The future of the United States'' social welfare commitments, including retirement and disability payments, unemployment insurance, Medicare and Medicaid, and the State Child Health Insurance Program, poses urgent questions as social and demographic change in the country accelerates. Yet even many social welfare policy experts fail to grasp the sheer size and intricacy of the Social Security Act, which governs those commitments, and the resulting complexity of any reform efforts. In this outstanding guide to the Act''s programs and policies, along with the context that shaped them, Andrew Dobelstein takes readers step by step through their maze, providing the kind of comprehensive view of the U.S. social welfare system that is essential for any would-be reformers to master. Since being signed into law in 1935, the Social Security Act has institutionalized the country''s social welfare undertakings into a massive package administered by a sprawling federal agency and state-level organizations that must implement its programs. Dobelstein provides the first complete guide to every entitlement authorized by the Social Security Act, drawing on his 38 years of research, teaching, and community service to explain in accessible, straightforward writing the origins, development, and ins and outs of their practical administration. By showing how the United States'' unique social welfare philosophy is reflected by the Social Security Act, this book provides a foundation for examining how its social welfare programs are bonded into a major social welfare enterprise. A fresh appraisal of the U.S. social welfare system''s evolution and current situation is necessary if the country is going to use efficiently its social welfare resources going forward. Students and scholars of policy and government, as well as public servants, whose work involves the real-life implications of the Social Security Act, will find this sweeping yet detailed overview an indispensable aid.

Part I Overview of the Social Security Act p. 1 Introduction p. 1 Conclusion p. 10 1 The Social Security Act in Perspective p. 13 Introduction p. 13 The General Structure of the Social Security Act p. 14 I The Program and Policy Structure of the Social Security Act p. 15 The Program Structure of the Act p. 15 The Policy Structure of the Act p. 18 Summary of Programs and Policies p. 23 The Dilemma of Insurance and Assistance Implementation Policies p. 23 II The Social Security Act in the American Political and Ideological Context p. 27 Conclusion: Shifting Politics and the Social Security Act p. 37 Part II The Social Insurances p. 43 Introduction p. 43 2 Title II: The Program Structure of Old Age, Survivors, and Disability Insurance p. 47 Introduction p. 47 The Social Security Program Structure p. 48 Related Retirement Instruments p. 63 Conclusion p. 66 3 Title II: The Policy Structure of Old Age, Survivors, and Disability Insurance p. 71 Introduction p. 71 Financing Title II Social Security in Its Larger Economic Context p. 75 Financing Summary p. 90 Policy Issues Confronting Social Security Programs p. 91 Conclusion p. 98 4 Title III: Unemployment Insurance p. 101 Introduction p. 101 Unemployed and Unemployment Characteristics p. 108 Unemployment Insurance Program Framework p. 112 Title III Unemployment Insurance Policy Issues p. 119 Summary of Title III Policy Issues That Call for Attention p. 125 Challenges Facing Unemployment Insurance for Future Consideration p. 126 Conclusion p. 128 Part III Introduction to the Assistance Programs p. 131 The Legacy of the Social Security Act''s Assistance Programs p. 131 Welfare Assistance and the Social Obligation p. 133 The Social Obligation in the American System p. 134 Conclusion p. 140 5 Title XVI: Supplemental Security Income p. 143 Prologue p. 143 Prologue Summary p. 154 The Program Structure of Supplemental Security Income (SSI) p. 155 The Policy Structure of Supplemental Security Income p. 158 Conclusion p. 168 6 Who''s Taking Care of the Children? Title IV: Temporary Assistance to Needy Families and Related Programs for Children and Families p. 173 Introduction p. 173 Program Structure of Title IV p. 179 Policy Structure of Title IV of the Social Security Act p. 194 Conclusion p. 204 Part IV Health: Insurance and Assistance p. 211 Introduction p. 211 Conclusion p. 219 7 Title XVII: Medicare Health Insurance for the Aged p. 221 Medicare in Its Social Welfare Context p. 221 Medicare''s Programs p. 228 Medicare Policy Issues p. 237 Obstacles to Reforming Medicare and Health Care p. 245 Conclusions p. 248 8 Titles XIX and XXI: Medicaid and the State Child Health Insurance Program p. 255 Introduction p. 255 The Political and Economic Context for Medicaid/State Child Health Insurance Program (SCHIP) p. 256 The Context of Providing Medical Care p. 258 The Program Structure of Medicaid/State Child Health Insurance Program p. 260 The Policy Structure of Medicaid and SCHIP p. 270 Conclusion p. 278 Part V Title XX: Social Services and the Social Security Act p. 283 An Introduction to Title XX of the Social Security Act p. 283 9 Title XX: Social Services p. 287 Introduction p. 287 Context for Title XX Development p. 288 The Program Structure of Title XX p. 297 The Social Service Program under Title XX p. 298 Title XX/SSBG Policy Structure p. 305 Conclusion p. 309 10 The Social Security Act for America''s Twenty-First Century p. 315 Introduction p. 315 The Social Security Act in Today''s Environment p. 317 The Theory of Social Welfare Imbedded in the Social Security Act p. 319 Expanding Welfare Theory through the Social Security Act p. 323 Reforming the Social Security Act p. 328 Concluding Thoughts p. 338 Index