37. Medicine and healthcare.

In the final decades of the 20th century vastly increases medical knowledge; each new discovery or procedure brings with it new questions to be answered. One example is the treatment of heart disease. Today surgeons routinely perform heart surgery that would have been unthinkable a few years ago. Heart transplants are becoming more common. Cardiac pacemakers, or heart regulators, keep many people from dying of abnormalities in the heart rhythm. Surgery, drugs and radiation treatments keep cancer patients alive longer. Surgeons can replace damaged joints with artificial ones, and eye doctors use lasers and other advanced techniques to preserve or restore sight. Advances in microsurgery have even made it possible to reattach limbs which have been detached in accidents, and burn victims benefit from the development of new skin grafting techniques. Physicians, nurses and orderlies can no longer staff a hospital alone. Hospitals now require a bewildering number of technical specialists to administer new tests and operate advanced medical equipment. As a result, hospital costs and physicians' fees rose steadily. By 1986, the average cost of a stay in the hospital had climbed to more than $500 a day. Americans pay their medical bill with the help of medical insurance. About 5 out of 6 workers, along with their families, are covered by group health insurance plans, paid for jointly by the employer and employee or by the employee alone. Under the most common type of health plan, the individual pays a monthly premium, or fee. In return, the insurance company covers most major medical costs, except for a minimum amount, called the "deductible," which the employee pays each year before insurance coverage begins. Medicare is a federal program financed through the Social Security Administration, which provides a national system of retirement and other benefits. Medicare pays a substantial part of the medical bills of Americans who are over 65 years of age or are disabled. Health care challenges Although Americans, on the average, are healthier and live longer today than ever before, a number of challenges still confront the medical care system in the United States. While advanced technology can provide artificial hearts or transplanted kidneys to a few at high cost, others still suffer from diseases, such as tuberculosis. Another severe challenge to the health care system is AIDS. Since 1981, more than 83,000 Americans have died of AIDS. Scientists and pharmaceutical companies are working on vaccines to prevent this disease and medicines to treat it. As of 1991, several drugs had been developed to treat some of the symptoms of AIDS, but not to cure or prevent the disease. Welfare The poor receive help from the federal and state governments. The public welfare system in the United States is very large. In addition to federal programs, there are programs in each of the 50 states which are designed to help people in need. Among the many programs that help people living in poverty are: • Welfare payments—sums of money which are given by the government each month to those whose income is too low to provide necessities such as food, clothing and shelter. • Medicaid—free medical and hospital care. • Food stamps—books of special stamps which can be used to buy food at any store. • School breakfast and lunch programs providing free meals to schoolchildren. • Surplus food programs, under which food is purchased in huge quantities by the government and distributed free of charge to the poor. In addition, the poor can become eligible to live in public housing. Public housing developments are groups of apartment buildings built at government expense. There are a number of other ways in which the federal or state governments help people: Unemployment Insurance: Each state provides money to workers who lose their jobs through no fault of their own. Veteran's Benefits: Persons who have served in the armed forces can receive inexpensive or cost-free hospital care at special veteran's hospitals. Education: Public schools are located in all states, all cities also have free public library systems. Anyone can come to these libraries to read or borrow books, magazines or phonograph records. Job Training: Government programs help young people and adults from poor families or minority groups learn a skill that will get them a good job. But some believe that the welfare system does not reward individual initiative—it encourages people to stay unemployed and spend, rather than save, money.

38. The American Family. Clearly the American Family, like all families in the Western Industrial countries, is now profoundly different from what it had been in the recorded past. It is typically a household with few children, with both parents working and with mothers producing their children at ever older ages. At the same time more adults then ever before are living alone or with unmarried companions and more women are giving birth out of wedlock. The traditional family with a single breadwinner working alone to sustain the family is no longer the norm. Only one in 5 married couples had just a single male, working outside the home. Only 36% has the mother staying at home with children and not working. More and more women are reducing the number of children they have. Women are marrying later and begin child bearing at later ages. Today both marriage partners need to bring in income to meet family bills. Although women are less financially dependent on their husbands. They continue bear the major burden of household and child care. After the Industrial Revolution the Amer.Family has been stripped of two of its traditional social functions: serving as unit for economic production and as the school for the vocational training of children. Two functions remains: the physical and emotional gratification of the family’s adult members and the socialization of the children into community. There are some social policies that are needed to protect the AF. 1) Protection of young mothers and their children against poverty (payment locks mothers into a cycle of dependency; health care coverage is uncertain and variable; Medicaid covers half of the coast of health care at best). The second policy calls for a federal legislation mandate at least 3 month paid leave with guaranteed job protection for either the mother or father after the birth of an infant. In 1990 Bush voted an unpaid leave bill. Even were parental leave available not all mothers would use it. When there is a father and he prefers to be the one to stay home with the baby, that may be a welcome alter native. The third element is high quality infant and child day care. And the fourth element is education for parenthood. These policies will not bring about the Golden Age of the family. The most they can do is to cushion children against poverty and monitor the state of the children.

39. Mid.Atl.States.3 states: New Jersey, New York, Pennsylvania. The traditional M-A States comprise the most densely-populated of the 9 regions. From early colonial times, the M-A region was settled by a wider range of European peoples than in New Eng. or the South. Early settlers were farmers, traders, fishermen, and the region served as a strategic bridge b/n North and South. The MA states served as the "melting pot" of new immigrants from Europe. Pennsylvania (Harrisburg) has been known as the Keystone State, based in part upon its central location among the original 13 Colonies. It was also a keystone state economically, having both the industry common to the North and the agriculture common to the South. Philadelphia is the largest city and is home to a major seaport and shipyards on the Delaware River. P's diverse geography also produces a variety of climates. Straddling 2 major zones, the southeastern corner of the state posses the warmest cl. P became the 2d state to ratify the Constitution in 1787. P ranks 19th overall in agricultural production. New York (Albany) is the 3d most populous, 27th largest state. NY City is known for its history as a gateway for immigration and its status as a financial, cultural and manufacturing center. NY was inhabited by the Native Am groups in the early 17th c. About 1/3 of all of the battles of the Revolutionary War took place in NY. It became an independent state in 1776. NY borders 2 Great Lakes (Erie and Ontario). Contrasting with NYCity's urban atmosphere, the vast majority of the state is dominated by farms, forests, mountains, lakes. NY's Adirondack Park is the largest state park in the US. Niagara Falls is a popular attraction. Weather in NY is heavily influenced by 2 continental air masses: a warm, humid from the southwest and a cold, dry from the northwest. If NY were an independent nation, it would rank as the 16th largest economy in the world. New Jersey(Trenton)is inhabited by Native Am-s for more than 2,800 years, the 1 European settlements in the area were established by the Swedes and Dutch in the early 1600s. The State's name was taken from the largest of the Eng. Channel Islands, Jersey. The Eng. later seized control of the region. NJ was an imp. site during the Am Revolutionary War. Later, working-class cities such as Paterson and Trenton helped to drive the Ind. Rev. in the 19^th c. NJ can be broadly divided into 3 geographic regions: North J, Central J, South J. Most of NJ has a temperate cl except in south that has humid subtropical cl. The summers are very warm to hot and humid. The winters in NJ are usually cold. NJ's economy is centered around the pharmaceutical industry, chemical development, food processing, electric equipment, tourism. Shipping is a strong industry because of the state's strategic location. NJ is the birthplace of many modern inventions such as: FM radio, the motion picture camera, the light bulb, transistors, the electric train.