Test 1 Flashcards
1
Q
Structural definition
A
“Two or more people related by blood, adoption or marriage” (lecture)
- who is in the family
- number of members
2
Q
Functional definition
A
“Two or more people who care for each other and share economically”
Roles of members, what they do
3
Q
Definition of family ( Census Bureau)
A
A group of two or more persons related by birth, marriage, or adoption who reside together in the same household
4
Q
Definition of family (Ooms and Preister)
A
Two or more persons related by birth, marriage, or adoption
5
Q
Definition of family (National Institute of Mental Health, 2005)
A
“Family = Network of Mutual Commitment”
6
Q
Definition of family (Stack, 1996, p. 31).
A
Ultimately, I define ‘family’ as the smallest, organized, durable network of kin and non-kin who interact daily, providing domestic needs of children and assuring their survival
7
Q
Definition of family (Collins)
A
• Any unit in which there exists:
- -Sharing of economic property
- -A caring and supportive relationship
- -A sense of commitment or identification with the other members
- -Including any children born to or raised by members
8
Q
Family, as defined by a 1970s Long Island, New York housing code (upheld by the U.S. Supreme Court in 1974)
A
“One or more persons related by blood, adoption, or marriage, living and cooking together as a single housekeeping unit, exclusive of household servants.”
“A number of persons but not exceeding two (2) living and cooking together as a single housekeeping unit though not related by blood, adoption, or marriage shall be deemed to constitute a family.”
9
Q
Should there be a universal definition of family?
A
Defining family is not easy
Risk of being either too narrow or too broad
10
Q
Precedence (being more important) of family
A
No legal definition of “family” in the U.S. Constitution, the federal statutes, or regulations, or many state statutes
“Family” is purposely absent from the U.S. constitution.
11
Q
Why should definitions of “family” matter to family policy makers?
A
Money, benefits, who it goes to, need to know who is included and where to draw the line
12
Q
Is this a family? (percentages)
A
**86% said a single parent and child constitute a family
**88% consider a married childless couple a family.
**If a heterosexual cohabiting couple (over 9 million people in U.S.) has no children, a majority of the public says they are not a family.
**80% said an unmarried heterosexual couple living together with a child is a family
**63% said a gay or lesbian couple raising a child is a family.
13
Q
Does it matter who is in or out of a system?
A
YES!
Who is in and who is out of a system matters!
14
Q
Overall take away on definition of family
A
**Analyzed definitions of “family”
**U.S. constitution does not have any definition of family
**U.S. government does not have one, clear definition of family
**U.S. policy defines family differently for different purposes
**In this course we will use the word “family” inclusively, but at times it will be useful to be clear about what definition is being use
15
Q
Structural or functional?
Two or more people who care for each other and share economically
A
Emma thinks both
16
Q
Where does family policy fit?
A
Public Policy
Social Policy
Family Policy
17
Q
Public Policy
A
The development, enactment, and implementation of a plan or course of action carried out through law, rule, code, or mechanism in the public or private sector
• EX: stop sign, punishment for robbing someone, having to wear a hard hat for job site, roads
18
Q
Social Policy
A
Policies that deal with individuals or groups of people in society
• Ex: individuals or groups of people, criminal justice, education system, family law, sexual harassment, discrimination, equal rights, pay
19
Q
Family Policy
A
A subfield of social policy which specifically focuses on “family business,” (Blankenhorn, 1990, p. 18), specifically four family functions:
1. family creation or composition,
o Divorce, childbirth, marriage
2. economic support,
o Food stamps, pay,
3. childrearing, and
- family caregiving
o Economic support for families, care for child
20
Q
Family creation/composition (Family Policy)
A
Examples: Childbirth, marriage, divorce, adoption, foster care
21
Q
Economic support (Family Policy)
A
Examples: Families’ ability to provide for basic needs such as food, shelter, clothing, health
22
Q
Development of children (Family Policy)
A
Examples: Parents’/guardian’s ability to nurture, rear and educate their children
23
Q
Family care (Family Policy)
A
Examples: Families’ ability to care for members who are chronically ill, frail, or have disabilities
24
Q
Is public school education family policy?
A
NO!
Seems like it should fit under “Development of children” (Parents’/guardian’s ability to nurture, rear and educate their children)
25
Explicit and Implicit family policy
There are many social policies that affect families even if they do not actually fit narrow definitions of “family policy”
• Can this policy exist if there is only one person involved?
o Have to have more than one person for explicit
26
Explicit Family Policy
Social policies in which the consequences for families are deliberately structured
They are directed at:
1. Family creation/composition
2. Economic support
3. Development of children
4. Family care
* Someone sat down and wrote a law or code and said this is how we are going to interact with family
* 4 categories of fam policy (above)
* Most in family creation/composition
* *Family composition: Childbirth, marriage, divorce, adoption, fostercare
* *Economic support: Families’ ability to provide for basic needs such as food, shelter, clothing, health
* *Development of children: Parents’ ability to nurture, rear and educate their children
* *Family care: Families’ ability to care for members who are chronically ill, frail, or have disabilites
27
Implicit Family Policy
Social policies that have nonfamilial objectives but which nonetheless affect families
They affect:
family stability
family relationships
family’s ability to carry out its responsibilities: economic support, development of children, family care
* Public school- busing, schedule, calendar
* EX: Roseville starting early and then wanting to start late
Are not deliberately structured to affect families
But they affect families’ ability to function especially in the areas of:
Economic support
Development of children
Family care
28
Family Policy Perspective
Family Policy Perspective: An analysis of any policy or program, for its impact on family well-being (e.g. family stability, family relationships, and the family’s ability to carry out its responsibilities)
Another term = “family impact perspective”
29
Label each of the following as “Explicit” or “Implicit” family policy
```
Child care
Health care
Child support
Housing
Divorce
Poverty
Juvenile crime
Teenage pregnancy
Substance abuse
Unemployment
Long-term care
```
```
**Explicit
Child Care
Child support
divorce
Juvenile crime
teenage pregnancy
long term care
```
```
**Implicit
Health care
housing
Poverty
Substance abuse
Unemployment
```
* Poverty- Implicit…. Not always b/c of things like TAMF
* Juvenile crime- Explicit b/c has to do with minor but could argue other side
* Teenage pregnancy- Explicit b/c has to do with minors and parents
* Substance abuse- Implicit b/c some could not have family and policies are just for the individual
* Long-term care (elderly)- explicit b/c a lot include families but there is some who don’t have family
30
What is an explicit family policy? (class 4)
```
Social policies in which the consequences for families are deliberately structured
Directed at:
Family creation/composition
Economic support
Development of children
Family care
```
31
Global Family Leave
190 countries
178 guarantee paid leave for new mothers
9 unclear about their maternity policies
3 countries clearly offer no legal guarantee of paid maternity leave -- Papua New Guinea, Swaziland and the United States.
32
Why should parental leave policy be a national concern?
Well loved, securely attached children are in society’s best interest
Grow up to be productive citizens
33
Example: Family Leave
Three levels:
1. Federal: Family Medical Leave Act (FMLA)
2. State: e.g. CA paid family leave
3. Individual employer: e.g. Maternity/ paternity leave policies
34
Federal level: Family Medical Leave Act (FMLA)
August 1993
| First unified attempt at Federal leave legislation in the US
35
What is FMLA?
Entitles eligible employees to take up to 12 weeks of unpaid, job-protected leave in a 12-month period for specified family and medical reasons.
36
What can FMLA be used for?
* Birth and care of the newborn child
* Set-up adoption or foster care
* To care for an immediate family member (spouse, child, or parent) with a serious health condition
* To take medical leave when the employee is unable to work because of a serious health condition
37
FMLA advantages
Uniformity, inclusiveness
Guarantees job back after you take a leave
Health insurance continued during the leave
Provides a grievance system for making complaints against an employer
38
FMLA disadvantages
* It’s unpaid!
* 41 million people - nearly half of the private workforce are not protected by the law.
* People aren’t aware of the variety of ways it can be used
* Mothers more encouraged to use it than fathers
* Not really long enough to be useful, but too long to be unpaid
lots not covered
39
Why must be eligible? FMLA
Been with employer 12 months yet
Work more than 25 hours/week
Work for company with more than 50 employees in a 75 mile radius.
“Key” employees are exempt
40
The National Defense Authorization Act for FY 2008
Amends the FMLA of 1993
“Spouse, son, daughter, parent, or next of kin" can take up to 26 workweeks of leave to care for a "member of the Armed Forces, including a member of the National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired list, for a serious injury or illness." (January 28, 2008)
Expanded protection for military families and airline flight crews
41
Moving to other levels
One way to attack work and family issues is at the National level
Risk of being too broad or too narrow.
Another approach is at the state level.
Several states have passed legislation that augments the federal legislation.
42
State Level
States that have enacted their “own versions” of family leave
California, Connecticut, Hawaii, Maine, Minnesota, New Jersey, Oregon, Rhode Island, Vermont, Washington, Wisconsin, District of Columbia
43
Minnesota FMLA
Employers with 21 or more employees must grant up to 6 weeks unpaid leave to new parents (birth or adoption)
FEB 2008:
Proposed paid parental leave for Minnesota workers to care for a newborn or newly adopted child.
State would reimburse employers for providing paid leave.
Minimum of 6 weeks but up to 26 weeks.
Employers would be reimbursed for half their weekly payment to their employees, up to $250 per week.
Status: The bill did NOT pass and no further action has been taken
44
State level: California FMLA
*CA passed first paid family leave
Six weeks of partial pay to workers who take family leave
Funded through the State Disability Insurance program
*CA paid leave July 2004
Funded entirely by employees.
Average additional annual cost is $46.00 per worker.
A minimum wage earner pays $11.23 a year
Benefits replaced approximately 55% of wages up to a maximum of $1011 per week beginning Jan 1, 2012.
45
Washington FMLA
Second state to pass paid family leave
Passed legislation in 2007
Up to five weeks off with $250 per week, effective October 1, 2009.
Not yet enacted!
46
New Jersey: Family Leave Insurance
Passed May 2, 2008
100% worker-funded
Workers pay 34-64 cents/week starting January 1, 2009.
2/3 of normal paycheck (capped at $524/wk in 2008) for up to six weeks starting July 1, 2009.
47
Rhode Island FMLA
Enacted a paid family leave benefit as of Jan 1, 2014
48
Individual Employers: Maternity/Paternity leaves
Mostly large corporations/businesses
6 weeks paid common for mothers
1-2 weeks paid common for fathers
49
The U.S. family leave system is confusing and overwhelming. Why?
Many new parents do not know what they are entitled to do.
Parents must figure out what combination they can use
Many parents cobble together a little of this and a little of that
Examples: ?
50
If you were a policy maker, how would you ensure that families had access to family leave?
In your opinion, is this a federal, state or individual employer issue to solve?
What if any changes would you make to the federal family leave policy?
Class discussion
51
History of family policy in the USA
Family policy should reflect values and meet the needs of the families who live in the United States.
This is a very difficult task given our size and diversity and the limitations of our “historical context”
52
Who founded this country and why?
It is important to consider the values and goals of the people who wrote our constitution
Revolutionary War
(1775-1783)
53
Breaking the ties of family legacy
* Goal of war to break away from the “Motherland”
* Break away from a system where individuals were judged based on their family names and ranks
* Founders wanted individuals to be able to prove themselves
- Didn’t matter if your family had land, money or anything… pretty much anyone could get land
*No mention of family in constitution
54
Preamble to the U.S. Constitution (1787
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
* Were thinking forward
* Many wanted to get away from past
55
Social Policy in the beginning
Support for Revolutionary War veterans
| Care for widows and “deserving” poor was often taken on by individual communities
56
Historical background
1861-1865 Civil War
1865-1914 Industrialization and urbanization of U.S.
1890-1914 Progressive Era
1914-1918 WWI
57
Immigration
After Civil War immigration increased
| 1880s: Italy, Poland, Russia, Greece
58
Changes to do industrialization and urbanizaiton
Industrialization:
1859 60% worked in agriculture
1914 69% worked in Non-agriculture*
```
Urbanization:
Ate up land
Housing issues
Sanitation issues
Transportation issues
Loss of feelings of community
```
59
Rich and Poor
A few people were very rich and powerful and could “buy” votes in Legislature and Congress
Most workers were very poor: low wages, long hours, no vacations, dangerous working conditions
EXample
Family of 4 needed $740-880/year to live subsistence level*
Many adult male full-time workers did not make that much
EXample
1900: 1% of U.S. population owned 47% of assets
2010: 1% owned 34% of assets*
But, next 4% owns another 27%
60
Progressive Era
About 1890s – 1914
“New middle class”
Large, often violent labor disputes interrupted production and distribution
Led middle class to feel pressure to do something to help the poor
Rise of public education, public health, etc
* Made policies about education
* Policies about hours and safety
* Middle class decided they were going to help the poor
Many people saw that change was necessary and important given the new realities
But many mourned the loss of the old values and structure
Makes policy change more difficult
61
In what ways are the dilemmas facing the U.S. today similar to the ones facing the country 100+ years ago?
In what ways are they different?
Large group discussion
Discussion
62
The New Deal
The New Deal was a comprehensive series of social and economic programs enacted by the Franklin D. Roosevelt Administration.
Programs included:
Social Security Act (1935) ~~~know this one
Agricultural Adjustment Act (AAA)
National Industrial Recovery Act (NIRA),
Public Works Administration (PWA)
Federal Deposit Insurance Corporation (FDIC)
Tennessee Valley Authority (TVA)
Civilian Conservation Corps (CCC)
Securities and Exchange Commission (SEC),
63
History of Helping people
U.S. Government has a history of helping citizens especially in times of crisis
But we also have a history of expecting individuals to work hard and “pull themselves up by their boot straps”
64
The U.S. government has a history of
A.Defining “family” narrowly when it suits their purpose
B. Creating programs to help those in need
C. Expecting individuals to work hard and “pull themselves up by their boot straps”
D. All of the above are true
D
65
Family leave as a broad topic is...
A. Explicit family policy
B. Implicit family policy
A. Explicit
66
FMLA is...
A. Explicit family policy
B. Implicit family policy
A. Explicit
67
Poverty as a broad topic is...
A. Explicit family policy
B. Implicit family policy
B. Implicit
68
Poverty
Temporary Assistance to Needy Families (TANF)-Explicit family policy example
Median hourly wage in US in 2012:
National: $16.71
MN: $17.74
Federal minimum wage
$7.25 (July 24th, 2009)
69
Poverty varies by number of people in family
Federal Poverty Guidelines (2013 guidelines)
Single individual = $11,490
Family of 3 = $19,530
Family of 4 = $23,550
Working 40 hours/week at minimum wage $7.25/hour = $15,080/year
70
National Poverty Rate
Total people in U.S. living in poverty
= 15.0% (2012)
Highest since 1994, but lower than 1959
71
Children in Poverty
National = 23%
Range from 12% (New Hampshire) to 32% (Mississippi)
Minnesota = 15.3%
MN children in poverty:
Children in immigrant families = 27%
Children non-immigrant families = 12%
72
Deserving and undeserving poor
U.S. has had a tendency to categorize poor based on whether they are seen as “deserving” or “undeserving”
Historic Example:
Veterans = “deserving”
Alcoholics = “undeserving”
73
History of poor mothers
Over the years, many changes in public perception of how to treat poor mothers of children
Historically, sometimes seen as “deserving” and sometimes as “undeserving”
Benefits to poor mothers of young children have changed over the years partially depending on whether mothers’ were needed in the labor force or not
74
The End of Aid to Families with Dependent Children (AFDC)
Common name = “Welfare”
General agreement that the system was broken
Many women stayed in system for long periods of time
Disagreement on why system broken and how to fix it
Example: System encouraged mothers not to marry
75
Temporary Assistance to Needy Families (TANF)
```
July 1, 1997
President Clinton passed “Personal Responsibility and Work Opportunity Reconciliation Act” (PRWORA)
TANF replaced AFDC
Block grants to states
Life-time limits on benefits
```
76
TANF gives block grants to states to spend as they see fit—within certain guidelines
What are the benefits and drawbacks of letting each state tailor its own program?
discussion
77
Purpose of TANF
Provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives
End the dependency of needy parents on government benefits by promoting job preparation, work, and marriage
Prevent and reduce out-of wedlock pregnancies
Encourage 2 parent families
78
Minnesota Family Investment Program (MFIP)
States received block grants to structure their own programs
MN generally thought to be more generous than many other states
MN = 60 month time limit
**Recipients must work
Requires to participate in work activities or look for a job at least 30 hours per week and must take any suitable job offer.
Failure to do so results in a 10 percent grant reduction in the first month and 30 percent months 2-6. After six months, a case is closed.
79
Results of MFIP
Three years after entering MFIP, approximately 70 percent of participants are either off cash assistance or working 30 or more hours per week.
In state fiscal year 2009, collected $10.5 million in child support
Distributed to families in the Minnesota Family Investment Program.
80
MFIP supports working parents with various services
Healthcare coverage
Child care while working or when following an employment plan approved by a job counselor
Must name father of child(ren) and allow state to collect child support
81
MFIP rewards working families transitioning to economic stability
37% of their earned income is disregarded.
Working parents get a grant standard that is 110% of the regular grant standard.
Families leave MFIP when their income is about 15 percent above the federal poverty level.
82
Do TANF and MFIP work?
Fact: fewer people receive “welfare” benefits now than in 1997
But does that mean that the program works?
Employment and income averages are still far below those for the general population in the state and below the Federal Poverty Guidelines.
83
Current controversies over TANF and MFIP
Should we raise minimum wage?
Cuts to food stamps/SNAP funding
Drug testing for parents who receive benefits
How to prevent fraud in the system
84
Demographic changes in U.S. 1950-Present
1. Increasing numbers of people
2. Increasing median age
3. Increasing diversity
85
Increasing numbers of people
* Approximately twice as many people in U.S. as in 1950
* Sources
- Fertility
- Life Expectancy
- Immigration
86
Increasing median age
Life Expectancy
1950= 68.2
2009 = 78.2
Age 65 and up
1950 = 2,397,000
2010 =40,267,000
87
Increasing diversity
White Black Other
1950: 89.5% 10.5% <1%
2000: 75.1% 12.3% 12.5%
2010*: 72.4% 12.6% 15.0%
*Obscures Latino population = 16%
88
Small group brainstorm—name 2 reasons why these changes (increasing numbers of people, increasing age, increasing diversity) matter to policy makers.
discussion
89
Other demographic changes in U.S.
Rural/urban
Increasing numbers of women in the workforce
Less marriage
90
Urban/Rural change
Percent of US pop. Urban Rural
1900 39.6% 60.4%
1950 64% 36%
1990 75.2% 24.8%
2000 79.3% 20.7%
rural=farm
91
Women in workforce
Married women with children
1970 = 39.7
2009 = 69.8
Single women with children
1980 = 52.0
2009 = 72.0
92
Marriage declining in all groups
1960 68% of people in 20s were married.
2008 26%
*But...
Marriage still norm for adults with a college education and good income
Lower socio-economic are just as likely to want to marry, but less likely to be married
93
Other changes in USA 1950- present
Increasing acceptance of Lots of demographic and social changes in the U.S.
94
Why is family policy controversial and difficult to move forward?
Discussion of family policy often begins with discussion of the demographic changes that have affected family life in the last 30 years. (Bogenschneider, 2007)
An individual’s perception of the consequences of these demographic changes helps define policy debate (Blankenhorn, 1990)
*What does that mean??
Some people see demographic changes as more negative (and want to prevent, stop, or slow changes) while other people see the changes as more positive (and want to celebrate, increase changes).
EXAmple: We can agree that there are more women in the work force than in the past
But may not agree on whether this is primarily positive or negative change
95
Star Wars
everyone views things differently
try to have perspective
Where/how the lens is focused leads to very different ideas about solutions for society’s issues
Which in turn leads to very different policy proposals
96
Points of views in policy
Elected official/voter
Business owner/employee
Banker/borrower
High income/low income
97
Policy proposals often shaped by either:
Life is worse now than past
Life is better now than past
Who is right? Look at the facts.
other card
98
Life is Worse View: Some people feel like America is falling apart
It is more crowded, harried
They may not feel safe
Jobs have gone oversees
Many small towns are struggling
Many have seen their “real earnings” decrease
They have lost jobs
They worry about debt, healthcare, retirement
Many people feel that the American Dream is further away than in the past
Unemployment 1950 = 5.3, 2010 = 9.6 (highest since 1982, before that it was low all the way back to 1940)
99
Life is Better View: We have become more accepting of diversity and individual differences
There is less overt discrimination
More recognition of abuse, bullying, hate crimes
Less strict gender roles
Many groups that were marginalized in the past are more accepted
```
Better than 60 years ago
-Fewer people live in poverty*
1950 = 22.4%
2000= 11.3 %
2009 = 14.3%
2011 = 15.1%
```
Items that were luxury items for most families 60 years ago are now standard in most homes—color T.V, car, dishwasher, air conditioning
100
How does life better or worse relate to policy making?
Increased population does mean bigger government
Increased diversity does make rules and regulations more complex
There are more laws and regulations than there were in the past
101
Policy Making Arenas
* *Levels of government in USA
- Federal (supreme court, president, govenor)
- State
- Local (county, city, school board)
* *Branches of government
- Legislative
- Executive
- Judicial
102
Federal Level: When and how are decisions made?
**What is a bill?
**How does the bill become a law?
A congressperson has an idea for a policy/program/law and becomes the “sponsor”
Submits idea and it is given a number, then it is a “bill”
Bill is assigned to a committee
103
Standing committees
• Do not have a committee on family or children …. Huge problem
104
What happens in committee?
Committee hears arguments on both sides
Can make changes to the bill
Decides whether to pass it on the to full House or Senate
Gets put on the calendar for the “floor”
May spend a lot of time being debated or may move quickly to a vote
* Speaker puts it on the calendar
* Put in on calendar where its pushed back so could be on purpose
105
If the bill passes in the House or Senate, then what?
It is sent to the other chamber.
Often it goes through a committee in the other chamber before going to the floor to be voted on (or not)
If it passes, it may end up in joint committee to work out differences between House and Senate versions (votes happen again)
106
What about the president?
After a joint version has passed both the House and Senate, then it arrives on the President’s desk and he can sign or veto
What happens if the President vetoes the bill?
* Govenor can veto line by line not entire thing…pres doesn’t have that … happened when Jesse was governor
* If pres vetoes it then go to house and senate but then need 2/3 and if they get majority they can over rule the pres but its super hard to do today
107
Family Policy making (gov branch)
Both the Legislative and the Executive branches of government are involved in family policy making
Long complex process
There are many, many places where things can get stuck, stopped, changed, etc.
What are all of the places a bill can get changes, hung up, or stopped?
108
Where does the Judicial Branch fit in?
Does the judicial branch play a role in family policy making?
***Can decide if the law is unconstitutional
109
State level policy decisions
Many similarities to Federal level
110
Minnesota gov
U.S. Senators = 2 (6 years)
U.S. House of Representatives = 8 (2 years)
Minnesota Senators = 67 (4 years)
Minnesota House of Representatives = 134 (2 years)
City/county/other:
mayor
city council
comissioners
```
Other players:
Lobbyists
Corporations
Citizens
Other countries
International laws
Voters
```
111
Summary of voting stuff
Voting rights have become more inclusive since country was founded
Percentage of voter’s who vote in any given election is low compared to the past
U.S. voter turn-out highest in 1870s = 80% of eligible voters
And low compared to other countries
National voter turn-out is around 30%
MN has higher voter turn-out than any other state (2008 MN = 77.8%)
112
Which of the following is false?
A. The U.S. is more crowded now than in the past
B.There are more employed women now than in the past
C.People in their twenties are more likely to be married than in the past
D.None of the above are false
C b/c people way less likely to get married
113
Some families think life in the U.S. in the past was better while others think the present changes are better
A. True
B. False
True...reasons for both sides
114
Which of the following can be used as evidence that life is worse in the U.S. now than in the past?
A.The U.S. is more crowded
B.Poverty is higher now than in 1950
C.People have fewer luxury items such as color televisions, air conditioners, and dishwashers
D.Since there is more diversity there is also more overt discrimination
A. it is more crowded
115
Health care is...
A.Explict
B. Implicit
Implicit
116
Healthcare system in U.S. Before “Health Care Reform”
Health insurance is often tied to employment
| Provided primarily by private insurance companies
117
US Non-elderly population 2003
```
62% = private employer-sponsored
5% = private non group (individual)
15% = public insurance programs (e.g. Medicaid)
18% = uninsured
```
118
Historical background of heath care
Prior to 1920s most people were treated for illness at home
Medical costs were low
Lost wages were the primary concern
Began to change as modern hospital practices emerged
119
How did employers get involved with health care?
WWII workers were scarce led to
1942 Stabilization Act
Employers could not raise wages to attract workers, but they could offer health insurance as an incentive
1943 Congress passed tax exemptions for money that employers put into employees’ health insurance
120
Are there advantages to this system? (health care from employer)
Disadvantages?
```
Insurance is cheaper when bought as a large group
Employers pay some or all of the premium
From a business perspective,
Less turn-over
Healthy employees are good for employers
```
```
DISADVAN
Changing jobs
COBRA 1986
Part-time jobs
Too ill to have a job
Employers who can’t afford to pay insurance
e.g. small business owners
```
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Comparing U.S. to the World in terms of health care
The United States is the only industrialized nation that does not have some form of universal government sponsored health care
Defined as a “basic guarantee of health care to all of its citizens”
U.S. spends more per capita on health care than any other industrialized country
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Why does the U.S. spends more on health care than any other country?
- unnecessary use of the ER
- Lack of preventive care and adequate care of chronic diseases
- More likely to develop complications and advanced stage disease, both of which are expensive to treat.
Unnecessary Tests to prevent law suits
Costs associated with our aging population—we face a huge ethical dilemma as a society as our aging population continues to get bigger and bigger and cost the system more than they put in over their lifetime
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Minnesota health care
9.1% uninsured in 2011
| More are rural than urban
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What about health care reform AKA obamacare?
*Same old problem
We can agree that the healthcare system is broken
But we can not agree on what “broken” means and/or how to fix it!
125
What does health care reform mean?
Does it mean improving the efficiency and coverage of people through the current system (primarily private insurance through employers)?
Does it mean completely rethinking health care, how it is delivered, paid for, managed, whose responsible for it?
Does it mean guaranteed right to coverage?
Other?
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Issues with health care are different for different people and groups
Chronically ill versus reasonably healthy
Insured versus uninsured
Privileged versus low-income
Business owners versus workers
Young versus old
People with children versus single adults
Bottom line: What’s it going to cost me?
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Patient Protection and Affordable Care Act = Obamacare
Officially began September 23, 2010
Marks a significant change in the American healthcare system.
**Some of the key provisions...
Have to allow children to stay on their parents’ policies through age 26
Required to cover people with pre-existing conditions
Insurance plans will have to stop
setting lifetime limits on coverage
canceling policy holders who get sick.
**In 2014..
By 2014 most people will have to have insurance or risk being fined
A family of four with an income less than about $88,000 can get tax credits, on a sliding scale, to help them pay insurance premiums and deductibles.
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Obamacare cont.
Small businesses, the self-employed and the uninsured can pick a plan offered through new state-based purchasing pools called exchanges, e.g. MNsure
This will allow them to purchase insurance in pools and supposedly get lower rates already enjoyed by employees of larger companies
**Supposedly...
Annual out-of-pocket medical costs will be capped at $5,950 for individuals and $11,900 for families
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Which aspect of healthcare law could you support?
Which aspect of healthcare law concerns you the most?
How will the changes affect you now or potentially in the future?
What questions do you have about the law, the controversies, etc?
discussion for test
130
Is there a clear, single definition of family in the U.S. constitution? Why or why not? *
NO
that way different levels of gov can all use their own definitions
131
Why do definitions of family matter in policy making? *
- concerned with money, benefits, health care
| - need to know who is being included and where to draw the line
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How do public policy, social policy, and family policy fit together? For example, are all family policies social polices? Are all social policies family policies? *
Public policy= overarching
social policy= next tear
family policy= smallest
All family policies are social, not all social parties are family
133
Explicit family policy involves which 4 main family functions?*
1. Family creation/consumption
2. economic support
3. development of children
4. family care
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What is a family policy perspective? Why is it useful for studying social policy? In other words, why don’t we just study explicit family polices and ignore implicit family policies?*
b/c many social policies are implicit its important to be able to take a family perspective on it
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1. What is FMLA? Specifically, who can use it and what can it be used for?
FMLA entitles eligible employers to take up to 12 weeks of unpaid, job protected leave etc..
Who can it be used for:
- newborns
- set up adoption/foster care
- care for immediate family member w/ serious health condition
*medical leave when employee is unable to work due to serious health condition
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What has California (and a couple of other states) done to give families more help?
passed first paid family leave
( 6 weeks partial pay to workers)
funded by employees
*Washngton 2nd state to pass it
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TANF vs MFIP
TANF
- encourages 2 parent families
- provide assistance to needy
MFIP
-must name father of child to collect child support
