By Ralph Segalman

ISBN-10: 0333470052

ISBN-13: 9780333470053

ISBN-10: 1349198692

ISBN-13: 9781349198696

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Extra info for Cradle to Grave: Comparative Perspectives on the State of Welfare

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4 Health in the Welfare State In the United States, the Federal government has so far limited itself to Medicare and Medicaid in terms of health service provision. Before the establishment of Medicare in the mid-1960s, medical delivery in the United States still retained a considerable degree of charity work by most physicians, with a heavy involvement of voluntary and philanthropic agencies in the operation of clinics and hospitals. With the introduction of Medicare, which supported a large proportion of medical and hospital costs for the elderly, and which was based on a fee-for-service system to doctors, medical purveyors and hospitals, there was a rapid rise in medical expenditures and medical delivery.

The harm that good men do has been ample . . ' This coalition of 'good men' is, of course, the same destructive element found everywhere in the welfare state acting as futile surrogates for the normative processes of community decision-making. THE UNEMPLOYMENT BUREAUCRACY In most of the developed nations, the employment market is serviced by both public and commercial employment placement agencies. Most of the public agencies are funded or subsidised by the central government and are operated by massive civil service rules and regulations, which have had the usual bureaucratising effects.

Neighbourhood associations, environmental groups, lawyers, ambitious politicians, and many others joined in the work of moving industry out of their neighbourhoods or the neighbourhoods of their constituents. With the loss of jobs came a loss of workrelated transportation. Efforts to economise and rationalise the subways and suburban trains meant cutting out stations and trains, and this was fought against in the name of minority rights. Smaller ridership meant more opportunity for crime, especially violent crime.

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Cradle to Grave: Comparative Perspectives on the State of Welfare by Ralph Segalman


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