Medicare is a federally regulated social welfare policy that is funded from income taxes, monthly premiums deducted from Social Security, and Congress. This policy specifically targets all individuals 65 and older, as well as persons with disabilities or permanent kidney failure. It is estimated that there were roughly 50 million Medicare beneficiaries in the United States between 2010 and 2011, approximately 16% of the total US population. Of those 50 million, 83% were eligible for Medicare because they were 65 or older.1 In fact, aging adults and their access to health care were the original motives behind creating Medicare.
Concerns for the aging and their health started to become a national and political concern during the Great Depression of the 1930s. During this time, elderly adults and their families were presented with an interesting dilemma. Historically, children were responsible for the care of their aging parents. Given the financial despair of this time period, however, individuals had fewer and fewer financial resources with which to support themselves and their aging family members. Medical costs were consistently the main issue for the elderly and a conversation began to form on how the United States government could provide assistance in the face of this growing concern.2
The economic changes that occurred during the Great Depression also led to a shift in how social welfare was viewed. As more people struggled against the weight of financial depression, more people became open to the idea of government intervention. The establishment of the Social Security Act of 1935 by President Franklin D. Roosevelt brought about the creation of many social welfare policies. This major piece of legislation also brought a new group of professionals to the political table: social workers. Frances Perkins, Harry Hopkins, and Whitney Young were some of the major players involved in the creation of the Social Security Act, and their knowledge and experiences as social workers enabled them to help the president properly address the concerns of American citizens in need. In fact, the ideals of equality took the United States by storm in the 1950s and 1960s as issues of civil rights took storm. The general opinion of the public during this time favored a more liberal perspective with Democrats becoming the majority party, and it was this more liberal ideal that helped support President Lyndon B. Johnson’s decision to make Medicare apart of America’s social welfare system in 1965.
Several conservatives during the 1960s felt that Medicare – and the other welfare policies bundled within the revamped Social Security Amendments of 1965 – was a shift toward socialism and that it was not the place of our government to interfere in personal matters, such as health care and medical insurance. Ronald Reagan produced a record titled “Ronald Reagan Speaks Out Against Socialized Medicine” in which he warns that Medicare will encourage other federal programs that “will invade every area of freedom we have known in this country.”3 Reagan also encouraged listeners to write to Congress or else “we will wake to find that we have socialism.”3 Physicians were also among the people opposed to Medicare, and they argued that Medicare would inevitably lead to a deterioration of care. This argument supported the idea that the government had no place telling educated professionals of medicine how to best provide and execute health care.4 Despite the opposition and accusations of socialism, Medicare became a policy in 1965 and more than 19 million individuals aged 65 and older were enrolled in the program just a year later.
It can be easy to dismiss the history of Medicare because it is a program that most people have heard mentioned all of their lives. Given the general public popularity of the program today, it can also be difficult to comprehend a time when Medicare was fought against and defined as socialized medicine. The history of the program is important to consider because it gives us a better idea of the general framework of the program, and it also helps us to better understand how the policy and opinions of the policy may have changed over time.
1The Henry J. Kaiser Family Foundation. (2012, September 7). United States: Medicare enrollment. Retrieved from http://www.statehealthfacts.org/profileind.jsp?sub=74&rgn=1&cat=6
2The Henry J. Kaiser Family Foundation. (Producer) (2012, December 17). The story of Medicare: A timeline. [Video ]. Retrieved from http://www.kff.org/medicare/medicare-timeline2.cfm
3Reagan, Ronald. Ronald Reagan Speaks Out Against Socialized Medicine. Operation Coffee Cup Campaign. American Medical Association, 1961, Phonograph Record. http://www.youtube.com/watch?v=fRdLpem-AAs
4Kristof, N. (2009, November 18). The wrong side of history. The New York Times. Retrieved from http://www.nytimes.com/2009/11/19/opinion/19kristof.html?_r=0
Common STIs and How To Avoid Contracting Them
Every year, an estimated 20 million adults in the USA contract some type of STI. While some STIs exhibit distinct symptoms, others might be completely unnoticeable. Whether they’re asymptomatic or not, any sexually active person will still need to be vigilant and informed when it comes to preventing the spread of STIs. With convenient, discreet, and affordable STD testing much more commonplace today, there’s no excuse for anyone to avoid taking charge of their own health and protecting others as well. Here are some of the most common diseases and how you can avoid contracting them.
HPV – Genital Human Papillomavirus
In the United States, about 14 million people get HPV every year, making it the most common STI. It’s so common that almost every sexually active person will contract it in their lifetime. There are over 40 different strains of HPV. Some strains can cause warts, while others can lead to cancer if left untreated.
HPV is spread by having oral, vaginal, or anal sex with someone who has the virus. With most strains of this virus, you may not experience any symptoms and it may go away on its own. However, if it doesn’t go away, then it can cause problems.
Sometimes, HPV can cause genital warts. These warts can vary in size or shape. So, it’s recommended that you consult your doctor examine you if you notice anything that could be a genital wart. Some strains of HPV can cause cancer. It can take years, even decades, to contract cancer after getting the virus. You could get vaginal, anal, throat, tongue, penis, vulva, or tonsil cancer.
The CDC recommends that you get the HPV vaccine. Many people get this vaccine around 12 years old, but you can get it up until you’re 26 years old.
This STI is a bacterial infection. You can contract chlamydia by oral, vaginal, or anal sex with someone who has it. Additionally, a pregnant person could pass the infection onto their newborn. Symptoms of this STI include:
- Unusual discharge from a penis or vagina
- Burning sensation during urination
Your doctor can provide tests to determine if you have chlamydia. If you do, you can treat it using antibiotics. It’s recommended that you get treatment as soon as possible as chlamydia can cause fertility problems in both genders.
An estimated 800,000 people deal with this STI every year. Gonorrhea occurs when bacteria infects the lining of a woman’s reproductive tract. It can also manifest in the mouth, throat, eyes, and anus. You can contract this infection by having oral, vaginal, or anal sex with an infected person.
With this infection, you may face no symptoms at all. If you do have symptoms, you may experience unusual discharge from your genitals and pain while urinating. Men may experience pain in their testicles, while women may experience vaginal bleeding in between periods.
After diagnosis, you may be treated with two, different strains of antibiotics. Like Chlamydia, if it’s left untreated you may experience fertility issues in the future.
Unlike most STIs, there is no cure for genital herpes. Each year, around 800,000 adults contract the disease nationwide. This infection is caused by the herpes simplex virus or HSV. There are two strains of this virus – type 1 and type 2 and you can be infected by having any type of sexual contact with someone who carries the disease.
While some people experience mild symptoms, others are completely asymptomatic. Symptoms include having blisters around the mouth, anus, or genitals. These blisters will break open, causing pain and discomfort. The fluid inside of the blisters carry the herpes virus.
While it cannot be cured, your doctor can prescribe medicine to ease your pain.
How To Avoid STIs
There are multiple things you can do to prevent getting STIs. First and foremost, you need to ask your sexual partners to disclose their sexual history before you have sex with them. This lets you know if they’ve had any STIs and how many partners they’ve had intercourse with. Additionally, you can ask your partners to get tested for any STIs before you have sex with them.
Whenever you have sex, you should be using latex condoms. Using a condom every time you have sex can vastly reduce your chance of contracting an STI. The CDC has many tips on preventing STIs.
I Have an STI – What Now?
If you do contract an STI, go to your doctor’s office as soon as possible. If you can’t afford to go to the doctor’s, there are many places that offer STD testing. It’s important to get tested so that you can protect yourself from having health problems down the road.
Parental Medicaid Expansion Translates into Preventive Care for their Children
When low-income parents enroll in Medicaid through the Affordable Care Act (ACA) state expansion program, their children have considerably better odds of receiving annual preventive care pediatrician visits, according to a new analysis by the University of Pittsburgh Graduate School of Public Health and Johns Hopkins University.
This “spillover effect,” explained in a study published online today and scheduled for the December issue of the journal Pediatrics, demonstrates that the potential benefits of Medicaid expansion extend beyond the newly covered adults.
“These findings are of great significance given the current uncertainty surrounding the future of the ACA and Medicaid expansions authorized by the law,” said senior author Eric T. Roberts, Ph.D., assistant professor in Pitt Public Health’s Department of Health Policy and Management. “Lawmakers crafting policy proposals that could curtail Medicaid benefits or eligibility should recognize that such efforts would not just limit the receipt of health care services by low-income adults, but also by their children.”
The ACA provided states the opportunity to expand Medicaid coverage to all low-income people at or below 138 percent of the federal poverty level. So far, 31 states and the District of Columbia have expanded Medicaid coverage.
Roberts and his colleagues identified 50,622 parent-child pairs from data collected in the 2001 through 2013 Medical Expenditure Panel Surveys, a nationally representative survey administered by the U.S. Department of Health & Human Services that includes detailed information on family structure and demographics, including health insurance status and health care use.
They discovered that children of parents who had recently enrolled in Medicaid had a 29 percent higher probability than children of unenrolled parents of receiving their well child visit, which is recommended annually for children age 3 and older, and more frequently for infants and toddlers.
During the visits, the children are examined for growth and development and given immunizations, and their caregivers are guided on proper nutrition and child behaviors. Studies have shown that children who get well child visits are more likely to receive all their immunizations and less likely to have avoidable hospitalizations. The U.S. has persistently low rates of well child visits, particularly in low-income families.
“There are many reasons that parental Medicaid coverage increases the likelihood of well child visits for their children,” said Roberts. “It could be that insurance enhances the parents’ ability to navigate the health care system for themselves and their children, increasing their comfort in scheduling well child visits. Medicaid enrollment could be a sort of ‘welcome mat,’ in which eligible but previously uninsured children are enrolled after their parents gain coverage. It also could be that parental Medicaid coverage frees up more money to provide preventive services to their children, because even copays can be a deterrent to medical care among low-income people.”
Maya Venkataramani, M.D., is lead author on this research, and Craig Evan Pollack, M.D., M.H.S., is a coauthor. Both are from the Johns Hopkins University School of Medicine.
How to Develop an Individual Grief Plan
My Mother always said that my Daddy was “a fool born on April fools”. This was the running joke all of my life. April 1 came along this year and it was not a joking matter. I was heartbroken and devastated that I could not hear my father’s voice or see his smiling face on his birthday.
Earl, My Pearl, was diagnosed with pancreatic cancer June 20, 2016, after suffering several months of abdominal pain, significant weight loss and limited mobility. He passed away peacefully on September 9, 2016, 4:30 am. This process was very difficult for all of us to watch, yet, we were there every step of the way and handled it a gracefully as possible.
I worked as a hospice social worker for several years prior to my father’s diagnosis. Our journey was still difficult but I was familiar with the language and processes pertaining to the end of life which afforded me the opportunity to assist my mother in talking with our team of doctors and making decisions. She found comfort and security in that and this made me proud. I saw this as an attempt to make this living nightmare a little less scary and slightly bearable.
My hospice experience also somewhat prepared me for being around death. I spent time with my Daddy after he passed away and I combed his hair prior to his wake with an unusual calm. These were tender moments that I will forever cherish.
I faced a dilemma as my Daddy’s birthday approached. My 8th wedding anniversary was a few days prior to Daddy’s birthday. My husband wanted us to go away to celebrate the weekend of April 1st. My plan had been to spend the morning at the cemetery with my mother.
After discussing it with my spouse and my mother (my voices of reason) I came to the conclusion that my father would not want me weeping at his grave on his birthday. He would prefer me to go away, live life and celebrate with my husband whom he was very proud of and admired. So, we continued with our anniversary plans although I did not know what April 1st was going to be like.
I was committed to getting through my Daddy’s first birthday in Heaven without ruining this special weekend that my husband had so thoughtfully planned. So, I allotted uninterrupted time and space for my grief and I planned activities to pull me out of those dark places that have the ability to consume us if allowed. I planned for my grief. Sound weird; keep reading. I hope my experience assists you in your process.
On the morning of April 1st, I woke up, attempted to post a memorial birthday wish to My Pearl on my Facebook page and the tears began. I went into the bathroom and cried hard for at least an hour if not more. I wasn’t simply misty eyed or a little teary; this was the ugly cry that people try not to do in public.
My husband tried to console me but I asked him to allow me to handle this on my own. I allowed the tears and emotions to flow without beating myself up for crying like a 37-year-old baby. I did not attempt to suppress my feelings which is typically our natural response. I went through the sadness of being Daddy’s little girl without her Daddy. I experienced the “maybe I could have done more” routine that we wallow in sometimes. I felt the guilt of not choosing to be graveside on his 75th birthday.
I felt horrible for abandoning my mother in her grief even though I knew she wanted me to continue with my celebration. It went on and on and I allowed it until it ran its course naturally. Once I was completely done, I sat in silence for a while then cleaned myself up. I felt weak, somewhat limp yet refreshed. My husband and I went to a lovely breakfast at our hotel; we changed our clothes and went to the gym together.
After that, I took a long hot shower, allowed myself to air dry across the crisp white comforter on our king size fluffy bed. I then turned on some relaxing beautiful music. I did not sleep, I simply allowed myself to be in total and complete relaxation for the remainder of the afternoon. Our friends met us for cocktails and a show and it turned out to be an amazing and wonderful trip overall. I planned for my grief, I executed and came through my Daddy’s first birthday relatively unscathed and empowered.
Make an appointment to grieve.
When we go to the doctor, we have an appointment. You have called ahead, maybe weeks in advance, to make the appointment. You have your appointment time, you see the doctor to discuss your health, meds, etc within your allotted amount of time (usually not over an hour) you say your goodbyes and you leave. Think of your grief in that way.
I set my grief appointment for first thing in the morning because we were on vacation. We had nothing pressing planned that morning and we had guests meeting us in the evening. Whatever your day is going to look like, carve out space and time to be alone with your grief and make it happen.
This is important because if you allow the grief to have its way, it will show up throughout the day and consume you for the better part of that day and possibly beyond. Take control of your grief by making an appointment, letting it present as it may, then, as you do with other appointments, say your goodbyes and leave it.
Don’t take “walk-ins”.
It is very difficult to walk into your doctor’s office and see them without an appointment. Apply this to your grief. Say you had your appointment, you successfully followed all of the steps and are moving on with your day. If grief shows up outside of its appointment time, turn it away: “Look grief, your appointment was 8 am. We saw you and dealt with you then. I will see you at your next scheduled appointment.” Acknowledge your grief but do not allow it to consume you outside of your appointment. Commit to having power and control over the grief.
Plan to grieve alone.
Our family members and close friends mean well in trying to assist us in our grief, especially around holidays and special events that we would normally share with our deceased loved one. Unintentionally, they can often be a hindrance, sometimes a crutch in our process. Additionally, we may subconsciously modify our grief in order to accommodate them and their level of comfort.
This appointment is not the time for such modifications. Maybe we will cry but suck it up and move forward prematurely because they might feel like we have cried long enough. Or maybe they, meaning well, will say the cliché things that people say when one is grieving in an effort to help ease the pain and stop the flow of tears: “it will be ok” or “time heals all wounds” and my all-time favorite “he’s in a better place”. We know that those things are true.
However, do we want to hear those things in our time of grief? NO!!! We are thinking “it won’t be ok because I can’t live without him”, “nothing will heal these wounds” and “the best place is here with me”. None of those clichés are needed or welcomed for that matter, at this point in the process. Again, you have to allow space and time for this process without guidance from well-meaning family members and friends. It has to run its own natural course. Friends and family have a more appropriate role in the next steps of this process.
Plan activities that you enjoy.
I knew that if I had grieved and simply remained still, I would have wallowed in a sad, hurtful place all day. Therefore, I moved on to an enjoyable breakfast then a workout with my husband to take my mind to better places. It’s not that you’re getting busy to suppress your feelings. Because of your grief appointment, you have dealt with your feelings and emotions head on and very appropriately.
You’re merely creating a beautiful welcomed distraction in order to move on with your day. After the grief appointment, it is imperative to get up and get busy living. This has to be planned for and executed. At this point, your family and social support system could play a huge, meaningful role without hindering your process. Remember, do not take walk-ins!
Take some time for relaxation and self-care.
My self-care was a long hot shower followed by resting to nice music. Your self-care may look like a spa day, a long jog through your favorite park, a scenic hike, cooking an elaborate meal or a shopping trip. Whatever makes you feel well, do it! Think of this as a special gift from your loved one on this special day; it’s your reward for bravely facing your grief and taking control of your grief process. I firmly believe that the ones that we loved and lost enjoy seeing us live happy and well despite their absence.
My father was here for all of my major life events: all of my graduations and performances, he moved me into my first apartment, he walked me down the aisle at my wedding, he was there during my pregnancy and formed a sweet relationship with my daughter…with all of that being said, how can I wallow in sadness? I am so grateful for having a father that was present until he passed away.
Others have not been as fortunate and I acknowledge that. For that reason, I choose on his birthday, holidays and any day of the week to be grateful for him and his life rather than focus on his absence. I am also grateful that he did not suffer long after his diagnosis.
As a hospice social worker, I saw patients and families suffer months and months; having their hopes of recovery dashed with the horrible news that their cancer had spread and there were no further options. This was not our case. We had our ups and downs but God was merciful and ended my father’s battle 3 months after he was diagnosed. For that I am grateful. My gratitude list could go on and on. My point is that in our sadness and on those birthdays and holidays, we have to immerse ourselves in gratitude in order to make it through.
The preceding technique is not the catch all or fix all for your grief issues around holidays and special occasions. This is merely a formula that worked for me and I was compelled to share it with the hopes of helping others. If you are experiencing complicated, ongoing grief issues, please, seek help from a mental health professional.
Individual sessions, grief support groups, and other therapeutic interventions to deal with grief may be necessary depending on your individual needs. Remember, death is inevitable for all of us. However, being proactive in our grief process and planning for the same may assist and make facing holidays without your loved one bearable and beautiful. It happened for me; that’s my hope for you!
Subscribe to Our Newsletter
Lessons in the Current Puerto Rican Disaster
Those who have worked in disaster areas know that coordination and transport can be difficult, but with the USS Comfort...
Opening Paths for Europe’s Children: Best Practices and Transitions from Introversion to Extroversion
The Social Welfare Center in the Central of Greece Region at the Ministry of Labor, Social Insurance & Social Solidarity...
Disruptive Leadership: Maximizing Inclusion, Invention, and Innovation in Human Services
“Disruptive leadership” is an approach to management that entails new ways of thinking, creative problem-solving, and utilizing innovative techniques to...
Parental Medicaid Expansion Translates into Preventive Care for their Children
When low-income parents enroll in Medicaid through the Affordable Care Act (ACA) state expansion program, their children have considerably better odds of receiving annual...
Fearless: How One Financial Expert Faced Her Fear Of Public Speaking
When you are on a collision course to face your fears in order to achieve your future career goals, what...
Elder Care4 months ago
Stressed Out Caregivers Are Using ER Visits for Respite, Study Finds
News4 months ago
5 Ways White Social Workers Can Respond to the Charlottesville Aftermath
Culture4 months ago
The Rise of Hookup Sexual Culture on American College Campus
Emergency Management3 months ago
How to Volunteer for Hurricane Irma Disaster Relief
Human Services3 months ago
9 Reasons Why Text Messaging is the Key to Efficient Communication in Social Services Agencies
Global4 months ago
Britain: We Need to Talk About the Benefits System
LGBTQ4 months ago
Military Service Boosts Resilience, Well-Being Among Transgender Veterans
Justice4 months ago
Exploring the Traumatic Impact of Criminalizing Policies on Black Women and Girls