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12 - Vaccine Opposition in the COVID-19 Age
- Edited by Glenn W. Muschert, Kristen M. Budd, Miami University, Michelle Christian, University of Tennessee, Knoxville, David C. Lane, Illinois State University, Jason A. Smith
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- Book:
- Social Problems in the Age of COVID-19 Vol 1
- Published by:
- Bristol University Press
- Published online:
- 23 March 2021
- Print publication:
- 24 August 2020, pp 122-133
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Summary
The Problem
Hope of ending the COVID-19 pandemic rests mainly on development of an effective vaccine. Availability of a vaccine is only part of the solution, though; Americans’ decisions to receive or forego the vaccine will determine its ultimate success. If too few people immunize, outbreaks will continue. Such outbreaks pose serious health risks to those who cannot vaccinate and translate into continued economic and health care costs, which those in higher-risk and disadvantaged groups disproportionately shoulder. Although a vaccine is not currently available, there are already troubling signs about Americans’ willingness to embrace one. The convergence of the anti-vaccination movement with the public's growing distrust of social institutions—including government, medicine, and the media—poses major challenges for COVID-19 immunization efforts.
Vaccine opposition was a growing social problem before COVID-19, and abundant misinformation, economic uncertainty, politicization of the pandemic, and anxiety about government overreach following pandemic-related restrictions have exacerbated existing anti-vaccination sentiment. Even during the earliest phases of the US COVID-19 crisis, unfounded reports circulated online suggesting the vaccine would be unsafe, an attempt at surveillance, and/or a dangerous yielding of personal freedom. The New York Times reported that by April 2020, the most widespread falsehood about the pandemic—viewed and shared millions of times in a matter of weeks—involved speculation that Bill Gates had helped create COVID-19 to profit from it and implant a surveillance device into Americans via an eventual vaccine. The viral “Plandemic” video circulating in May 2020 suggested that vaccinations Americans have received in the past make them more susceptible to COVID-19 by weakening their immune systems. In addition, some antivaccination groups see concerns about pandemic-related government restrictions as an opportunity to expand their movements and recruit adherents. During the first wave of the outbreak, anti-vaccination groups were behind some of the protests for ending stay-at-home orders and reopening the economy. These events demonstrate concerted efforts to influence Americans’ views of a COVID-19 vaccine before one is even available. They also suggest that not only is the pandemic affecting views on vaccination, but that these changing views will pose an important barrier to ending the crisis.
Five - In Pursuit of Justice in U.S. Health Care Policy: Pathways to Universal Coverage
- Edited by Glenn W. Muschert, Kristen M. Budd, Miami University, Michelle Christian, University of Tennessee, Knoxville, Robert Perrucci, Purdue University, Indiana
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- Book:
- Agenda for Social Justice
- Published by:
- Bristol University Press
- Published online:
- 12 March 2021
- Print publication:
- 05 August 2020, pp 43-52
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Summary
The Problem
Nearly a decade since the contentious passage of the 2010 Patient Protection and Affordable Care Act (ACA), which aimed to expand Americans’ access to health insurance, the legislation remains highly controversial. Several attempts to repeal and replace the law failed in 2017, but legislative and executive action have altered the law in fundamental ways since then. Public opinion on the ACA has remained divided since its passage, with about 40 percent of the U.S. public reporting an unfavorable view both immediately after its passage in 2010 and in mid-2019. Instead of the ACA ushering in reform and subsequent stability for the health care system, it does not function the way it was originally intended and Americans have not coalesced around it. This has set the stage for a continued battle for health care reform.
Notably, the ACA did not fundamentally reshape the U.S. health care system. Prior to the ACA, the U.S. was the only developed nation without universal health care, and it retains that distinction even postreform. Americans receive health insurance through a labyrinthic and patchwork-like system, in which one's age, economic situation, and employment status dictate coverage. About half of Americans receive insurance through an employer (whether their own or a partner’s/parent's employer), coverage which is generally terminated upon retirement or changing jobs. After turning 65, the vast majority of older Americans are shuttled into a different health insurance system, receiving their coverage through the federal Medicare program. About a quarter of Americans receive coverage through the Medicaid program, a public health insurance program for people with low income that is funded jointly by the state and federal government. Although the ACA attempted to extend Medicaid coverage to all Americans with income up to 138 percent of the federal poverty line, 14 states have not expanded their Medicaid coverage as of July 2019. Therefore, inconsistencies in eligibility for Medicaid persist across states, with some states imposing work requirements on recipients, limiting eligibility to certain groups, and/or drawing eligibility thresholds even lower than the federal poverty line.
Six - The Problem of Unpaid Parental Leave
- Edited by Glenn W. Muschert, Kristen M. Budd, Miami University, Michelle Christian, University of Tennessee, Knoxville, Robert Perrucci, Purdue University, Indiana
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- Book:
- Agenda for Social Justice
- Published by:
- Bristol University Press
- Published online:
- 12 March 2021
- Print publication:
- 05 August 2020, pp 53-62
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Summary
The Problem
The United States is the only high-income country – and, along with Papua New Guinea, one of only two countries worldwide – with no national paid maternity leave policy. Although six states have legislation mandating statewide paid parental leave and some employees receive paid leave as a fringe benefit from their employer, access to paid parental leave remains unjust. Statistics from the U.S. Department of Labor show that only about 16 percent of workers in the private sector have employer-provided paid family leave, and this figure drops to 7 percent of workers who earn less than $14 an hour. Similarly, parents who struggle the most to meet the financial needs of raising children are the least likely to have access to any workplace accommodations, and research shows this burden is disproportionately borne by women with lower levels of income and education.
The 1993 Family and Medical Leave Act (FMLA) established national unpaid family leave regulations, but it has resulted in notable inequities. The FMLA allows employees up to 12 weeks of unpaid leave to care for a newborn child or to tend to the illness of one's relative or self. However, only employees working for an employer with 50 or more employees and who have worked at least 1,250 hours over the past 12 months are eligible. According to estimates from the Kaiser Family Foundation, these exemptions mean that only about 60 percent of Americans are eligible to use FMLA leave. Even for those who are eligible, the leave is unpaid, often resulting in parents forgoing or abbreviating their leave. A Pew Research Center poll showed that, among those who take parental leave, the majority did not take as much as they needed or wanted; when asked the reason, 69 percent indicated they could not afford to lose more wages or salary. The failure to provide paid leave to new parents is a significant social justice issue with implications for successfully balancing work and family obligations. Moreover, given the gendered division of household labor (including parenting), as well as gender inequalities in the workplace (e.g., the pay gap and glass ceiling), the absence of a mandate to provide paid leave reflects a form of institutional discrimination for working mothers.
five - After Health Care Reform: Enduring Challenges for Justice in the American Health Care System
- Edited by Glenn W. Muschert, Khalifa University, Brian V. Klocke, Robert Perrucci, Purdue University, Indiana, Jon Shefner, University of Tennessee, Knoxville
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- Book:
- Agenda for Social Justice
- Published by:
- Bristol University Press
- Published online:
- 18 April 2023
- Print publication:
- 03 August 2016, pp 49-58
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Summary
The Problem
Numerous sources, including the World Health Organization, Institute of Medicine, and the Commonwealth Fund, show that the U.S. spends more than any other developed nation on health care, but lags behind in terms of key health indicators such as life expectancy and infant mortality. Despite the high spending, U.S. citizens express lower satisfaction with their health care than those in other industrialized nations, and the U.S. is the only developed country that does not have a universal health care system. These shortcomings, coupled with steady growth in the number of uninsured and underinsured Americans, set the stage for the passage of the Patient Protection and Affordable Care Act (hereafter referred to as the ACA) in 2010. Although legislators aimed to solve a major social problem by making health care more accessible and affordable, early results suggest this intent has not been fully realized. The number of uninsured peaked at over 49 million in 2010, according to estimates by the U.S. Census Bureau. By 2015, a Kaiser Family Foundation (KFF) analysis shows this number had dropped to 32 million after passage and implementation of the ACA. Although a reduction in the number of uninsured is laudable, millions of Americans remain uninsured, and health care is still not considered a basic human right.
The ACA aimed to expand insurance coverage to more Americans through three main avenues: increasing employer responsibility, increasing individual responsibility, and increasing government responsibility. It also placed a number of restrictions on insurance companies, such as prohibiting consideration of pre-existing conditions and placing annual or lifetime limits on coverage. These changes have been beneficial in reducing the number of people who are uninsured and helping to ensure that Americans have more comprehensive coverage. However, recent evaluations of the legislation point to some enduring challenges. Estimates by KFF suggest that, of the 32 million people who remain uninsured, about half are either eligible for Medicaid or subsidies to aid them in purchasing insurance. Another 10 percent are individuals who fall into the Medicaid gap: they live in states that did not expand their Medicaid program, but have income too low to qualify for subsidies that would help them purchase insurance. Fifteen percent are undocumented immigrants, who are not eligible for Medicaid or subsidies to purchase insurance through the exchange.
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