Are we a civilized country?

From my smart phone dictionary app:

Civilized

1) having advanced or humane culture, society, etc.

2) polite; well-bred; refined

3) of or pertaining to civilized people

4) easy to manage or control; well organized or ordered

This thought came to mind in conjunction with the events of the week while reading an article regarding Medicaid in Reason, which I probably would have never read except that it came to me via @pharmagossip. @pharmagossip is an excellent twitter follow and blog out of the UK, which follows the pharmaceutical industry. The article argues for block grants for health care for the poor, under the premise that Medicaid pays so poorly that it is very difficult for Medicaid patients to get care, so difficult that people without insurance are “better off”.  The article highlighted some physicians who do some pro bono care and insisted that states could do a better job on their own.

First of all the idea that if you have no insurance physicians, hospitals, are much more anxious to see you then if you have crappy insurance plan-well, no. “No insurance” does not get you in any door, especially if it is clear you have no money with you. It is true that the Medicaid program has a lot of problems but this is mainly due to underfunding. The idea that if you put it through a block grant it could magically do more, no, it can’t. “Block grant” is code for “do whatever you want”. So when “welfare” was put into a block grant--temporary assistance for needy families (TANF)--states could do whatever they wanted and in fact frequently to do use it for state items other then poverty. 

My thought was that in a civilized country, maybe block grants for Medicaid could work. A state that really wanted to give health care to all, regardless of financial means might sit down with health care people and try to figure out just how much money was needed and see how far that money could go. But, emphasizing the first definition of “civilized”, i.e. humane, we do not live in a civilized country.

Does a humane country venerate previous leaders-regardless of the level of harm they inflicted? 

Does a humane country imprison people who have been determined innocent of original charges-and give them NO hope they will ever be released? When said people engage in a hunger strike to take control of their lives does a humane country force-feed them?

Does a humane country allow citizens who film violations of the law be criminalized? 

Does a humane country allow needless cuts to social services but ensures that flights arrive on time? 

Does a humane country allow millions to go unemployed for years, to face discrimination for BEING unemployed, and then elected officials of said country demonstrate no interest in a hearing designed to help the situation? 

I could make a longer list, I know some people would argue that we never were a civilized country, but still I have found this week difficult to bear. On the other hand, here in Chicago hundreds of low wage workers went on strike this last week to call for a living wage of $15.00 an hour, and there continues to be constant push-back against the CPS school closings. There is always hope in the people, if not their rulers.

The Deserving and the Undeserving

There was a Planet Money/This American Life piece that ran this week regarding the federal disability program. It was interesting timing, coming just a few months after Nicholas Kristof’s articles on children and SSI. Kristof’s article basically suggested that the parents of children on disability encourage disability for the checks, and, not unrelated, have poor parenting skills. The TAL piece covered remarkably similar territory. I don’t question the works were independent of each other but I can’t believe the TAL people were unaware of the Kristof piece and therefore I thought it was odd they did not respond to any of the criticisms of Kristof's article. I read the piece online, having been alerted to it by multiple tweets, which is the same way I came across the Washington Post piece that ran last Sunday, about a town in Rhode Island where the entire town appears to survive on SNAP (food stamp) payments.

These pieces coming so close to each other had me wondering about what was the thinking behind them. The Post article was descriptive; there was little, if any, editorializing.  Sorry, if you felt anything but acute pity for a couple (both who work) who had to debate about whether to eat a cheese stick or not, because it was the end of the month and one of their kids might need it, you are awful. The TAL piece on the other hand, had a fairly clear message hey look at all these people not working. Do they deserve this check? No. It was framed in a friendly way, but the implications were clear.

 I’m not going to get into specific criticisms of the TAL piece, you can read that here.  Instead, I’d rather wonder aloud about the timing of these pieces. There is no question the economy is still struggling; the way the average person defines that is by their wages and their job security. By all reasonable measures wages are stagnant and unemployment is still high. When the economy is discussed in the mainstream press, the economy tends to get conflated with debt/deficit issues. Time and time again the VSP (Very Serious People) insist that things are bad, people are suffering and the way to fix that is to  . . . “fix the debt” (an actual advocacy group of CEOs to, fix the debt). The simple fact of the matter is that if immediate actions were taken to reduce debt and the deficit people would immediately be unemployed—somehow this part of the story is never fully articulated. Instead there is a constant drumbeat of what-can-we-cut –from-the federal-government. Changes in Medicare are suggested, such as raising the age to 67 or privatizing aspects of it—which would be MORE expensive. Or we could make “changes” to Social Security such as moving from the CPI to the unchained CPI. Changing CPI is devastating cut—note that cuts to social programs like Medicare and Social Security are always described in the mainstream media as “changes”.  The vast majority of seniors are completely dependent on their Social Security—contrary to popular belief there are not that many wealthy seniors--and 401(k)s have officially been proclaimed a disaster.

Reading theses articles gives the sense of somebody saying, as main character says in the Rocking Horse Winner “there must be more money.” Here-look at these “disabled” people, living on federal checks –here’s some money. Here, look at this town that LIVES on federal payments-here’s some money. There were more then a few comments under the Post piece which referenced the family’s tattoo bill as a sign the parents were undeserving of support. What kind of parents paid for a tattoo when they had kids to feed? Qualifying for government support means that every aspect of your life is open for discussion, judgment.

Just today there was a story on Morning Edition, on a woman living by the Jersey Shore, after Hurricane Sandy, looking to move to the  . . . Jersey Shore.  Although Sandy “shook her” she was looking for another a house, closer to the shore, an “upgrade”.  There was no judgment placed on her decision, it was framed as a typical response after disasters. There was no mention of the $60 billion federal emergency bill passed to support people like this woman, or any question of the wisdom of rebuilding close to a shoreline in an era of rising shorelines and storms of increasing destructibility. Unlike people who are disabled or who have the misfortunate to be poor, disaster victims are usually portrayed with sympathy, as deserving, even if it can be argued that they too, have made decisions that may have not been wise and that are covered by the federal government.

It is striking how often in the public discourse the individual is dissected but business interests are not. SNAP payments are a regular target for cuts by Republicans, less often mentioned are the hefty fees the government pays to the banks for LINK cards, or the complete lack of transparency of the program in general.  The constant focus on Medicare cuts rarely focuses on a known source of waste, drug payments which are the highest in the world, even as we know ways to change this. 

We inevitably define people as good or bad by their actions and lifestyle based on what we know and what we are familiar with. We feel we can tell a mother how to manage her family because we have managed a family, or we know somebody close to us who has. But the actions or inactions of a corporation are more often something of a black box, we either are not familiar with that decision-making process or don’t know about it's true impact.  This needs to change. Corporate effects--taxes, privatization, "subsidies, i.e. hand-outs--usually dwarf the individual in sheer numbers and therefore are more appropriate to judge and probably modify.  If we are going to get to a society which works for the 99% we need to get above the question of which individuals are “deserving” or “undeserving” and focus on the forces that are truly taking what they have not earned.