Poor Families in America's Health Care Crisis examines the implications of the fragmented and two-tiered health insurance system in the United States for the health care access of low-income families. For a large fraction of Americans their jobs do not provide health insurance or other benefits and although government programs are available for children, adults without private health care coverage have few options. Detailed ethnographic and survey data from selected low-income neighborhoods in Boston, Chicago, and San Antonio document the lapses in medical coverage that poor families experience and reveal the extent of untreated medical conditions, delayed treatment, medical indebtedness, and irregular health care that women and children suffer as a result. Extensive poverty, the increasing proportion of minority households, and the growing dependence on insecure service sector work all influence access to health care for families at the economic margin.
1. The unrealized hope of welfare reform: implications for health care; 2. The health care welfare state in America; 3. The tattered health care safety net for poor Americans; 4. State differences in health care policies and coverage; 5. Work and health insurance: a tenuous tie for the working poor; 6. Confronting the system: minority group identity and powerlessness; 7. The nonexistent safety net for parents; 8. Health care for all Americans.