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For example, those who work in professional or managerial occupations are much more likely to have employer-sponsored insurance than those working in construction, sales or farming. Similarly, those working in the manufacturing industry are more likely to have coverage than those employed in wholesale and retail trade.
Finally, those working for large companies are more likely to have coverage than those who are employed by smaller firms. There are a number of reasons why small employers are less likely to offer health insurance than larger employers.
Second, small employers frequently state that their employees have access to other forms of coverage e. Third, small business owners often argue that many of their employees would never acquire coverage anyway, since turnover rates are relatively high and there is usually a waiting period before benefits kick in for new employees.
As noted above, the central financing mechanism is employer-sponsored private health insurance, supplemented by an array of public insurance and subsidy programs designed to help cover those most likely to lack coverage through an employer in particular the poor and the elderly.
This section of the paper explores the historical development of the employment-based system of health insurance.
In particular, it explains why the U. The institutional evolution of the American health care system is, perhaps, most fruitfully examined in relation to the institutional evolution of American capitalism.
For the history of health care provisioning reveals the myriad of ways in which the system has been shaped by developments within the broader political economy of American society.
We therefore begin with an examination of the social, economic and political forces that laid the foundation for the emergence of the modern health care system. The Failure of National Health Insurance Proposals Throughout the nineteenth century, there was scarcely a market for health insurance in the United States.
Family members cared for one another within the home, and there was little reliance on the services of doctors or hospitals. By the end of the nineteenth century, this was beginning to change. Partnership in health and social care analysis social work essay individual households, sickness now interrupted the flow of income as well as the normal routine of domestic life, and it imposed unforeseen expenses for medical care.
In the economy as a whole, illness had an indirect cost in diminished production as well as a direct cost in medical expenditure Starr,p.
Acute illnesses were increasingly treated at medical facilities as opposed to homes and hospitals became the centers for surgeries, X-rays and laboratories Thomasson, Along with these advances came an increase in the costs of treating illness and a desire for some form of social protection to replace the traditional relations embedded in the household economy of pre-industrial America.
In response to these and other developments, groups of social reformers arose in the early part of the twentieth century to champion the cause of compulsory national health insurance. The plan was to be financed by contributions from workers and their employers with additional support from general tax revenues.
The program was defended on the grounds of social justice and economic efficiency — the former because it spread the risks of financial ruin and the latter because it mitigated the social costs of illness.
However, the campaign got underway just as support for Progressivism, as a political force, was beginning to wane. It was two decades before there would be another political campaign to increase the involvement of the national government in the management of social welfare.
This time it was President Franklin D. Roosevelt who believed that Americans needed some form of protection against the growing costs of illness and economic insecurity.
During the Progressive Era, advocates for social insurance placed health insurance near the top of the agenda. Although health insurance was no longer considered a top priority, Roosevelt came close to introducing legislation for universal health care coverage after his election in At the time, a proposal for universal health insurance was linked to the Social Security Act, which Roosevelt strongly supported.
But the American Medical Association AMA had a great deal of political clout, and it strongly opposed a universal entitlement to health care. Roosevelt is said to have pulled his support for national health insurance in order to prevent the AMA from dooming his Social Security legislation Blumenthal, Truman became the first American president to wholeheartedly advocate for national health insurance.
He proposed a single health insurance system to protect all classes of society, but his program met with considerable resistance on both professional and political fronts. As soon as the details of the plan were released, the National Physicians Committee issued an emergency bulletin encouraging doctors to oppose the program.
The Emergence of an Employment-Based System: The increasing supply and demand for health care — with its attendant rise in prices — required a means of financing which did not rely on family income and savings.
However, a non-market based solution to rising costs and expenditures was precluded by the failure of reform proposals in the first part of the twentieth century.
To fill this void, an alternative system of private health insurance emerged. Although they were initially reluctant to do so, hospitals and insurance companies helped to accommodate the growing demand for medical care and health insurance by organizing prepayment plans and marketing them directly to worker groups.
Offering health insurance coverage to groups of employees yielded two major benefits to the underwriter. Second, the plans allowed employers to deduct premiums from employee paychecks, thereby lowering the administrative costs associated with selling insurance Thomasson, The popularity of these prepaid health insurance plans increased during the Great Depression, when hospitals relied on them in order to smooth receipts in the face of declining revenues.
In exchange for these special provisions, Blue Cross and Blue Shield were initially required to community-rate their policies, which required them to charge different employee groups the same premium, regardless of their health status.
The success of the Blues soon invited competition from commercial, for-profit insurance companies that were not required to community-rate their policies.
When it came to marketing policies to healthy employee groups, the for-profit insurance companies could often undercut the Blues because they were allowed to experience-rate their policies, offering lower-priced policies to healthier employee groups and charging higher premiums to sicker groups.Nov 18, · Working in Partnership in Health and Social Care essay.
the effective implementation of the partnership in health care and social work is possible only on the condition of the effective monitoring and control of the performance of professionals providing health and social care services and organisations responsible for the provision of such /5(3).
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Duty of care is a legal obligation for each individual in the health and social care setting that requires them to adhere to a standard of reasonable care. Dear Twitpic Community - thank you for all the wonderful photos you have taken over the years. We have now placed Twitpic in an archived state.
Social exclusion, or social marginalisation, is the social disadvantage and relegation to the fringe of society. It is a term used widely in Europe and was first used in France.
It is used across disciplines including education, sociology, psychology, politics and economics.. Social exclusion is the process in which individuals or people are systematically blocked from (or denied full access.