Poor people's medicine : Medicaid and American charity care since 1965 /

Engel (Seton Hall Univ.) carefully reviews the historical constructs of American charity care, with emphasis on the implementation and various changes in the Medicaid program since 1965. A recurring theme throughout history related to charity care is ambivalence of the public about who deserves such care, who should pay for "free" care, and where and by whom it should be provided. Engel notes that the introduction of Medicaid services in 1965 "unintentionally" institutionalized a two-tiered system of medical services in the US--one for those who can pay or have insurance, and another of lesser quality for those who cannot pay. Engel makes links between US society's tepid efforts at social welfare and charity health care. His walk through the history of charity care is a story of fights over eligibility, professional autonomy, and the struggle between federalism and States' Rights. Engel makes the case that Medicaid holds a central role for government involvement in charity care, with a history of many failures and some successes; infant mortality has failed to decline, and the number of uninsured in the US is growing. This is a well-written, easy-to-understand work. ^BSumming Up: Recommended. Graduate students and above; general readers. J. E. Thompson Western Michigan University