The Affordable Care Act’s impact on coverage, access to care, and systematic exclusion in our health care system The Affordable Care Act set off an unprecedented wave of health insurance enrollment as the most sweeping overhaul of the U.S. health insurance system since 1965. In the years since its enactment, some 20 million uninsured Americans gained access to coverage. And yet, the law remained unpopular and politically vulnerable. While the ACA extended social protections to some groups, its implementation was troubled and the act itself created new forms of exclusion. Access to affordable coverage options were highly segmented by state of residence, income, and citizenship status. Unequal Coverage documents the everyday experiences of individuals and families across the U.S. as they attempted to access coverage and care in the five years following the passage of the ACA.It argues that while the Affordable Care Act succeeded in expanding access to care, it did so unevenly, ultimately also generating inequality and stratification. The volume investigates the outcomes of the ACA in communities throughout the country and provides up-close, intimate portraits of individuals and groups trying to access and provide health care for both the newly insured and those who remain uncovered. The contributors use the ACA as a lens to examine more broadly how social welfare policies in a multiracial and multiethnic democracy purport to be inclusive while simultaneously embracing certain kinds of exclusions. Unequal Coverage concludes with an examination of the Affordable Care Act’s uncertain legacy under the new Presidential administration and considers what the future may hold for the American health care system. The book illustrates lessons learned and reveals how the law became a flashpoint for battles over inequality, fairness, and the role of government. More books on the health care debate
This fully revised and expanded fifth edition of Social Work in Health Settings: Practice in Context maintains its use of the Practice-in-Context (PiC) decision-making framework to explore a wide range of social work services in healthcare settings. The PiC is updated in this edition to attend to social determinants of health and structural conditions. The PiC framework is applied in over 30 case chapters to reflect varied health and social care settings with multiple populations. Fully updated to reflect the landscape of healthcare provision in the US since the Affordable Care Act was reaffirmed in 2020, the cases are grounded by "primer" chapters to illustrate the necessary decisional and foundational skills for best practices in social work in health settings. The cases cover micro through macro level work with individuals, families, groups, and communities across the life course. The PiC framework helps maintain focus on each of the practice decisions a social worker must make when working with a variety of clients (including military veterans, refugees, LGBTQ+ clients). The ideal textbook for social work in healthcare and clinical social work classes, this thought-provoking volume thoroughly integrates social work theory and practice and provides an excellent opportunity for understanding particular techniques and interventions.
What happens when natural gas drilling moves into an urban area: how communities in North Texas responded to the environmental and health threats of fracking. When natural gas drilling moves into an urban or a suburban neighborhood, a two-hundred-foot-high drill appears on the other side of a back yard fence and diesel trucks clog a quiet two-lane residential street. Children seem to be having more than the usual number of nosebleeds. There are so many local cases of cancer that the elementary school starts a cancer support group. In this book, Jessica Smartt Gullion examines what happens when natural gas extraction by means of hydraulic fracturing, or “fracking,” takes place not on wide-open rural land but in a densely populated area with homes, schools, hospitals, parks, and businesses. Gullion focuses on fracking in the Barnett Shale, the natural-gas–rich geological formation under the Dallas–Fort Worth metroplex. She gives voice to the residents—for the most part educated, middle class, and politically conservative—who became reluctant anti-drilling activists in response to perceived environmental and health threats posed by fracking. Gullion offers an overview of oil and gas development and describes the fossil-fuel culture of Texas, the process of fracking, related health concerns, and regulatory issues (including the notorious “Halliburton loophole”). She chronicles the experiences of community activists as they fight to be heard and to get the facts about the safety of fracking. Touted as a greener alternative and a means to reduce dependence on foreign oil, natural gas development is an important part of American energy policy. Yet, as this book shows, it comes at a cost to the local communities who bear the health and environmental burdens.
This coffee table book documents in a step-by-step manner a solution for breast cancer screening and detection, beginning from inception, planning, implementation and finally impact in Malaysia. What makes this solution even more interesting is that the free mammogram screening programme has been running for more than three years and is within its fourth year at the time of writing of this book – which is an extrapolation into its long-term sustainability.
Supervision is the cornerstone of clinical training across all types of mental health providers. It facilitates the growth of mental health trainees and maintains the integrity of the field of mental health services by ensuring the competency of clinicians. However, the process can be complex and potentially confusing for both supervisors and trainees at any stage of their development or post-licensure career. Utilizing strength-based approaches is crucial to the success of supervision. This workbook facilitates a collaborative and strength-based approach to clinical supervision that both supervisors and trainees can use during the entire course of supervision, or for specific goals related to supervision. Each chapter of this workbook contains information and activities specific to both the trainee and supervisor to facilitate dialogue about individual and combined strengths, areas for growth, and goals for collaborative work. This is an essential start-to-finish guide addressing the entire supervision process, from preparing for the first session to conducting the last session, and everything in between.
Canadian Maternity and Pediatric Nursing prepares your students for safe and effective maternity and pediatric nursing practice. The content provides the student with essential information to care for women and their families, to assist them to make the right choices safely, intelligently, and with confidence.
Whatever the number, domestic violence victims remain far too many for a preventable crime. More and more victims of intimate partner violence are reaching out to police, prosecutors and judges only to be sorely disappointed, even betrayed. While laws and programs have multiplied over the last few decades to address domestic violence, the country is getting safer for almost everyone except for women who have, or have had, abusive male intimate partners. Andrew R. Klein and Jessica L. Klein look at the criminal justice response to domestic violence across America today, ranging from police to prosecutors and courtrooms across the nation. Abetting Batterers reveals the troubling pattern of inattention and incompetence that compromises the safety of women and encourages their male abusers to continue their abuse and violence. Although criminal justice system agencies vary among cities, towns and counties within the same state they all too often relegate domestic violence to the backburners of the system, dismissing victims and ignoring even the most serious and chronic abusers. The variation reveals the real problem in preventing intimate partner violence lies in these agencies’ commitment and will, rather than their ability to do the job. The authors unveil what is working in regard to protecting victims of domestic violence and holding their abusers accountable, and they suggest strategies for ensuring that what is being done right can be replicated and become the law and practice across the nation. The wide variation in how intimate partner violence is handled by similar jurisdictions demonstrates the real problem in preventing it lies in these agencies’ commitment, rather than ability to do the job. This book proves to be invaluable in understanding what is and is not being done in the reality of domestic violence in America.
This book analyses and develops overarching concepts for forest policy and forest governance and includes a detailed investigation into the historical discussion on forests. It examines opportunities and limits for negative emissions in a sector that – like peatlands – appears significantly less ambivalent compared to highly technical large-scale forms of climate geoengineering. The analysis shows that the binding climate and biodiversity targets under international law are much more ambitious than most people assume. Measured against that, the volume critically reviews the potentials of afforestation and reforestation for climate mitigation, which is often presented as the new saviour to fulfil the commitments of the Paris Agreement and to reach climate neutrality in the future. It becomes clear that ultimately only biodiverse and thus resilient forests can function as a carbon sink in the long term. The volume shows that the existing European and international forest governance approaches fail to comply with these targets and insights. Furthermore, the book develops a bundle of policy measures. Quantity governance systems for livestock farming, fossil fuels and similar drivers of deforestations represent the most important approach. They are most effective when not directly targeting forests due to their heterogeneity but central damaging factors. With regard to the dominant regulatory and subsidy-based governance for forests we show that it remains necessary to supplement these quantity governance systems with certain easily graspable and thus controllable regulatory and subsidy regulations such as a regulatory protection of old-growth forests with almost no exceptions; extension of the livestock-to-land-ratio established in organic farming to all farming; far-reaching restriction of bioenergy use to certain residues flanked by import bans; and a national and international complete conversion of all agricultural and forest subsidies to “public money for public services” to promote nature conservation and afforestation in addition to the quantity control systems.
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