2018/03/01 by Jonathan Bell · 1 citation
Social Sciences · #Social Policy and Reform Studies
paper · doi:10.1093/jahist/jax430
This article considers together questions of political economy and sexual politics to establish how welfare bureaucrats, health care advocacy groups, and queer activists understood and debated health care policy at both the federal and state levels between the late 1970s and late 1980s.Much attention has been paid to political struggles for treatment of HIV and AIDS during the 1980s, but this article focuses on efforts of people with AIDS (PWAs) to access the labyrinthine and, up to that point, resolutely heteronormative welfare system.I argue that efforts of AIDS activists to access public health benefits through the welfare state highlighted the inadequacies of a system predicated upon the centrality of disability as a marker of eligibility for health benefits.As more and more of those suffering from medical conditions related to what we now know as HIV lost private health insurance, they were forced to seek classification by state social welfare agencies as medically disabled in order to access public funds.However, the state welfare apparatus did not work on the principle of medical need, but rather adopted the Center for Disease Control's categorization of disability via disease categories that rendered those with more powerful advocacy voices more likely to gain the imprimatur of state approval.As the AIDS crisis developed and affected a diverse range of people by the end of the decade, it became clear that the Social Security Administration was unwilling to broaden access to the welfare system to cope with a diversifying epidemic, one that exemplified a wider reality of poverty and exclusion rather than a limited crisis affecting small numbers of primarily white males.I examine the dynamics of welfare politics via both grass roots activist efforts and bureaucratic Rethinking the "Straight State": Welfare Politics, Health Care, and Public Policy in the Shadow of AIDSIn 1975, the Society of Individual Rights, a San Francisco gay rights organization that had been a leading part of the campaign for equal rights since the mid-Sixties, published a "survival manual" under the auspices of its magazine, Vector.Announcing the city as "the Mecca of nearly every form of lifestyle you would ever want to encounter," the manual provided information for the newly-arrived gay resident on "housing, food, clothing, legal, medical and dental referrals.We even tell you how to get on General Assistance."Readers could view information on helplines, social services, and gay-friendly businesses.A whole section on "medical aid" detailed hospitals, health centers, and clinics, including St Mary'sHospital Clinic whose "fees on sliding scale, will help you get on Medi-Cal," and the City VD Clinic, described as a walk-in facility with "no age or residency requirements."A section on "welfare" detailed how General Assistance and Supplementary Security Income for the disabled (SSI) worked and gave information on how to apply for food stamps. 1It was no coincidence that a manual devoted to showcasing the opportunities furnished by gay liberation would also advertise routes into the nation's ramshackle welfare system.The emergence of gay men and women from the closet in these years was about more than sexual "liberation," an ongoing process of community formation to free queer Americans from the shackles of heteronormativity.Those who came out had health care needs, whether they be access to sexual health clinics, women's clinics, or private health coverage protected in an increasing number of jurisdictions by anti-discrimination laws.When a Philadelphia doctor wrote in the mid-1970s that the "gay health movement is coming out of the closet," he was referring to national gay health advocacy as an addition to the plethora of interests in the wake of the rights revolution pushing for greater access to health 93 Kaldjian to King, 14 February 1992, David Rogers Papers, Box 21, AIDS Advisory Council file.