Medicaid's Role in Moves Toward Universal Health Care

This paper considers the problems currently facing the Medical Assistance (Medicaid) program in light of the major problems confronting the American health care system. Actual and proposed Medicaid reforms are reviewed, their merits noted and their shortcomings detailed. It is argued that substantial Medicaid reform can take place only in the context of radical reform of the entire U.S. health care system. Similarly, Medicaid should be incorporated into any plan aimed at providing universal health care coverage.     

LOCAL GOVERNMENTS AS IMPLEMENTORS OF PUBLIC POLICY

This study expands the growing literature in comparative public policy that examines welfare services. By now, it is accepted that a combination of economic, social, and political factors are influential in the delivery of these services by the 60 states. This paper finds that similar factors are also operating at the county level in New York state. Most notably, political factors affect the distribution of welfare benefits–despite federal and state mandates that require distribution to be based solely on need. This raises a number of issues. concerning the nature of political influence and the autonomy of local bureaucracies, which require further exploration.