I am expected to be on WHYY radio tonight to discuss today’s NJ Spotlight story, by yours truly, on the issues facing undocumented immigrant children in New Jersey. We’ll be taping this afternoon. Wish me luck — I’m surprisingly nervous.
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Daniel Froomkin asks one of the right questions in the wake of yesterday’s ruling in the Hobby Lobby case: “Why should employers have anything to do with people’s health insurance anyway?”
I alluded to this argument on Facebook yesterday, but Emily Divito does a more thorough job than I did. Her argument: that the Hobby Lobby challenge and decision were, to some degree, set in motion by the passage of the Affordable Care Act’s short comings. The ACA, she says, “is fatally flawed” and it “is clear we now need a public, single-payer health care system.”
The Hobby Lobby case, she writes, “exposes the primary and unavoidable weakness of the ACA.”
Because it still requires that private companies enforce what should be considered public policy – health care – the ACA will always face potential legal contention with the personally held religious beliefs of employers.
And what kind of health “insurance” have Americans gotten under this strange arrangement? Once again, uniquely in the industrialized world, it has been ephemeral coverage that is lost with the job or changed at the employer’s whim. Citizens in any other industrialized country have permanent, portable insurance not tied to a particular job in a particular country.
Nor has this coverage been cheap by international standards. American employers can be said to have played a major role in driving up health spending per capita in the United States measured in internationally comparable purchasing power parity dollars, to roughly twice the level found in other industrialized populations. As a recent article in the health policy journal Health Affairs reported, a decade of health care cost growth wiped out real income gains for the average American family during the period from 1999 to 2009.
The ACA offers some improvement over what had existed — though its full impact is still difficult to gauge. But it still leaves most of what is wrong with the American health care system in place. In the end, that is the real problem with the contraception mandate and much of the rest of the ACA.
While this issue has been framed as a fight between women’s rights and religious freedoms — which it is, at least to a degree — and the outrage over the court’s decision is real and warranted, we should use the decision to put single-payer back on the table. If we don’t want our employers making these decisions, then we should cut them out of the process.
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This is a fascinating story on a study in Mexico that offers some evidence that distributing cash, rather than vouchers or food, does a better job of assisting the poor.
As the story makes clear, this is just one story and one study and drawing broad conclusions doesn’t make a lot of sense. But what the study does is “it adds to a growing pool of evidence that cash transfers actually aren’t ‘wasted’ on frivolous things and do improve poor peoples’ lives in observable ways.”
Studies like these are important, therefore, because they have the potential to move us away from a system of welfare (I use the term to describe the broad set of programs that include general assistance, food aid, housing, etc) constructed on a punitive, behavioral model toward one in which we acknowledge that assistance is needed and that it is in the best interests of both those being helped and the larger society to help without strings.
Let people who are receiving the aid make their own decisions about what to do with it. Let them set their own priorities.
Will they all make smart decisions all of the time? No. None of us do, and it does not stop us from receiving various forms of government aid, whether in the form of mortgage deductions and various tax right offs or direct outlays. No one checks to see that we have used the money in a “morally acceptable” manner. We just take the money and do what we want with it. Why should the poor be treated any differently?
Yes, some are going to buy drugs or drink, but many — maybe most — will use the money to keep their heads above water, making choices based upon what is required of them at the moment.
That’s how the rest of us live. We take our paychecks and the other money that comes in, and we balance the various interests in our lives. When money is tight, we might opt to cut back on food to make sure the rent is paid, or to keep the lights on. Or we might buy a six pack and watch baseball or buy porn or go out carousing.
The poor, however, are not afforded that leeway simply because they are poor. We have decided that they are morally or intellectually inferior, so we treat them as 10-year-olds, attaching strings to every bit of help we offer. It is worse in some states than others, though, even in relatively generous states, the application processes for receiving assistance is long and complicated and designed to intimidate. (Read both Jonathan Kozol and Michael Harrington on this.)
There is no evidence that our paternalistic approach to aid is more efficient or more effective than a more generous and open approach. But there are few efforts — and fewer studies of these efforts — being made to explore alternatives aside from finding new hoops for the poor to jump through as they attempt to get help.
It is part of a larger cultural/social mindset that assumes that the poor lack value, that their lack of resources somehow is evidence of a lack of humanity on their part, which then allows us to treat them like they were less than human. Isn’t it time this changed?
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This about sums up how the Supreme Court views the world:
Protest is fine when the rabble are the target, but not quite so fine when the men (and women) in robes are on the receiving end.
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This is a sad story — and far more typical than care to admit: Melvin Jenkins was a diesel mechanic who badly injured himself on the job, found himself in thrall to drugs and living on the streets. He died earlier this month at age 58 of a heart attack after seemingly cleaning himself up.
Some might look at Jenkins and blame him for his failings. They’ll say he could have cleaned himself up sooner, that he should have resisted the demon of drug and alcohol abuse, that he had a skill and he should have used it and remained productive. There is some truth to these claims. That Jenkins failed to stay clean and productive is mostly his fault, though he probably had an assist from a society that has little patience for those battling substance abuse and mental health issues.
Even if we accept that his failings were his own, doesn’t the fact that Jenkins is just one of hundreds of thousands of homeless men and women in this country say something about the way we view productivity and usefulness, about how little we regard people living on the edge of the economy?
Lakewood is forcibly closing Tent City this week, which is part of an agreement between the township and the homeless that resulted in a year of housing for those in the camp last year. It is doing so in an aggressive manner that treats those remaining as animals — rooting them out and chasing them away, caring little about what happens to the last of them.
And, perhaps more importantly, no one has addressed the issues that resulted in the tent encampment sprouting in the woods along Cedar Bridge Avenue in the first place — the lack of quality affordable housing or even emergency shelter in the region in a region known for having a high cost of living, a lack of jobs that pay a living wage to the unskilled or moderately skilled, and a broader economic attitude that assigns value only to those who can help businesses create profits.
As my friend Ken Wolman points out on Facebook: “I’m sure that not so long ago, he didn’t think he’d become the Man On The Grate either. Avoiding that fate doesn’t require strength of character, just good fortune and being able to avoid painful injuries.”
It also may require a reconsideration on our part of how we value our fellow human beings.
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Hank Kalet 