Insurance Companies Have Been Getting a Free Ride from the Public

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					Domestic Policy

    1.   What If… We had universal health care?
    2.   The Policymaking process
    3.   Health Care
    4.   Poverty and Welfare
    5.   Immigration
    6.   Crime in the Twenty- first Century
    7.   Environmental Policy

                                   LEARNING OBJECTIVES
After students have read and studied this chapter, they should be able to:
 Describe the policy-making process:
    o Agenda building.
    o Policy formulation.
    o Policy adoption.
    o Policy implementation.
    o Policy evaluation.
 Discuss the rising cost of heath care and provide several reasons for this trend.
 Define Medicare and Medicaid.
 Identify some of the characteristics of the uninsured and the problems they face.
 Explain how national health insurance works and provide some international examples.
 Define the Health Savings Account plan.
 Explain how the government determines who is in a state of poverty.
 Briefly describe major government programs to reduce poverty, including TANF,
    Supplemental Security Income, food stamps, and the earned income tax credit (EITC).
 Describe the Welfare Reform Act.
 Describe trends in crime rates over the last few decades, including changes in the rate of
    violent crime, theft, and murder.
 Give one or more reasons crime has decreased in the last ten years
 Define the incarceration rate and explain the demographic categories of prisoners.
 Compare U.S. incarceration rates with those of other nations.
 Understand the origins of the modern environmental movement.
 Explain the major provisions of the Clean Air Act of 1990, the Clean Water Act of 1972,
    Superfund, and the Endangered Species Act.
 Explain what global warming is, basic provisions of the Kyoto treaty, and the nature of the
    political dispute over global warming.

                                  TOPICS FOR DISCUSSION
Presuming that national health insurance is off the table in the United States, what else could be
    done to protect the uninsured population from catastrophic medical costs?
What steps can the government take to control health care costs? Is controlling costs even a good
   idea? What negative consequences could follow from attempts to control costs?
The Welfare Reform Act poses a controversial solution to a difficult problem. What are the major
   components of the act? With which facets of the act do critics most disagree? Does giving
   more control of welfare to the states benefit the taxpayers? The recipients? Why or why not?
   What are the advantages and disadvantages of devolution in welfare?
How important is income in children’s achievement? What things can money buy that help
   children achieve? What things can it not?
What are the factors contributing to increases in homelessness?
Are there underlying social changes that may have helped reduce crime rates in recent years?
Why is the problem of juvenile crime so disconcerting? What have states done to attempt to
   address this problem?
Why are environmental problems often difficult to legislate away? What improvements have been
   made in air and water quality in recent years? What problems still need solutions?
Do your students believe that global warming is actually a problem that we should address?

                                     BEYOND THE BOOK
Americans have spent many billions of dollars on health care over the last half-century. What
   kind of return have they received for that spending? One way to answer the question is to
   observe that since 1950, the life expectancy of the average American has increased about one
   year with the passage of each span of six years. Much of that increase in life expectancy is
   doubtless due to health-care spending. In today’s dollars, since 1950 the average American
   spent $11,400 on health care in every span of six years. Therefore, we could say that on
   average, Americans spent $11,400 to buy one year of additional life. If someone asked you
   how much your life is worth in dollar terms, you probably would be hard-pressed to provide a
   figure. You might reject the question entirely. Insurance companies and government
   agencies, however, routinely need to estimate the economic value of a person’s life. A typical
   estimate by economists would be about $75,000 a year. This is about six times what it cost to
   buy those additional years of life. By these calculations, health-care spending appears to be a
   bargain. That does not mean, however, that we are spending too little on health care. To ask if
   we are spending too little, the correct question is as follows: If we spend one additional dollar
   on health care, will we get one additional dollar’s worth of benefit? This is a hard question to
We stated in this chapter that Americans spend more on health care than the people of almost any
   other country. It is not an accident that the United States is also the only truly rich country
   that does not have a national health insurance system. Insurance provision by the government
   tends to hold down total costs for several reasons. One is that the government is in an
   excellent bargaining position to demand lower prices from medical care providers and from
   pharmaceutical companies. But is such bargaining a good idea? The pharmaceutical industry,
   for example, makes much more in profit selling drugs in America than in Germany, where the
   government has negotiated lower prices. One effect of the high profits that the industry earns
   in the United States is that it is able to fund a vast research effort aimed at finding new drugs.
   Some experts believe that the industry would be unable to mount such an effort if Americans
   paid German prices for drugs. (Such thoughts may have been on the minds of the
   Republicans who barred the government from negotiating lower drug prices as part of the
   Medicare drug benefit.) American spending, in other words, may be providing the rest of the
   world with a “free ride” in terms of pharmaceutical research. What applies to pharmaceuticals
   may also apply to other branches of medicine. It is possible that America’s lavish medical
   spending is one of the main engines driving worldw ide progress in medical science.
When most health-care spending is government spending, then anyone who wants lower taxes has
   an incentive to oppose spending on health care. That may be another reason that health-care
   spending in countries with national health insurance is lower than it is in the United States.
   Indeed, it is common to hear political leaders claim that health-care spending is too high.
   These leaders would never make such a statement about spending on automobiles, but then,
   the government does not buy cars for its citizens.
Health-care spending, however, is different from some other kinds of spending. You can only eat
   so much food—and spending on food, as a proportion of total spending, has been falling in
   the United States for many years. Most items of consumption bring less benefit the more they
   are consumed. If you do not own an automobile, buying one is important. But how much
   additional benefit do you truly derive from owning a Mercedes Benz instead of a Toyota
   Camry? If you are truly rich, will you gain much from owning two, three, or ten Mercedes?
   In contrast, there is no upper limit to the number of years that most people would wish to live.
Nor is the biblical lifespan of “three score years and ten” the limit that most people take it to be.
   We are accustomed to fictional depictions of future heroes traversing the galaxy at speeds
   faster than that of light. This is, in point of fact, impossible. On our current understanding of
   science, there is no way we will ever be able to travel faster than the speed of light. No such
   barrier exists to prevent us from someday determining the causes of the “aging syndrome”
   and inventing methods to combat it. We simply do not know how to do this yet.

                                      CHAPTER OUTLINE
I.   The Policy-Making Process
       The first step in the policy-making process is identifying a problem. Numerous problems
       exist, but their solutions are impossible until they are identified by policymakers. Typically
       this occurs through public debate. Policymakers also rely on their constituents, interest
       groups, and the media to bring policy problems to their attention. The identification of a
       problem, the reaction to the problem and the solution all form the policy process. There are
       five key steps in this process.
       A. Agenda Building. This is the effort of identifying a problem and getting it on the
            agenda. This may come about through crisis, or through the lobbying efforts of interest
            groups or others concerned about the problem.
     B. Policy Formulation. This consists of the debate that occurs among government officials
          and the public in the media, in Congress, and through campaigns.
     C. Policy Adoption. This is the selection of a strategy for addressing the problem from
          among the solutions discussed.
     D. Policy Implementation. This is the administration of the policy adopted by bureaucrats,
          the courts and others.
     E. Policy Evaluation. Groups evaluate the policy to determine if it has had the desired
          impact. The feedback also evaluates unintended consequences of the policy adoption.
          The feedback is considered part of the agenda building and formulation process, so that
          policy can be “fixed” if needed.
II. Health Care
          Healthcare spending has gone up from 6 percent of our income in 1965 to 15 percent
          today. Compared to other advanced industrial countries, our spending as a percentage
          of GDP is quite high, double the rate of some countries.
     A. The Rising Cost of Health Care. One cause of the rising cost is that the population is
          growing older, and older people need more care.
          1. Advanced Technology. While useful, advanced diagnostic machinery is very
          2. The Government’s Role in Financing Health Care. The government funds about 45
               percent of health care spending, private insurance provides about 35 percent, and
               the rest is picked up by individuals or charity. Key terms: Medicare, Medicaid,
     B. Medicare. Medicare is a federal health-insurance program that covers U.S. residents
          over the age of sixty-five. The costs are met by a tax on wages and salaries. When
          created in 1965, Medicare did not cover medicine. Beginning in 2006, the Medicare
          program began paying part of the cost of medicines. Medicare is the second most
          expensive federal program after Social Security. To contain costs, the government has
          placed caps on payments for procedures, with mixed results. Some health care
          providers now will not serve Medicare clients.
     C. Medicaid. Medicaid is a joint state/federal program that provides medical care to the
          poor, including indigent elderly persons in nursing homes. The program is funded out
          of general government revenues.
          1. Why Has Medicaid Spending Exploded? One reason is that the income ceiling for
              Medicaid eligibility has increased, making it a more attractive option for low-
              income workers than the health insurance offered by their employers.
          2. Medicaid and the States. While the federal government pays almost sixty percent
              of Medicaid’s costs, the portion paid by the states has increased rapidly.
     D. The Uninsured. 15 percent of the population lacks health insurance. 35 percent of
          working Hispanic Americans lack coverage.
          1. The Uninsured Employed. Smaller businesses often find it hard to supply health
               insurance to their employees, as it costs $9,000 or more per employee. Many of the
                working uninsured are young and healthy. A health catastrophe for such a person,
                however, could force them into bankruptcy.
            2. Shifting Costs to the Uninsured. A special problem is that many health care
                providers charge the uninsured steeply higher rates for services than the insured,
                because insurance companies and the government have the power to negotiate
                lower prices for their clients.
       E. One Alternative: National Health Insurance. The United States is the only advanced
            industrial country that does not have a system of universal health insurance run by the
            government. Such systems have lower administrative expenses than the U.S. system,
            but may have trouble controlling spending on unnecessary procedures.
       F. An Alternative: A Health Savings Account. This plan has been passed by Congress
            under George W. Bush. It allows people to create tax-free savings accounts for health-
            care expenses, providing the participant also buys a high-deductible insurance policy.
III. Poverty and Welfare
       Key concept: income transfers, transfers of income from some individuals in the economy
       to other individuals. This is generally done by way of the government.
       A. The Low-Income Population. To define poverty, the government devised a system
            beginning in 1963 that defined poverty based on family income in comparison to the
            cost of a nutritious food plan. All families whose income level was not at least three
            times larger than the food plan were classified as below the poverty line. Since 1969
            the government has revised the formula based on changes in the consumer price index
            (CPI). In an attempt to assist these families, the government made transfer payments to
            them in the form of programs like food stamps and housing vouchers.
       B. The Antipoverty Budget. In an effort to resolve some of the most pressing problems of
            poverty, the federal government has established a variety of programs. The 2007
            budget allocated about one-sixth of all federal expenditures to programs that support
            persons of limited income. Of this amount, almost half was for Medicaid.
      C. Basic Welfare. Aid to Families with Dependent Children (AFDC) provided aid to
           children in poverty. This program was administered by state governments but was
           financed by the federal government. This program was eliminated by the Welfare
           Reform Act of 1996 and replaced with Temporary Assistance to Needy Families
           (TANF). TANF is a state-administered block grant program. The states, not the
           national government, now bear the burden of any increased welfare spending. The
           Welfare Reform Act of 1996 had several key components. A key provision provided
           for devolution of the welfare system. Most welfare recipients are now limited to two
           years of assistance at one time, with a lifetime limit of five years. The act sought to
           reduce the number of people receiving benefits and in fact the number has been cut
           about in half.
       D. Welfare Controversies. Basic welfare is often criticized on several grounds. Some
            believe it reduces the incentive to find work. Others say it is anti-marriage because it
          makes it easier for unmarried mothers to get by. Finally, some may dislike the fact that
          so many recipients are members of minority groups.
      E. Other Forms of Government Assistance.
          Supplemental Security Income (SSI) was established as part of Social Security in 1974
          to provide a minimum income for the aged, the blind, and the disabled. Food Stamps
          are designed to help provide adequate nutrition for low-income families. The program
          began as a twofold mission to help farmers to sell surplus products and to eliminate
          malnutrition. The Earned Income Tax Credit (EITC) helps lower-income workers by
          providing a rebate on Social Security taxes.
      F. Homelessness—Still a Problem. The problem of homelessness continues to be an
          important one, and many advocates for the homeless argue that the Welfare Reform
          Act has exacerbated the problem. Estimates are that on any given night there are
          anywhere from 230,000 to 750,000 people who are homeless. The fastest growing sub-
          group of the homeless is families. The debate surrounding the policy issue of
          homelessness is couched in ideological terms, as are the solutions to this problem.
IV. Immigration
      Immigration has shaped American society from the very beginning.
      A. The Continued Influx of Immigrants. Immigration rates are now higher since their peak
         in the early twentieth century.
         1. Minority Groups’ Importance on the Rise. About a million people a year
              immigrate to this country. Four out of five immigrants come from Latin America or
              Asia. Later in the twenty-first century immigration could help lead to the United
              States becoming a majority-minority country.
         2. The Advantages of High Rates of Immigration. Immigrants expand the workforce
              and help to support, through their taxes, government programs such as Medicare
              and Social Security.
      B. Attempts at Immigration Reform. In 2006 the controversy over illegal immigration
          reached a boiling point as some argued that jobs were being lost, wages were being
          depressed and services were being stretched to the breaking point. In response
          hundreds of thousands took to the streets protesting in favor of immigrants and their
          rights. Congress split over the issue, with some members favoring amnesty for illegal
          immigrants, some favoring a plan for the gradual awarding of citizenship and others
          favoring sending illegal immigrants back to their home countries. Ultimately no
          substantial action was taken and Congress moved toward the midterm elections with
          promises to study the problem.
V. Crime in the Twenty-First Century
      A. Crime in American History. Crime has always been considered a problem in American
          society. After rising for many years, violent crime rates have come down over the last
          ten years. The reasons for this are not clear. One explanation might be the large
          number of perpetrators who have been sent to prison, putting them out of commission.
     Increased spending on law enforcement has also been suggested as a reason. One study
     even claimed that legalized abortion has had a major effect by reducing the population
     likely to commit crimes.
B.   Crimes Committed by Juveniles. These crimes have been a special concern, though
     juvenile crime rates are dropping as well. Curfews and “boot camps” are two solutions
     that have been advanced. Increasingly, young offenders are being tried as adults,
     especially for violent offenses.
C.   The Cost of Crime to American Society. One calculation put the cost of all crime in
     America—violent and nonviolent—at a trillion dollars. Perhaps half of that sum is a
     valuation placed on pain, suffering, and reduced quality of life.
D.   The Prison Population Bomb. Stiff sentences are now national policy. By 2007, the
     number of persons held in jail or prison exceeded 2.2 million. In 1990, the figure was
     only 1.1 million.
     1. The Incarceration Rate. Key term: incarceration rate, the number of persons held
          in jail or prison for every 100,000 persons in a particular population group. Today,
          the rate for U.S. men is 1,309 and for U.S. women, 113. Among the most-
          frequently incarcerated demographic group, non-Hispanic black men aged 25 to
          29, the rate is a stratospheric 11,955. At any given time, almost 13 percent of this
          group is in jail or prison.
     2. International Comparisons. At 701/100,000, the United States has the highest
          reported incarceration rate of any nation on earth. Only Russia (584) comes close.
          (North Korea’s rate is almost certainly higher than ours but that reclusive
          dictatorship does not release statistics.) Rates for comparable nations include 140
          for Britain and 118 for Canada. The figure for Japan is 54. In many cases (certainly
          Britain) these figures reflect different sentencing policies, not fewer convictions.
     3. Prison Construction. It follows that prison construction is a booming business. In
          1923, there were only 63 prisons in the entire country. Since 1980, Texas alone has
          built 120 new prisons, Florida 84, and California 83.
     4. Effects of Incarceration. A majority of all persons arrested each year are arrested
          for drug offenses. From twenty to forty million people may violate the drug laws
          each year, so the supply of potential prisoners seems virtually limitless.
E.   Federal Drug Policy. One of the major causes of crime in the U.S. is the use and sale of
     illegal drugs. Illegal drug sales can result in violence because of turf wars between
     rival drug gangs, because dealers operate outside the justice system and therefore resort
     to violence to settle disputes, and because drug users may resort to crime to finance
     their drugs. Money spent on federal drug interdiction programs has not met with much
     success, as illegal drug consumption in the U.S. has remained steady. State and local
     governments, however, have been attempting new remedies to curtail the drug
     problem. One strategy includes sentencing drug offenders to rehabilitation, rather than
      F. Confronting Terrorism. Probably the most devastating type of crime is terrorism
          because of its potential to inflict violence on thousands of victims. After the attacks of
          September 11, 2001, the federal government enacted many policies in an effort to
          combat terrorism. Some policies enjoyed widespread public support; others did not.
          What seems clear, however, is that counter-terrorism strategies will necessarily be a
          part of federal government policy for years to come.
VI. Environmental Policy
      Concern about pollution has made environmental policy an important part of domestic
      A. Environmentalism. Early in the twentieth century, environmentalism was focused on
          wilderness land use issues. Conservation was a policy under which natural resources
          should be used, but not abused. In contrast, preservation called for natural preserves
          that are isolated from the effects of human activity.
          1. The Environmentalist Movement. Beginning in the 1960s, a new movement arose
               that was more focused on pollution. A series of well-publicized pollution
               catastrophes helped bring attention to the problem.
          2. Ecology. In the 1970s, some environmentalists began to advocate policies that were
               a radical elaboration of the old preservationist philosophy. Many even claimed that
               the human race itself was the problem. This line of argument was controversial, to
               say the least.
      B. Cleaning Up the Air and Water. The public had a growing awareness of environmental
          problems throughout the 1970s and 1980s. Major environmental problems like oil
          spills and toxic waste sites led the government to formulate long-term policy aimed at
          protecting the environment without causing major damage to the economy. The
          following polices reflect the government’s recognition of the need to protect the
          1. The National Environmental Policy Act. This was enacted in 1969 in an attempt to
               set national standards for assessing the impact that major federal projects
               (construction of roads, buildings, etc.) would have on the environment. Such
               projects could not be started without first receiving an environmental impact
               statement (EIS).
          2. Curbing Air Pollution. The 1990 amendments to the Clean Air Act of 1963
               constitute a comprehensive policy mandating cleaner air in urban areas. Utility
               plant emission levels are monitored and the plants must significantly reduce the
               amount of carbon monoxide emissions. Automobile manufacturers must reduce
               emissions of nitrogen oxide progressively until 2007.
          3. Water Pollution. The Clean Water Act of 1972 amended the Federal Water
               Pollution Control Act of 1948. The Clean Water Act sought to make waters safe
               for swimming, to protect fish and wildlife, and to eliminate the discharge of
               pollutants into the water. The Clean Water Act has proven controversial, however,
             because of its broad definition of “wetlands” (which are subject to prohibitions on
             filling and dredging) and because of the “migratory bird rule” (which ruled any
             waters suitable for use by migratory birds was subject to regulation as wetlands).
     C. Cost-Effective Solutions. Critics of our environmental policy contend that these
         restrictions cost jobs and negatively affect the economy. Without doubt, there are
         substantial costs involved in the new policies. But there are also substantial costs
         involved in not attempting to resolve the environmental problems.
         1. The Costs of Clean Air. One method of supporting cost-effective solutions was part
             of the Clean Air Act of 1990. The act capped overall national sulfur dioxide
             emissions but also permitted free trade in “rights” to emit sulfur dioxide. As a
             result, the sulfur dioxide emissions are made by the companies that reap the
             greatest economic advantage from their right to emit.
         2. There Have Been Improvements. As a result of legislation, air and water pollution
             is down dramatically from what it was three or so decades ago. Lead content in the
             air is three percent of what it was. Sulfur dioxide is down by four-fifths.
     D. The Endangered Species Act (ESA). Passed in 1973, ESA made it illegal to kill, harm,
         or otherwise “take” a species listed as endangered or threatened. The government could
         prevent landowners from engaging in development that would harm a listed species.
         Restrictions on development and on property rights in general have made ESA
     E. Global Warming. In the 1990s, climate scientists determined that CO 2 emissions were
         causing the earth to warm up due to a “greenhouse effect.” The results are most
         noticeable in the Arctic and Antarctic.
         1. The Kyoto Protocol. In 1997, a meeting in Kyoto, Japan, drew up a treaty to limit
             CO2 emissions. The treaty did not place restrictions on developing nations. As a
             result, the U.S. Senate opposed the treaty in a resolution and President Bush
             refused to submit it. Even in those European nations that most enthusiastically
             supported the Kyoto protocol, the results have not been overly positive.
         2. The Global Warming Debate. Considerable disagreement exists as to how much
             warming can be anticipated during the coming century, and presuming the
             warming effect exists, what is to be done about it. Global warming has “become a
             major political football to be kicked back and forth by conservatives and liberals.”
VII. Features
     A. What If . . . We Had Universal Health Care?
         Although there is a great appeal to the idea, universal health care would likely impose
         extraordinary costs on employers, would result in people choosing to go without health
         insurance and would increase the burden on existing hospitals and clinics.
     B. Beyond Our Borders: The Canadian Health Care Program.
         Canada is frequently cited as the shining light of governmental health care systems, but
         a closer look reveals a number of problems. Long waits to receive care are routine and
   the quality of care is rarely rated as excellent. In fact, many Canadians seek private
   health care providers on Indian reservations or by flying to other countries for
C. Which Side Are You On? Can a “Housing First” Policy Alleviate Our Homeless
   While many programs designed to help the homeless are conditioned on the
   willingness of the homeless to accept counseling or treatment, some cities are
   discovering that there is a population of hard-core homeless, single male drug and
   alcohol abusers that do not want any sort of treatment or counseling. These cities have
   determined that it is more cost-effective to simply provide this group of hard-core
   homeless with a place to stay at night without trying to change their circumstances.
   One of the main drawbacks of this program is the diversion of funds away from the
   population of homeless that includes families.
                      Guided Reading: Domestic Policy

1. Define Domestic policy:

2. List some ways in which issues are identified as domestic problems:

3. Agenda building:

4. On which issue did George W. Bush attempt to "steal the clothes of the other
   party" and demonstrate that his administration could endorse moderate policy

5. When Medicare reform was considered in Congress the _____________
proposed that not all drug expenses be covered, establishing certain amounts
that would have to be paid for by the people.

6. The part of the policy making process that involves choosing a specific policy
from among the proposals that have been discussed is known as

7. What happened in 2003 that may have guaranteed the success of Medicare

8. Policy implementation:

9. After the Medicare reform law went into effect the federal government refused to
reimburse ____________that were covering the costs of prescription drugs for
Medicare beneficiaries who were confused by the new program.

10. Since 1965, spending on health care in the United States as a percentage of
national income has ______________.

11.   Health care in the United States is about ________ percent of the economy.

12.   Describe/Characterize the Medicaid system:

13.   Describe/Characterize the Medicare system:

14.    _______ is a joint federal-state program designed to subsidize health care
costs for the poor.

15. On average the federal government pays almost _______ percent of
Medicaid's costs and the states pay the rest, although the portion paid by the
states is on the increase.
16. Those people who are least likely to have health insurance are

17. List the countries mention in the textbook in which the the national
government DOES NOT provide basic health insurance to all citizens.

18. Typically, under a single-payer plan the ___________________ has a
monopoly on issuing basic health insurance.

19. Under the recently established ___________________program individuals
can set up a tax-free savings account for medical care if they also buy a high-
deductible insurance policy.

20.   Income transfers:

21. The absolute number of people in poverty declined in the 1960s under
presidents ____________ and _____________ and then remained low through the

22. Currently, adjustments to the poverty income threshold are based on

23. ________________ if counted, would reduce the number of poor

24.   The poverty level in the United States is ________ as high as the world's
per capita income level.

25. By far the largest portion of the federal budget that goes to aid limited-
income persons and families is spent on ____________________.

26. The program that most people think of when they hear the word welfare is
now called _____________________________________________.

27. The ________________ Act of 1996 has largely met the objectives it was
intended to accomplish.

28. The basic welfare program provides payments that average nationwide
_________ per month per family.

29. The federal program that provides assistance to elderly and disabled
persons is called __________________________________________.

a. The ___________________ program was created in 1975 as a way to provide
rebates of Social Security taxes to low-income workers.

30.   What are the reasons for homelessness (according to your text)?

31.   The fastest-growing subgroup of the homeless population is composed of
32.   Examples of attempts to "criminalize" homelessness include:

33. Currently, four out of five immigrants to the United States come from
________________ and______ ______.

34.   When Congress addressed the issue of ________________ in 2006, it
prompted over one million demonstrators to take to the streets across America in
support of the rights of immigrants.

What are the explanations for the decline in crime rates in recent years?

35.    During which period did the crime rate rise twice as fast as the population?

36. Political responses to the rise in serious juvenile crimes do not include
many states lowering the death penalty age to _________.

37. Rates of ___________crime in the United States were roughly stable from
1973 to 1995, and thereafter gradually dropped until they were half what they had

38. Homicide rates in the United States were at their peak in the period

39. _________ rates in the United States have declined substantially during the
last two decades.

40. The number of incarcerated persons in the United States has almost
______________ over the last fifteen years.

41. The population group with the highest incarceration rate is _______________
aged 25–29.

42. The nation with the highest reported incarceration rate of any country in the
world is ______________________________.

43.   What reasons are given for connecting Illegal drugs to crime?

44.     In the summer of 2006 the government of _________ foiled a plot to take
bomb materials onto a number of airplanes and implement the most substantial
terrorist attack since 9/11.

45. What are the reasons Americans became more aware of environmental
problems in the 1960s?

46.   The National Environmental Policy Act of 1969:

47.   The 1990 Clean Air Act:

48.   The Clean Water Act of 1972:
49. In 2001, the Supreme Court ruled (against/in favor of) the "migratory bird

50. Discuss some of the issues facing federal agencies regarding the
Environmental Policy.

51. The Endangered Species Act:

52.   Global warming:

53. The ______________ protocol called for a reduction in the emission of
greenhouse gases to 5.2 percent below 1990 levels by 2012.

54.      Approximately _____ Americans do not have health insurance.

55. San Francisco's _______________________ is financed by local government,
______________contributions from employers and income -adjusted premiums
from users.

56. If a _______________ health care plan is implemented, it is likely that the
demand for health care will increase.

57.    The Canadian health care system:

58.    Housing-first programs focus on _________________ substance abusers
and leave less funding available for homeless families.

59.   Examine the consequences of the establishment of a system of universal health

ANS: Students' answers may vary.
REF: What If We Had Universal Health Care?

60.    Explain the stages of the policymaking process.

ANS: Students' answers may vary.

61.    Examine the rising costs of health care and the governmental efforts to address
this matter.

ANS: Students' answer may vary.

62.   What are the advantages and disadvantages of the Canadian health care

ANS: Students' answers may vary.
REF: Beyond Our Borders—The Canadian Health Care System

63.    Examine the government programs designed to fight poverty.

ANS: Students' answers may vary.

64.    To what extent does government have an obligation to assist the poor among

ANS: Students' answers may vary.

65.   Assess the advantages and disadvantages of a nation having a substantial
immigrant population.

ANS: Students' answers may vary.

66.    Explain why immigration reform was not realized in 2006.

ANS: Students' answers may vary.
67.    Is the quest to address crime simply a matter of government getting "tougher on

ANS: Students' answers may vary.

68.    Analyze the governments' attempts to protect the environment since the 1960s.

ANS: Students' answers may vary.
69.   Do the benefits gained from governmental initiatives to protect the air, water and
endangered species outweigh the costs?

ANS: Students' answers may vary.

70.    Should the United States ratify and follow the Kyoto protocol?

ANS: Students' answers may vary.

Description: Insurance Companies Have Been Getting a Free Ride from the Public document sample