No abstract

The literature defines the role of interest groups and administration officials in the evolution of health care policy but does not acknowledge the impact of Congressional casework or the initial Social Security (OASI) eligibility criteria. There is, as a result, an inadequate appreciation for (1) the extent to which the initial development of federal policy was a function of Congressional delegations pursuing initiatives that would increase the flow of federal dollars their states could use to expand health services or (2) the way in which the regional cleavages created OASI eligibility criteria combined with the South's control of Congressional leadership positions to yield an expansion of health care for indigent people while intentionally delaying the creation of Medicare. This chapter addresses these gaps and provides a more complete picture of the way in which the incremental, unplanned evolution of federal health care policy was the product of using federal resources to diminish the states' fiscal needs and the south's capacity to temporarily control the health care agenda.

The literature defines the role of interest groups and administration officials in the evolution of health care policy but does not acknowledge the impact of Congressional casework or the initial Social Security (OASI) eligibility criteria. There is, as a result, an inadequate appreciation for (1) the extent to which the initial development of federal policy was a function of Congressional delegations pursuing initiatives that would increase the flow of federal dollars their states could use to expand health services or (2) the way in which the regional cleavages created OASI eligibility criteria combined with the South's control of Congressional leadership positions to yield an expansion of health care for indigent people while intentionally delaying the creation of Medicare. This chapter addresses these gaps and provides a more complete picture of the way in which the incremental, unplanned evolution of federal health care policy was the product of using federal resources to diminish the states' fiscal needs and the south's capacity to temporarily control the health care agenda.

This study analyzes the findings of a fieldwork study conducted between two distinct cultural traditions: Puerto Rico, a U.S. territory with a predominantly Hispanic population, and Indiana, a predominantly Anglo Midwestern state. Specifically, the study compares the satisfaction of older adults with the implementation of the home health care policy sponsored by Medicare in both settings. The study focuses on older adults’ attitudes toward the qualities and performance of home health aides. Due to cultural differences in both settings, the thesis statement was that older adults in Indiana and Puerto Rico are likely to be satisfied with different qualities of home health aides. The results of the data, however, do not support this hypothesis, as older adults in both settings demonstrate satisfaction with similar qualities in their home health aides, although the Puerto Rican sample shows higher levels of satisfaction.