From 1991 to 2009, the fraction of Medicaid recipients enrolled in HMOs and other forms of Medicaid managed care (MMC) increased from 11 percent to 71 percent. This increase was largely driven by state and local mandates that required most Medicaid recipients to enroll in an MMC plan.
CPI Research
In many countries, concern about socio-economic inequalities in educational attainment has focused on inequalities in test scores and grades. The presumption has been that the best way to reduce inequalities in educational outcomes is to reduce inequalities in performance.
Severe economic downturns, like the Great Depression, are associated with substantial increases in poverty and material hardship.
As the economic downturn wears on, the debate about U.S. spending on the safety net has become increasingly rancorous. Indeed, former presidential candidate Newt Gingrich famously referred to Barack Obama as "the food stamp president" in the early-2012 campaign trail.
The Great Recession and the slow recovery since have been the longest economic slump in seventy years. It affected vulnerable populations more than others.
Americans have long been, and continue to be, a famously charitable people. Whereas Europeans have well-developed and comprehensive welfare states, the United States has always relied more on private charity to support a multitude of causes, including aid and assistance to the poor.
The particular trauma of severe downturns is that declining consumer spending, itself a reaction to the economy's contraction, also undermines the prospects for recovery. Consumption is, in other words, a fundamental determinant of business cycles - a kind of litmus test of economic health.
Common sense tells us that crime should increase during hard times. After all, more than 90 percent of the serious "index" crimes reported each year in the government's Uniform Crime Reports involve some kind of financial remuneration.
