Social Security and Public

Welfare
Chapter 12
Governments Responsibility for
Welfare
The passage of the Social Security Act in l935
affirmed the principle of government responsibility for
public welfare.
The Cabinet level department responsible for public
welfare is Health and Human Services (HHS).
During Reagans presidency there was a shift in the
thinking about governments responsibility for
welfare.
Greater emphasis was placed on limiting
governments role it should do only what people
could not do for themselves.
The Social Security Act
In general, this act, with its many
amendments, is the chief means by which
government at the local, state and national
levels provides income security to citizens.
Old Age, Survivors, Disability, and Health
Insurance (OASDHI).
Medicare and Medicaid are two of its health care
systems under this program.
The Social Security Act
OASDHI is a contributory system.
It is a social insurance.
Distinguishing features of OASHDI:
Provides health care
Provides income maintenance arrangements
Provides provisions for disability
Provides provisions for survivors of insured
workers.

OASDHI
This program is not paid from general tax
funds.
The tax burden for OASDHI is heaviest on
workers currently employed.
Basically the Social Security System is a
pay-as-you-go system.

OASDHI
Other characteristics of OASDHI:
The scope and coverage has been greatly
broadened and extended since it was enacted.
Designed to protect people against want and
need.
Taxes workers and employers to pay for it.
Dont have to be in need to get it.
Unemployment Insurance
OASDHI and unemployment insurance are
the two insurance provisions of the Social
Security Act.
Unemployment insurance is a non-deterrent
system.
Most characteristic of unemployment
insurance is the amount of payments to
workers is not the same in every state.
Aid To Families With Dependent
Children (AFDC)
Families cannot qualify for AFDC where
there are no children under the age of 18 (21
if in school full-time).
AFDC is often under attack because, it is
believed, that it:
Encourages out-of-wedlock pregnancies
Encourages large families
Costs the taxpayer huge amounts of dollars.
AFDC
The highest percentage of children in
families receiving AFDC was one child.
Steps taken to control cost for financing
AFDC include:
Locating absent fathers
Collecting child support payments
Establishing paternity
Imposing liens on property
Assignment of wages
Welfare Reform
The Personal Responsibility and Work
Opportunity Reconciliation Act of l996
contains all of the following features:
A requirement for states to withhold court-ordered
child support payments.
That states establish JOBS programs.
Welfare clients must be enrolled in JOBS
programs.
States required to provide welfare benefits to two-
parent families.
General Assistance
General assistance, residual to OASDHI, is intended
to aid those who cannot qualify under the federally
financed SSI program for the aged, the blind, or the
disabled, or AFDC or who are not covered by social
insurance.
General assistance is not a popular program.
Taxes for it must be raised at the state and local
levels.
Homelessness
Although experts argue over the number, estimates
range from a low of 600,000 to a high of three million
Americans who are without shelter in a place of their
own.
Each year as many as two and a half million people
are displaced by rent inflation, economic
development plans, condominium development,
abandonment, and arson.
Although the waiting lists for new federally funded
housing units are growing, the number of units
available had decreased by nearly 90 percent since
l981.
Homelessness
Large numbers of homeless parents are
minorities with few job skills and little
experience in the work place.
A growing number of single parents, often in
their teens or early twenties, with small
children, are joining the ranks of homeless.
Estimates place this group at about one-fourth of
those in shelters or on the streets.
Homelessness
School-age children (perhaps as many as
700,000) who move from shelter to shelter
change schools frequently.
They not only have difficulty academically,
they also have more chronic illnesses, and
need the services of mental health
specialists more often than children who live
in their own homes.
Homelessness
Approximately one-fourth of the adults are
alcoholics, one-fourth are drug abusers,
another one-fourth have had a felony
conviction or have served time in a state or
federal prison. A smaller number are
mentally ill. (Many fit more than one
category).
Medicare
In l965 Congress legislated health insurance for the
aged and disabled under the provision of the Social
Security Act.
Medicare is a compulsory hospital insurance plan
and a voluntary supplemental medical insurance.
The action by Congress to provide Medicare hailed
the beginning of what many leaders predict
eventually will become a national health insurance
program providing coverage for virtually all
Americans.
Medicare
Medicare was expanded by the l972
amendments to extend the coverage to
certain disabled workers, disabled widows
and widowers, and childhood disability
beneficiaries.
Workers and their employers, including the
self-employed, are taxed to pay for health
insurance.
Medicare Reform
Senior citizens are anxiously awaiting a number of
proposed reforms to the Medicare program.
One is a universal Medicare prescription drug benefit
that would be affordable to both taxpayers and
beneficiaries.
According to the Congressional Budget Office, $1.5
trillion dollars will be spent on prescription drugs by
the Medicare population over the next 10 years.
Medicare Reform
Another concern is the spiraling cost of nursing
home care and the limited coverage provided by
Medicare.
The Medicare program only covers the costs of
skilled nursing home care and even that coverage is
limited to so many days a year.
Senior citizens who are being care for in semiskilled
or personal care facilities have no Medicare benefits.
The cost of maintaining a senior citizen with
Alzheimers Disease in a semiskilled nursing home
can cost $4,000 or more a month.
Medicaid
Medical care for low-income people (Medicaid) is
administered by the states.
States have the option to include persons who are
able to provide for their own daily living but whose
income and resources are not sufficient to meet all of
their medical costs.
The main advantages of Medicaid are:
Provide hospital and medical care for poverty stricken
people who have no regular income from employment.
May be used for others whose income is so low that they
are unable to pay the high cost of medical and health care
for themselves and their families.
Social Services and Social Work
Pubic services are available to certain categories of
the population.
These services provide for children, families, and
certain adults.
Until l972 service and assistance were combined
under one administration.
It was assumed that services were needed for
purposes of rehabilitation.
Rehabilitation meant becoming independent of
assistance.
Social Services and Social Work
Assistance payments are made mainly for the
benefit of dependent children, their parents (usually
an unemployed mother), to the aged, the disabled
and the blind, and to a few employable males and to
mothers needed in the home to provide for their
children.
Service patterns are widely diverse.
Approximately 1,313 services are offered in the
United States.
Government and Public Welfare
There is a growing realization that
government cannot solve all problems.
In some ways these failures resulted from the
lack of leadership.
Since 1935 and the passage of the Social
Security Act the federal government has
increasingly assumed responsibility for the
protection of citizens against want as an
enduring principle.