others failed
Suzanne Mettler
Advocate of the submerged state, emphasis on what was explained to the public and what was actually included in the ACA, primarily concerning the sway of private interest groups
Altman and Frist
Focus on the fact that Medicare and Medicaid represent 39% of national health spending, serve as an indicator for the rest of the industry
Jonathan Oberlander
Critic of the argument to “voucherize” Medicare, counters with the claim that Medicare is already voucherized and partially privatized
