The Politics of Medicaid

by Laura Katz Olson

In 1965, the United States government enacted legislation to provide low-income individuals with quality health care and related services. Initially viewed as the friendless stepchild of Medicare, Medicaid has grown exponentially since its inception, becoming a formidable force of its own. Funded jointly by the national government and each of the fifty states, the program is now the fourth most expensive item in the federal budget and the second largest category of spending for almost every state. Now, under the new, historic health care reform legislation, Medicaid is scheduled to include sixteen million more people.

Laura Katz Olson, an expert on health, aging, and long-term care policy, unravels the multifaceted and perplexing puzzle of Medicaid with respect to those who invest in and benefit from the program. Assessing the social, political, and economic dynamics that have shaped Medicaid for almost half a century, she helps readers of all backgrounds understand the entrenched and powerful interests woven into the system that have been instrumental in swelling costs and holding elected officials hostage. Addressing such fundamental questions as whether patients receive good care and whether Medicaid meets the needs of the low-income population it is supposed to serve, Olson evaluates the extent to which the program is an appropriate foundation for health care reform.

Genres: Nonfiction, Health Care

426 pages, Hardcover

First published May 21, 2010

About the author

Laura Katz Olson, AGF Distinguished Professor of Political Science, has published nine nonfiction books focusing on healthcare and aging. Her novel, Wrinkled Rebels, will be released by Vine Leaves Press on July 23, 2024.

The Politics of Medicaid received Lehigh University’s Williamson Book Award in Social Research (2012). Elder Care Journey: A View from the Front Lines, which relates her personal experiences as a caregiver for her mother, won a Gold Medal in the Ninth Annual Living Now Book Awards (September 2017). Ethically Challenged: Private Equity Storms U.S. Health Care (2022) won a gold medal in both The North American Book Awards and the Axiom Business Book Awards. The book was also a finalist in the American Book Fest Best Book Awards. In 2009, she won the Charles A. McCoy Lifetime Achievement Award and, in 2022, the Joseph A. Dowling Award for Excellence in Research and Teaching.

Reviews

[Brandon Minster · Rating 3 out of 5]

This book has two defects, one of which it cannot control, but one of which it can.
Defect 1: Written mostly before ACA in 2009. That's not Olson's fault, but it means a lot of things have changed. To her credit, though, Olson correctly predicts that Obamacare will not make any serious headway against the problems of American healthcare.
Defect 2: 120 pages of notes for a 240-page text. With the smaller font, the notes are nearly as voluminous as the text. I feel a lot of material that the editor struck from the text got turned into notes. "Just don't read the notes," you say. But sometimes a note is important. I just wish Olson had been more judicious in her note creation.

[Beth Haynes · Rating 3 out of 5]

Lots of good information and history of Medicaid---but the polemics are a significant distraction. The author's assumptions are that anyone who does not favor government welfare is stingy, selfish (in a negative sense) heartless, horrible and only cares about money. This stems form her belief that health care is a right and we are morally obligated to meet others' needs.

Oh yes, and profits are evil and corrupting.

So far the factual information I am gaining is outweighing her self-righteous attitude. I am on page 110 of 369. We'll see if I can last till the end of the book.

[Jason · Rating 5 out of 5]

This was an excellent book if you are interested in the various components that make up Medicaid. The authors concludes the book noting that she has a strong preference for a single payer system, but the rest of the book is very objectively written. The policies, problems, and vested interests are all laid out in well-researched detail. A must-read for any Medicaid policymaker or researcher.

[Jake · Rating 4 out of 5]

Really dense, really not fun to read. But very informative. THE book to read to understand the complexities of the Medicaid program, its flaws and successes (although the latter could be emphasized a bit more).