Chapter 10: Caring for The Poor in Jefferson County, Alabama: A Model of Change in Government-Run Healthcare

Meeting the healthcare needs of citizens is increasingly a challenge for all levels of government, federal, state, and local and nowhere is this challenge greater than when it comes to providing healthcare to the indigent poor. The cost of healthcare in the United States continues to increase, placing added stress on already strained public-sector budgets. As a result, governments are pursuing models of healthcare delivery that maximize access to their underserved populations in as cost-effective and efficient ways as possible.

Modeling healthcare for the poor requires an understanding of both the economic and sociological aspects of healthcare delivery to this unique population. While the passage of the Patient Protection and Affordable Healthcare Act in 2010 represented perhaps the most significant regulatory overhaul of the U.S. healthcare system since Lyndon B. Johnson signed Medicare and Medicaid into law in 1965, it is important to note that lack of access to healthcare is multidimensional, particularly for low-income populations. Health insurance coverage alone does not guarantee access to healthcare.