The Health Care Welfare State in America

2009 ◽  
pp. 33-52
Author(s):  
Ronald J. Angel ◽  
Laura Lein ◽  
Jane Henrici
Keyword(s):  
Health Care ◽  
Welfare State

Welfare State Replacements: Deinstitutionalization, Privatization and the Outsourcing to Immigrant Women Enterprise

2018 ◽  
Vol 48 (2) ◽  
pp. 247-266 ◽  
Author(s):  
Jennifer Nazareno
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Welfare State ◽  
Mental Health Care ◽  
Immigrant Women ◽  
Health Care Facilities ◽  
Direct Care ◽  
Term Care ◽  
Severely Mentally Ill ◽  
The U.S

The U.S. government has a long tradition of providing direct care services to many of its most vulnerable citizens through market-based solutions and subsidized private entities. The privatized welfare state has led to the continued displacement of some of our most disenfranchised groups in need of long-term care. Situated after the U.S. deinstitutionalization era, this is the first study to examine how immigrant Filipino women emerged as owners of de facto mental health care facilities that cater to the displaced, impoverished, severely mentally ill population. These immigrant women–owned businesses serve as welfare state replacements, overseeing the health and illness of these individuals by providing housing, custodial care, and medical services after the massive closure of state mental hospitals that occurred between 1955 and 1980. This study explains the onset of these businesses and the challenges that one immigrant group faces as owners, the meanings of care associated with their de facto mental health care enterprises, and the conditions under which they have operated for more than 40 years.

scholarly journals Perspectiva bioética del Trastorno por déficit de atención e hiperactividad (TDAH)

Bioderecho.es ◽  
2019 ◽  
Author(s):  
Diego José García Capilla ◽  
María José Torralba Madrid
Keyword(s):  
Health Care ◽  
Twentieth Century ◽  
Pharmaceutical Industry ◽  
Welfare State ◽  
Children And Adolescents ◽  
Right To Health ◽  
Critical Perspective ◽  
The Right ◽  
Siglo Xx ◽  
The Welfare State

La aparición del Estado del bienestar a mitad del siglo XX tuvo consecuencias sanitarias que culminan con el reconocimiento del derecho a la protección de la salud y el deber de asistencia sanitaria del Estado, con una extensión de la medicina a campos desconocidos, medicalizando la vida de las personas. El TDAH es un caso paradigmático, convirtiéndose en una patología psiquiátrica a partir de su inclusión en el DSM-III 1980, con inconsistencias y subjetividad en las clasificaciones. La etiología del trastorno es desconocida, su diagnóstico es subjetivo y dudoso, su tratamiento poco efectivo y con riesgos, incrementando el número de casos diagnosticados y los beneficios de la industria farmacéutica. Desde la Bioética se impone una reflexión sobre los posible daños derivados de la medicalización (no-maleficencia), una prudente actuación de los profesional (beneficencia), respeto al criterio de niños y adolescentes (autonomía) y una perspectiva crítica en relación con el gasto derivado de su diagnóstico (justicia). The emergence of the welfare state in the mid-twentieth century had health consequences that culminated in the recognition of the right to health protection and the duty of health care of the State, with an extension of medicine to unknown fields, medicalizing the life of people. ADHD is a paradigmatic case, becoming a psychiatric pathology due to its inclusion in the DSM-III 1980, with inconsistencies and subjectivity in the classifications. The etiology of the disorder is unknown, its diagnosis is subjective and doubtful, its treatment ineffective and with risks, increasing the number of cases diagnosed and the benefits of the pharmaceutical industry. From the Bioethics a reflection on the possible damages derived from the medicalization (nonmaleficence), a prudent action of the professional (beneficence), respect to the criterion of children and adolescents (autonomy) and a critical perspective in relation to the expense is imposed derived from his diagnosis (justice).

P–472 Single mothers by choice - experiences of single women seeking treatment at a public fertility clinic in Denmark: A pilot study

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
M L Steenberg ◽  
R Sylvest ◽  
E Koert ◽  
L Schmidt
Keyword(s):  
Public Health ◽  
Health Care ◽  
Welfare State ◽  
Single Mothers ◽  
Nuclear Family ◽  
Single Mother ◽  
Single Women ◽  
Public Health Care ◽  
Fertility Treatment ◽  
Fertility Clinic

Abstract Study question Are single women in fertility treatment stigmatised and what do they experience? Summary answer The women did not feel stigmatised. They experienced self-blame and negative thoughts about themselves, despite experiencing empowerment and receiving positive reactions from families and friends. What is known already Since 2007, medical doctors in Denmark have been permitted to offer medically assisted reproduction (MAR) also to single women. Denmark is a welfare state with a public health care sector providing MAR free of charge, 240 days of paid parental leave, and public full-time day-care. There has been an increase in the number of single women deciding to have children through the use of MAR. These women are referred to as ‘single mothers by choice’ (SMC), and they have been criticised for being selfish when raising a child without a father. Previous studies have shown how SMC can feel stigmatised. Study design, size, duration: Semi-structured qualitative interviews at a public fertility clinic in Copenhagen, Denmark. Data collection took place between September and October 2020. Participants/materials, setting, methods The participants were single and childless women (N = 6) undergoing MAR at the Fertility Clinic, Rigshospitalet in Copenhagen, Denmark. Five women received IVF and one received IUI. The women were between 30 and 40 years old and were all residents in the Capital Region of Denmark. The interviews were audiotaped, anonymised, and transcribed in full. Data were analysed using qualitative content analysis. Main results and the role of chance Single women did not differ from cohabiting women seeking MAR in relation to their experiences and attitudes towards motherhood. Four main themes were identified; (1) Experiences of single women seeking fertility treatment, (2) Emotions associated with becoming a single mother by choice, (3) The decision of becoming a single mother by choice, and (4) Family formation – a social interaction. The women would have preferred to have a child in a relationship with a partner and the shattered dream about the nuclear family has caused a wide range of experiences and emotions. The women did not feel stigmatised but they all had an awareness of the prejudices other people might have towards single mothers by choice. Hence, they were ready to defend their choice if necessary. On the other hand, they had received positive reactions and the process of becoming a single mother by choice was influenced by their social relations with family and friends. Despite their dream of the nuclear family the women choose to become SMC because motherhood was of such importance and they feared they would otherwise become too old to have children – the biological clock was ticking. Limitations, reasons for caution The participants were recruited from a public fertility clinic in the Capital Region of Denmark and may not be representative of all single women seeking MAR. Results might not be transferable to other countries with a different cultural context regarding the societal acceptance of different ways to establish a family. Wider implications of the findings: This study contributes to the understanding of the experiences of single women seeking fertility treatment in a welfare state where there are no differences in the possibilities for different social classes to seek MAR in the public health care sector. Trial registration number N/A

Die freie Wohlfahrtspflege und die wachsenden Steuerungsansprüche des Staates: Fokus Kostendruck

2019 ◽  
Vol 68 (1) ◽  
pp. 67-74
Author(s):  
Ulrich Stoebe
Keyword(s):  
Health Care ◽  
Welfare State ◽  
Social Service ◽  
Service Providers ◽  
Social Resources ◽  
Health Care Sector ◽  
Federal State ◽  
European Law ◽  
Crucial Importance ◽  
Welfare Mix

Zusammenfassung Subsidiarität ist in vielfältiger Weise ein verbindlicher, wenn auch auslegungsbedürftiger Grundsatz im deutschen und europäischen Recht. Zum Subsidiaritätsprinzip (als „Grundsatz des hilfreichen Beistands“) gehört die Verantwortung von Staat und Kommunen für die Vorhaltung von infrastrukturellen und sozialen Ressourcen. Anders als in vormodernen Gesellschaften mit ihren klaren Rollenzuweisungen in Familie und Gesellschaft ist für eine moderne Gesellschaft aber charakteristisch, dass sie eine Vielfalt von Akteuren kennt. So hat im deutschen Sozial- und Gesundheitssektor die verbandlich organisierte Wohlfahrtspflege eine herausragende Bedeutung. Innerhalb eines neu gestalteten subsidiären wohlfahrtsstaatlichen Arrangements muss gewährleistet werden, dass sich die Stärken und Schwächen der verschiedenen Träger sozialer Dienste optimal ergänzen. Ziel sollte die Transformation vom versäulten Wohlfahrtskorporatismus hin zum vernetzten Wohlfahrtsmix sein. Abstract: Association Welfare and Welfare Market Reformulation of Subsidiarity? Although subsidiarity is in many ways a binding principle in German and European law, it always requires interpretation. In accordance with the principle of subsidiarity (as a „helpful assistance principle“) the federal state as well as municipalities have the responsibility to provide infrastructural and social resources. Unlike pre-modern societies with their clear distribution of roles in family and society, modern societies are characterised by a variety of actors. For example, welfare associations in the German social and health care sector are of crucial importance. Within a newly designed subsidiary welfare state arrangement it is necessary to ensure that the strengths and weaknesses of the various social service providers are taken into account. The goal should be the transformation of the welfare corporatism of isolated columns to a vertically linked welfare mix. JEL-Klassifizierung: I1, I2, I3

Economics and policy analysis: ‘from state to market’?

2018 ◽  
Author(s):  
Daniel Benamouzig ◽  
Frédéric Lebaron
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Decision Making ◽  
Welfare State ◽  
Think Tanks ◽  
Historical Process ◽  
Economic Discourse ◽  
Academic Knowledge ◽  
Historical Viewpoint ◽  
And Diffusion

This chapter describes and analyses the progressive spread of economic "expertise" in the sphere of public policy. It sketches the historical process of the expansion of economic expertise in France, and discusses the way it involves a reshaping of the relations between the State, markets, universities, and other relevant institutional entities (e.g., political parties, unions, etc.), as well as society in general. Considered from this socio-historical viewpoint, economic expertise seems to have contributed to the opening of State-centered regulation to more pluralistic and market-driven public policies in a number of sectors. The analysis draws more specifically on the case of health care, which has been engaged in a clear transformation from a traditional (welfare) State-centered regulation to more open and economically-driven policy. Various components of economic expertise and its concrete uses are under scrutiny, such as classic macroeconomic/econometric forecasting and conjunctural analysis; sectorial expertise; think tanks and organization-related expertise or counter-expertise; academic knowledge in the sphere of policy advice and decision-making; and the production and diffusion of economic discourse through newspapers, magazines, books, etc.

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