HEALTHCARE IN THE UNITED STATES

SPECIAL POPULATIONS

Although the treatments during hospitalization were considered six-times costlier than home care, Medicaid only paid for treatments within a hospital. President Reagan learned about the issue in 1981 and changed this rule so that Katie and other children in similar situations could return home for continued care rather than live in hospitals. Katie’s quality of life improved through the years with home care and Katie was eventually able to live in her own apartment, where she relied on night care from nurses and a ventilator for fifteen-hours a day. After a series of illnesses, Katie succumbed unexpectedly and died at the age of 34. Her legacy has helped to highlight the importance of keeping disabled children in the home rather than within institutions. (Shapiro, 2012)

7.6.2 Adults with Disabilities

According to the CDC (2019c), one in four adults have some type of disability. And, according to the Social Security Administration (2019), “the sobering fact for 20-year-olds is that more than 1-in-4 will become disabled before reaching retirement age” (para. 5). Adults with disabilities also include those who became disabled prior to age 22 (consider our two child disability examples of cerebral palsy and traumatic brain injury). Disabilities could include back injuries occurring from work; physical or cognitive injuries from an accident; hearing loss from high-noise work environments; or decreased function resulting from disease processes, such as multiple sclerosis, chronic fatigue syndrome, or diabetes. In addition, many mental health conditions, such as severe depression, schizophrenia, or bipolar disorder, could create disability. Depending on the disability, adults affected may be unable to work. The need for financial support is tremendous in these cases. According to the National Council on Disability (2017):

• People with disabilities live in poverty at more than twice the rate of

people without disabilities

• More than 65% of the 17.9 million working-age adults with disabilities

participate in at least one safety net or income support program

• Only 32% of working-age people with disabilities are employed

compared with 73% of those without disabilities

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