1. Lesson Starter List as many different aspects of life in a ghetto as you can. List the main features of a middle class suburb. You have 5 minutes to complete this task. Help each other!

2. Today we will… Identify groups who face health inequalities in the USA. Examine how the government attempts to solve these problems.

3. Success Criteria I will be able to explain the health inequalities that exist in the USA. I will be able to describe what Medicaid and Medicare are. I will be able to identify Obama’s planned reform.

4. Task Look at these two logos. What do you think each of them are? What do they represent? Clue: they are linked to health.

5. Health Insurance The USA does not have a National Health Service like Britain. In Britain the money for the NHS is taken directly from everyone’s wages each month. In the USA people have to take out private health insurance for themselves or their families

6. Why are there Inequalities? There were 49.9 million uninsured Americans in 2010 making up 16.3% of the total population. It is estimated that 26.9% of people earning less than $25,000 a year were uninsured. Many may be unemployed and therefore do not get cover from an employer. Not all employers provide insurance.

7. Task Using your ‘placemat’, –On your own, write down the consequences of not having health insurance. –Now in your groups, choose 3 and note these in your jotter. Answer: –Lack of routine care – health problems may not be detected before they become serious. –Reluctance to use medical services – not getting medical care until things become serious. –People with no insurance are more likely to die before seeking medical help than an insured person. –Less access to new technology which could save your life.

8. Task Social Target: Listening Academic Target: To understand the consequences of poverty. 1. 2. 3. 4. 5.

9. Think-Pair-Share Thinking about what you have learned in previous lessons: –Individually come up with as many reasons how inequality in other areas of life may make Black and Hispanic Americans more likely to face health inequalities? – 1 min –Now share with your shoulder partner – 1 min –Now share with the rest of your group – 1 min

10. Health Problems Facing Black and Hispanic Americans. Blacks and Hispanics are 3 times more likely to have no medical insurance cover. Black and Hispanic children are less likely to visit the doctor. 7.3 million children without insurance Black and Hispanics face greater health problems. There is also a very high infant mortality rate. Drug and gang related problems mean Blacks and Hispanics are more likely to die from guns and drugs. Obesity- 30% of Blacks and 25% of Hispanics are obese. Linked to drug abuse is the incidence of AIDS. This is on the increase.

11. Government Healthcare Schemes Medicaid Provides healthcare for low-income adults. Children receive health coverage through Medicaid and the state Children’s Health Insurance Program (CHIP). More than 58 million Americans rely on Medicaid services. These people could not afford adequate healthcare without Medicaid. Medicare provides health cover for: –people age 65 or older, –people under 65 with certain disabilities. In 2010, Medicare covered about 48 million Americans. One in five is a member of an ethnic minority group. Most people will have paid monthly contributions throughout their working lives to cover the scheme. 3 main parts: –Hospital insurance –Medical insurance (GP, Physio,etc.) –Prescription drug coverage.

12. The Affordable Care Act In 2010, President Obama and Congress signed the Affordable Care Act into law. Opponents nicknamed the act ‘Obamacare’. We will now watch a clip about the Affordable Care Act. You should answer the following questions as you watch: 1.Under the act, what four ways can people be covered? 2.What benefits might people see? 3.What happens if people don’t buy insurance? 4.Where does the money come from to fund the scheme?

13. Obamacare Major features of the new law include: –young adults will be covered by their family's insurance plan until they turn 26. –more help for people who can't afford insurance. –insurance companies cannot deny coverage to people with pre-existing conditions. People not covered by insurance by 2014 will need to get it or pay a fine. In 2014, uninsured people will face a fine of $95 or 1% of their income.

14. Opposition Those who opposed the bill challenged it in the Supreme Court claiming it was ‘unconstitutional’. In June 2012, the Supreme Court ruled that the Affordable Care Act was constitutional. In 2013, people who make more than $200,000 have to pay an additional 0.9 % tax for the Medicare Hospital Insurance. In 2014, businesses with more than 50 employees will have to insure their workers or pay a $2,000 fine per uninsured worker. Why might these people oppose the Affordable Care Act?