Multiple program participation and exits from food stamps among elders.

This article uses population-level administrative data from Rhode Island's Food Stamp Program to examine exits from the Food Stamp Program by elders. Multivariate event history models estimate the relations of multiple program participation and the timing of eligibility reviews to the probability of exiting food stamps. Results suggest that elders who are age 65 or older and who receive both Supplemental Security Income and food stamps have a higher probability of exiting the Food Stamp Program than do elders who receive only food stamps. The timing of eligibility reviews is also found to be positively associated with the probability of exit from food stamps. This article is argued to extend conceptual models of the determinants of food stamp exits.

Between less eligibility and the NHS: the changing place of poor law hospitals in England and Wales, 1929-39.

In 1929, the Local Government Act broke up the apparatus of the Poor Law Guardians and Unions, and transferred responsibility for the care of the poor to local councils. In theory, the period between the passing of the Act and the formation of the National Health Service witnessed a large-scale reclassification of the sick poor as patients rather than paupers. In reality, as this investigation of contemporary judgements of hospital quality and bed and staff numbers in English and Welsh county boroughs shows, the national picture was very varied at the local level. Local and sometimes regional traditions of care, finance and council priorities had a large influence on the ongoing development of a unified medical service which included the poor. In the best case scenario, hospitals were classified by patient type, and the principle of 'less eligibility' was discarded. Elsewhere, economic status continued to direct medical treatment, but in almost all cases, the chronic and elderly poor were more likely to remain in low-quality and unmodernized buildings than the acutely sick. The investigation highlights the disjuncture between the changed vision for the sick poor and its patchy enforcement on the ground.

The Medicare approach: political choice and American institutions.

The most significant health reform in American history was the passage of Medicare in 1965, but this was an accomplishment born of defeat. Medicare was designed and understood by its early promoters as an approach to health reform, not simply as a discrete program for a distinct target population. Although Medicare incrementalism has tended to be shunted aside when the opportunities for health reform are most promising, the final years of the Johnson administration reveal previously underappreciated efforts to expand Medicare eligibility to large new population groups and offer insights into the continuing potential of Medicare incrementalism in our own time.

Policy lessons from children's allowances for children's savings accounts.

This article examines the history and current structure of children's allowances around the world as well as the history of such allowances in the United States in an effort to provide the United States with a policy framework for children's savings accounts. The authors also provide policy direction for children's savings accounts.

Medicaid eligibility policy in the 1980s: medical utilitarianism and the "deserving" poor.

Between 1981 and the early 1990s, the Medicaid program grew substantially, in part because, for the first time in the program's history, eligibility for medical assistance was severed from eligibility for income-maintenance payments. Program participation had always been reserved for the "deserving poor," and these were originally defined as persons excluded from market relationships through no fault of their own. The Medicaid expansion of the 1980s, however, created a new constituency of poor, and not-so-poor, persons whose actual or predictable medical problems promised a calculable return on program funds.