SAGE Journal Articles
Explore full-text SAGE journal articles that have been carefully selected to support and expand on the concepts presented in the chapter.
Click on the following links. Please note these will open in a new window.
The United States spends considerably more on medical care than any country in the world but is the only resource-rich country where a substantial portion of its residents lack health insurance coverage. Moreover, the US continues to rank low on most measures of health outcome compared to other developed countries. Therefore, there was considerable incredulity by those unfamiliar with the US as to why a revamping of this obviously broken system was not widely embraced by the American public when in 2009 a popularly elected president made healthcare reform his top priority. This commentary examines this phenomenon and discusses why a meaningful transformation of the US healthcare system has proven so elusive. Among the factors discussed here are political institutions and economic forces, a powerful medical establishment, the dominant private insurance industry, an extensive liability system and a public that is highly suspicious of any government involvement in healthcare.
There are approximately 2.3 million mixed-status families in the United States, containing varied combinations of citizens, permanent legal residents, undocumented immigrants, and individuals in legal limbo. These families offer an opportunity to examine the functioning of the contemporary state and its penetration at the household level. For many Latino youth, experiences are framed not only by their own but other family members’ legal status. This article reports on health care seeking experiences of mixed-status families in the Lower Rio Grande Valley of South Texas and the impact of the recent health care reform (Affordable Care Act). We utilized qualitative ethnographic methods including 55 semi-structured interviews with mixed-status families and 43 interviews with health care providers, caseworkers, and public health officials. Results indicate that changes accompanying the reform directly and indirectly affect mixed-status households’ ability to access care. We describe strategies in times of illness, including those unique to border communities. We conclude that, for successful implementation of policies associated with health care reform, broader issues related to immigration status must be addressed, especially anxieties regarding future chances of regularization. These uniquely affect mixed-status families, create a ripple effect on all household members, and result in unintended consequences for U.S. citizen children. Implications point to the need for a pathway to citizenship for parents as a basic step in improving well-being of children.