American Welfare State Research Articles

LIFETIME TAXPAYER CONTRIBUTIONS AND BENEFITS OF MEDICARE AND SOCIAL SECURITY

Many criticisms of Medicare and Social Security have suggested that beneficiaries get more than they paid into the system over their lifetimes and these entitlement programs may be unsustainable if they are insufficiently funded. But studies do not always use appropriate assumptions for estimating lifetime values. Our simulation model properly aligns the financing sources with the benefits received by making consistent comparisons and using a more appropriate inflation adjustment. Our study suggests that using different assumptions can dramatically change the balance between contributions and benefits as compared with other analyses. Choosing the appropriate assumptions is essential for a reasoned debate on the important issues about the future and financing of Medicare and Social Security. (JEL I13, H5, H24)

"The Service I Rendered Was Just as True": African American Soldiers and Veterans as Activist Patients.

In this article, I examine how African American soldiers and veterans experienced and shaped federally sponsored health care during and after World War I. Building on studies of the struggles of Black leaders and health care providers to win professional and public health advancement in the 1920s and 1930s, and of advocates to mobilize for health care rights in the mid-20th century, I focus primarily on the experiences and activism of patients in the interwar years. Private and government correspondence, congressional testimony, and reports from Black newspapers reveal that African American soldiers and veterans communicated directly with policymakers and bureaucrats regarding unequal treatment, assuming roles as "policy actors" who viewed health and medical care as "politics by other means." In the process, they drew attention to the paradoxes inherent in expanding government entitlements in the era of Jim Crow, and helped shape a veterans' health system that emerged in the 1920s and remained in place for the following century. They also laid the groundwork for the system's precedent-setting desegregation, referred to by advocates of the time as "a shining example to the rest of the country."

Impairment on the move: the disabled incomer and other invalidating intersections

In this article, I argue that disabled people and immigrants are subjected to similar forms of representation. I draw on examples from theology in the Christian Middle Ages, the influence of eugenics on late nineteenth and twentieth-century US immigration policy and welfare reform in contemporary neoliberal Britain. These vignettes are invoked as case studies to illustrate how ableism follows impairment on the move and to point to the ways in which the confluence of ethnocentric and ableist fantasies about strangers brings the history of disability and migration onto the same terrain of disrepute.

Navigating Networks: How Nonprofit Network Membership Shapes Response to Resource Scarcity.

Central to the contemporary American welfare state, nonprofits are increasingly squeezed between declining resources and a simultaneous peak in demand for services. Scholars have outlined a number of ways that nonprofits strategically respond to resource scarcity. Why nonprofits select particular strategies, however, is less clear. This article motivates a network membership perspective via a mixed-methods study of one food bank and its associated food pantries, wherein actors navigate competing network demands that are emblematic of those faced by other nonprofits. Food banks source food from three types of networks - a cartel-like network orchestrated by a national coordinating body, a peer-to-peer inter-food bank network, and a bureaucratic network anchored by the USDA - that place overlapping and conflicting constraints on the organizations. In combination, network demands entangle the food banks within a web of tensions that prevent many forms of adaptation while enabling others, a predicament I refer to in this article as network entrapment. How organizations navigate network demands has implications for the vitality of the organizations and the wellbeing of their beneficiaries. My results suggest that entrapment can lead to organizational burden and the adoption of neoliberal-inspired efficiencies, but also innovations that prioritize citizen rights over cost-benefit ratios.

The Politics of Work-Family Policies: Comparing Japan, France, Germany and the United States

Postindustrial countries display a broad range of work–family policies, with Japan representing but one of many variations. Ever since the publication of Esping-Andersen’s classic The Three Worlds of Welfare Capitalism in 1990, political scientists have devoted considerable attention to explaining the variation in how states organize and provide services to support families. The vast majority of research has focused on comparisons among European welfare states, with Sweden generally held up as the ‘gold standard’ in terms of ideological and infrastructural support for working mothers. A much smaller literature has considered welfare states in East Asia, which are more limited in size than most of those in Europe. In The Politics of Work-Family Policies, Boling brings Japan into comparative focus not only with two carefully chosen European cases (France and Germany), but with a case not generally included in comparative studies: the US. While not central in her analysis, Sweden constitutes an implicit comparison for Boling’s four cases, allowing her to use it as a touchstone for how states can forge policies to support a dual-earner/dual-caregiver model. At the same time, she is very careful not to hold Sweden up as an example, as is often done, of what other welfare states should strive to emulate. Indeed, a great strength of Boling’s research is in explaining the difficulties that Japan, the US, and other welfare states would face in trying to be like Sweden. This is in fact the key puzzle motivating her book: why has it proven so difficult for states to enact work–family policies that support working parents and, in particular, working mothers? Boling brings to this problem a political scientist’s sensitivity to party politics, competing interests, state fiscal constraints, and the dynamics of policy-making processes across time. An additional strength of the book is her attention to variation in the structure of labor markets across the four country cases she analyzes in depth. In representing different skill regimes, Boling argues, labor markets play a critical role in structuring the opportunities and constraints women face as they try to utilize work–family policies to balance childrearing and career development. The difference in labor market institutions and skill regimes, as well as the size of the public versus private sector, has profound implications for women’s ability to move across firms and to move in and out of the labor market without suffering serious wage depreciation. Labor market institutions thus constitute a critical complement to work–family policies, influencing employers’ stake in the development and enforcement of policies, and thus affecting women’s ability to utilize policies without suffering stigmatization or career penalties.

Maintaining Perspective on the Economic Issues of Today

As the new administration takes office it is important to maintain some perspective on the economicchallenges facing the nation. The situation is far better today than when President Obama took office in2009 and 2013. Unemployment is close to pre-Great Recession levels, incomes are rising and poverty ratesfalling. We face economic challenges but the most important ones are not international trade or immigration.Sluggish economic growth, a fiscal crisis in our entitlement programs, high inequality in incomes andwealth, and climate change are what should demand our attention.

Improving Captive Marine Mammal Welfare in the United States: Science-Based Recommendations for Improved Regulatory Requirements for Captive Marine Mammal Care

Congress passed the Animal Welfare Act1 1 7 U.S.C. § 2131. (AWA) in order “to ensure the humane care and treatment of various animals used in research or for exhibition or kept as pets.22 Animal Le...

‘The opposite of a European democracy’: the American real estate lobby, French and British social housing, and the making of the postwar American welfare state, 1945–1949

This article takes a new approach to the question of postwar American welfare state ‘exceptionalism’ by arguing that scholars should look at ideas and discourses of American welfare exceptionalism in historical context as a social construct and a political project. By focusing on the National Association of Real Estate Boards’ lobbying campaign against US public housing legislation in the late 1940s, I show that US business interests often used the example of Western European welfare state initiatives in order to not only decisively shaped specific pieces of social legislation, but to contest the very meaning of the postwar New Deal state.

The Evolution of the Animal Welfare Movement in U.S. Zoos and Aquariums

The welfare of animals under human care has become a major concern in many parts of the world over the last several decades. The public's concern for the welfare of animals in zoos and aquariums has perhaps evolved more recently than its concern for laboratory and farm animals. However, professionals working in zoos and aquariums have been concerned with the welfare of animals for a long time, as efforts to develop and improve husbandry for an astonishing array of animal species has been undertaken. Using interviews and gathering of information from the literature and zoological community, we trace the evolution of the zoological profession's focus on animal welfare in the United States and draw comparisons to how a welfare focus developed in U.S. laboratories and on farms. We also discuss the zoological profession's elaboration of and role in the field of wildlife welfare science. We assert that the welfare focus in U.S. zoos and aquaria has largely been driven internally and is characterized by unique challenges and solutions. Zoos and aquaria are also leading the science of captive wildlife welfare with relatively little contribution from universities, governments, or non-government organizations.

President Obama and the American Welfare State: Transformation or Punctuation?

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Whose Welfare?: New Directions in the History of the American Welfare State

Whose Welfare?: New Directions in the History of the American Welfare State

Medicare and Medicaid at 50: America’s Entitlement Programs in the Age of Affordable Care

Medicare and Medicaid at 50: America’s Entitlement Programs in the Age of Affordable Care

Informal norms trump formal constraints: the evolution of fiscal policy institutions in the United States

AbstractTwo shifts of informal rules occurred in the decades around the turn of the 20th century that continue to shape U.S. fiscal policy outcomes. Spending norms in the electorate shifted to expand the scope of the government budget to promote economic security and macroeconomic stability. Simultaneously, norms for elected office shifted to careerism. Both norms were later codified into formal rules as legislation creating entitlement programs, macroeconomic responsibility, and organizational changes to the fiscal policy process. This institutional evolution increased demand for federal expenditures while creating budgetary commons, thus imparting strong motivations to spend through deficit finance in normal times. Despite the last four decades of legislative attempts to constrain spending relative to taxes, the informal norms have trumped the formal constraints. While the empirical literature on deficits has examined the constraining effects of informal rules, this paper offers a novel treatment of shifting norms as having expansionary effects on deficits.

Informal Norms Trump Formal Constraints: The Evolution of Fiscal Policy Institutions in the United States

Two shifts of informal rules occurred in the decades around the turn of the 20th century that continue to shape U.S. fiscal policy outcomes. Spending norms in the electorate shifted to expand the scope of the government budget to promote economic security and macroeconomic stability. Simultaneously, norms for elected office shifted to careerism. Both norms were later codified into formal rules as legislation creating entitlement programs, macroeconomic responsibility, and organizational changes to the fiscal policy process. This institutional evolution increased demand for federal expenditures while creating budgetary commons, thus imparting strong motivations to spend through deficit finance in normal times. Despite the last four decades of legislative attempts to constrain spending relative to taxes, the informal norms have trumped the formal constraints. While the empirical literature on deficits has examined the constraining effects of informal rules, this paper offers a novel treatment of shifting norms as having expansionary effects on deficits.

Debt Stability Under Entitlement Spending

Economists have traditionally used a simple rule that restricts primary deficits to less than a threshold given by the interest rate growth rate differential and existing debt level to judge fiscal sustainability. This rule derives from a single period application of the government’s budget constraint. It does not allow for the predictable dynamic effects of spending liabilities, such as entitlement spending. In this paper, we derive the equivalent dynamic rule for this case. It still depends on the interest growth rate differential, but now includes a restriction on spending growth in relation to income growth. Several new results emerge. Debt remains stable; but the rate of convergence to stability varies with different parameters. And the growth in spending has to be less than a damping factor that controls convergence. This puts a limit on spending growth. To penalize the use of unpopular taxes further limits debt and the incentive to use debt finance.

Pharmacy Benefit Managers as Bargaining Agents

The largest expansion of entitlement programs in the United States in decades – Medicare Part D – is set to commence on January 1st of 2006. On that day, retirees will be eligible for subsidized insurance covering outpatient drug prescriptions. The plan will be managed by private sector entities called pharmacy benefit managers (PBMs)This paper attempts to reverse misconceptions about PBMs that can be traced to price theory. Proposed is an alternative view based on bargaining theory. There are several fundamental insights gained by looking at PBMs through bargaining theory. First, rebates are not received in consideration for “moving markets” but for refraining from discretionary switching of one brand prescription for another. Second, rebates are not linear price reductions designed to increase demand, but the fixed component of a two-part tariff designed to shift rent to the buy side in a bilateral oligopoly.

Options to Restore More Discretion to the Federal Budget

will manually insertUS fiscal policy has long been unsustainable, driven largely by automatically growing entitlement spending and insufficient revenues. Often overlooked is the extent to which this preordained fiscal policy limits policymakers’ discretion to act on new priorities each year, whether through newly legislated increases in spending or through tax reductions. This study lays out reforms to the federal budget process that could restore greater discretion to congressional lawmakers, so that a greater share of revenues is not automatically allocated without any vote by a current Congress. Such reforms include various triggers in entitlement and tax programs that limit their automatic growth, more transparent reporting and informative displays of budget information, and more requirements to subject programs to periodic review and reauthorization. Examples are provided for how such reforms could be applied to specific entitlement and tax programs.

Divided we reform? Evidence from US welfare policies

Divided government is often thought of as causing legislative deadlock. I investigate the link between divided government and economic reforms using a novel data set on welfare reforms in US states between 1978 and 2010. Panel data regressions show that, under divided government, a US state is around 25% more likely to adopt a welfare reform than under unified government. Several robustness checks confirm this counter-intuitive finding. Case study evidence suggests an explanation based on policy competition between governor, senate, and house.

Medicare and Medicaid at 50: America's entitlement programs in the age of affordable care

List of Abbreviations Introduction: The World that Medicare and Medicaid Made Alan Cohen, David Colby, Keith Wailoo, and Julian Zelizer Part I: Origins, Vision, and the Challenge of Implementation The Contentious Origins of Medicare and Medicaid Julian Zelizer Civil Rights and Medicare: Historical Convergence and Continuing Legacy David Barton Smith Looking Back: The Early Days of Medicaid and Medicare Rashi Fein The Road Not Taken: What Happened to Medicare for All? Jonathan Oberlander and Theodore Marmor Part II: The Remaking of Values, Relationships, and Society The Transformation of Medicaid from Poor Law Legacy to Middle-Class Entitlement? Jill Quadagno How the Courts Created the Medicaid Entitlement Sara Rosenbaum Medicare and the Social Transformations of American Elders Mark Schlesinger Part III: Retrenchment, Reform, and Reaction The Third Rail of Politics? Medicare's Untouchability Mark Peterson Medicare Innovations in the War Over the Key to the U.S. Treasury Uwe E. Reinhardt Medicaid Rising: The Perils and Potential of Federalism Frank Thompson Independence and Freedom: Public Opinion and the Politics of Medicare and Medicaid Andrea Louise Campbell Part IV: The Road to Affordable Care The Era of Big Government: Why It Never Ended Keith Wailoo Built to Last? Policy Entrenchment and Regret in Medicare, Medicaid, and the Affordable Care Act Paul Starr The Missing Piece: Medicare, Medicaid, and Long-Term Care Judith Feder From Servant to Master? Medicare, Cost Control, and the Future of American Health Care Jacob Hacker Part V: Looking Ahead Medicare in American Political History: The Rise and Fall of Social Insurance James Morone and Elizabeth Fauquert Conclusion Alan Cohen, David Colby, Keith Wailoo, and Julian Zelizer

Race, prejudice and attitudes toward redistribution: A comparative experimental approach

AbstractPast work suggests that support for welfare in the United States is heavily influenced by citizens' racial attitudes. Indeed, the idea that many Americans think of welfare recipients as poor Blacks (and especially as poor Black women) has been a common explanation for Americans’ lukewarm support for redistribution. This article draws on a new online survey experiment conducted with national samples in the United States, the United Kingdom and Canada, designed to extend research on how racialised portrayals of policy beneficiaries affect attitudes toward redistribution. A series of innovative survey vignettes has been designed that experimentally manipulate the ethno‐racial background of beneficiaries for various redistributive programmes. The findings provide, for the first time, cross‐national, cross‐domain and cross‐ethno‐racial extensions of the American literature on the impact of racial cues on support for redistributive policy. The results also demonstrate that race clearly matters for policy support, although its impact varies by context and by the racial group under consideration.