Tag: social services

As we approach the 8th anniversary of a U.S. invasion of Iraq, and having just passed the 20th anniversary of another, it’s worth reflecting on what’s been accomplished through two wars and the intervening sanctions that former Secretary of State Madeleine Albright so famously approved of even at the cost of a half million children’s lives.

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Your tax dollars at work, my fellow Americans. You cannot destroy a nation and hire religious fanatics to attack other types of religious fanatics without creating hell on earth.

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As we busy ourselves denouncing the Republican budget for all of the traits it shares with Obama’s proposal, and as Obama fights off the teeny cuts to the Pentagon that the Republicans are seeking, bear in mind what that money is used for. If we really bear it in mind, if we really consider what the majority of every US tax dollar goes to fund, the day will come when Freedom Plaza in Washington DC resembles Tahrir Square in Cairo. May that day come before it is too late.

by David Swanson…

Flying somewhat underneath the radar this week has been a controversial remark made by South Carolina Lt. Governor Andre Bauer (R).  Last week, the Lt. Governor of the Palmetto State made a particularly toxic and highly offensive remark regarding the nature of assistance programs designed to aid the poor and disabled.  

“My grandmother was not a highly educated woman, but she told me as a small child to quit feeding stray animals. You know why? Because they breed! You’re facilitating the problem if you give an animal or a person ample food supply. They will reproduce, especially ones that don’t think too much further than that.”

I’ve mentioned this before, I know, but at that instant my mind couldn’t help but flash back to a particular quote made by Earl Butz, Secretary of Agriculture under Richard Nixon and Gerald Ford.

The only thing the coloreds are looking for in life are tight pu**y, loose shoes, and a warm place to s**t.

I think conservatives assume that welfare services and the safety nets provided to those living at or near the poverty line are some kind of all-you-can-eat buffet line whereby some dubiously defined underclass can stuff themselves silly on taxpayer funded giveaways.  The most obvious response to this is, of course, that they are desperately needed, often life-saving, otherwise unavailable options which those with adequate means already have and as such frequently take for granted.  But for some reason this isn’t sufficient enough in and of itself to satisfy the concerns of the average GOP voter or elected official, so perhaps a description of the incredible limitations of welfare agencies needs to be noted once more.  As you will see, one can either decry them as money drains or lament their inefficiency, but certainly not both.

Social service agencies and welfare services are almost always underfunded, meaning that they are also almost always understaffed.  Without enough manpower to answer phones, attend to daily business, and keep things running smoothly, the average applicant must be persistent and also must be his or her own advocate.  Often it is necessary to spend hours on the phone attempting to find someone who either knows to even be connected to a competent worker who has had enough experience with the system to know how to properly process a claim or initiate a service.  Those who lack the patience or the time are often left out altogether.  The working poor don’t have the luxury of being able to devote more than a small fraction of their time to sign up for basic services and have to divide their attention among demanding, often thankless jobs, and the constant time and energy drain that is known as parenthood.  Those with families and dependents often are the ones who need these services the most, but can’t carve out extra time in already busy, over-booked schedules.  Regarding food stamps, which supply one of the most basic of all human needs, what transpires often is that deserving individuals don’t have the time to come into an office or wait for hours, or have great difficulty scheduling a block of time in which to speak on the phone with a worker to complete the process.

Social service agencies and welfare services are dependent on state and local tax revenue, and though the amount of funding varies from city to city, county to county, and state to state, most are barely able to absorb the needs of the less fortunate in good economic times.  In bad economic times, budgets are stretched to the gills, the deficiency in number of workers needed is much more visibly pronounced, and as a result the system quickly grinds to a halt or at least a slow trickle.  In situations like these, with three and four times as many applicants in the pipeline, it takes even longer to obtain even the minimum and it may mean that three and four times as much effort and persistence is needed until one finally receives a place on the rolls.  When budgets are tight, it also means is that coverage for any service can be terminated at any time, for any reason, based on some mysterious internal audit or the flimsiest of justifications, all implemented based on the compulsion to save money and keep from depleting the General Fund.  

Speaking to my own recent experience, just to obtain a referral to a clinic that treats basic physical ailments the way any GP would took two frustrating days on the phone, whereby I called at least seven different numbers and spoke to close to ten people.  Eventually I finally, quite by chance, stumbled across the right person who finally got everything in order.  I was told at the time that the reason for the vast amount of confusion was, in part, a result of the fact that low salaries at certain centers designed to direct patient inquiries meant that there was always quite a bit of turnover.  Since the system itself was complex, it often took a while before any worker properly understood it enough to convey accurate information to anyone.  Though I am thankful for my success, I couldn’t help but think about all the others who found themselves with blood pressure raised high enough for long enough to set aside any subsequent efforts to see a doctor.  It is no wonder that the rates of easily preventable conditions are high among the working poor, since if it takes this degree of effort, I know many will go without rather than undergo what at first seems like a fruitless search.

This leads me to my next point, at which I discuss another barrier to obtaining needed services—senseless complications and poor networking between agencies.  Many times these are products of all the barriers I have stated above, but what this also reflects is our compulsion to micromanage the affairs of the poor.  Not only that, we wish to control their lives because many of us believe that they are clearly up to no good and only a step above either common criminals or lazy ne’er do wells with nothing so much as ambition or drive.  I wouldn’t exactly call this tough love so much as I would call it punitive retribution.  One needs only look at the ACORN matter to see evidence of that.  Conservatives saw exactly what they’ve always wished to see in that case, confirming their own darkest suspicions in the process.  I honestly believe if it were up to them, many would do away with all taxpayer funded programs designed to assist the less fortunate among us, unsympathetically remarking like Herbert Hoover that these services ought to be the domain of churches and faith-based organizations, but certainly not of government.    

Where one sees frustrating evidence that the right hand doesn’t know quite what the left hand is doing in any circumstance, or that everyone’s not quite on the same page, it is tempting to deem it indisputable proof that larger government is both a waste and a headache.  This is what drove the Tea Party protesters to spout off and also motivated those who feared and still fear the enactment of some nebulously defined, super scary government-controlled health care plan, but I counter that assumption by noting that with an adequate amount of funding, an adequate amount of staffing, a moderate amount of reform, and a network of customers of ample economic means, the system would run far more efficiently.  Most people who are used to medicine on demand would simply not stand for the degree of complication and delay as currently exists, and money has a way of smoothing out many of the kinks in any system.  Not all of them, of course, but many.  Money has a way of giving people a reason to stay in a job for more than a short time and encouraging competent management that would attend to the needs of a much more educated, much more affluent demographic that would expect more and not a group of citizens who have unfortunately long come to expect that the few concessions thrown them will be of inferior quality.

Returning to the system the way it is today, the elephant in the room, naturally, is a very pronounced element of racist and classist assumption.  Since discrepancies between wage earnings are still very pronounced between Whites and Blacks, most who qualify for and use safety net programs are poverty-line African-Americans, and more recently a rapidly growing number of Latinos.  Most, but not all, of course.  In my experience, I was the only White person applying for food stamps and the only Caucasian seeking treatment and prescription drug coverage.  As we well know, nothing instigates GOP ire faster than the notion of welfare cheats or avoidable drains on Good Honest American Taxpaying Citizens™, as seen above with Mr. Bauer.  I’m not quite sure what I find more offensive about his remarks, the dehumanizing element reducing poor Americans to feral animals, the element of eugenics which suggests that poverty could be reduced or eliminated by means of forced sterilization or starvation, or the implication that all those in need are simple-minded strays who aren’t concerned with anything much more than just reproducing and creating burdens for humans who have to take the time and effort to keep their numbers in check.  I’ve heard some fairly creative theories for population control and elimination of inferior races, but yours, Mr. Bauer, is not one of them.                  

The real enemy here is not conservatism, or liberalism, or an entitlement mentality, or even an underclass.  The issue is equality, pure and simple, or should I say the lack thereof.  I will be honest here.  I was raised by a Father who placed complete faith in Ronald Reagan and his view of the waste and graft of welfare and with it a simultaneously dismal opinion of the efficiency of any government program, regardless of its stated purpose or function.  Indeed, there was a time where I myself held similar beliefs.  But though I had changed by tune well before then, my eyes were truly opened when it came my time to use these same basic lifelines granted anyone who qualifies.  I recognized quickly that had I not been born into a middle class, highly educated family, I might not have been able to chart my way through a very convoluted system and obtain the services I needed along the way.  Working the system requires a good bit of guesswork and tremendous amount of trying to successfully solve a problem with multiple unknown variables.  

The system is not designed for the undereducated and the impoverished, rather it is a construct of those whose job description clearly must include a love of complicated solutions for simple problems and an insistence upon a variety of completely unrealistic constants, like minimal turn over among workers on the front lines and at the field office.  Again, equality in pay would do much to keep that in check, as would a system that was put together with greater skill and dexterity.  I’m not arguing that throwing money at a problem is any adequate means to fix it, but what I am saying is that if each of the individual pieces of the system were designed with the ability to be revised easily and as the situation demanded, and if those who worked this system took a job as a career, not just a vocation, then many of these problems could be eliminated.  

If these social service agencies and welfare programs were run like a business in the private sector, they would have gone bankrupt years ago, but the fault here is once again that we honestly must not really have much regard for human life, particularly for those “not like us” for whatever reason.  Oh sure, we’ll give money to Haiti and vow to offer our services in any way that we can.  I don’t mean to come across as cynical regarding anyone’s motivation to assist the victims of that battered island nation.  The outpouring of help would soften the heart of even the most bitter person, but many will see Haiti as a one-time, special occasion.  I live in the District of Columbia and in a relatively small area based on surface area both the richest of the rich of the poor living side by side.  The ostentatious wealth of Georgetown is countered by the desolation of Anacostia and recently gentrified areas like Columbia Heights or right near by the Capitol paint an even starker view of the discrepancy.  As I’ve seen the money rolling in to be sent to Haiti, I can’t help but wonder what even a fraction of that outpouring could do for the District’s poor, and especially for those infected with HIV/AIDS since the District itself has an obscenely high number of cases that put it on par with an African nation, not a region within the borders of the United States.

Any system designed to assist those without our fundamental advantages depends upon the cooperation of those farther up the totem pole, and if our checkbooks, if not our hearts are closed to them, then the system will always be insufficient and dysfunctional, poverty will always exist, disparities will always exist between race and class, and so too will the desperate attitudes that lead to drug addiction and crime.  The life we save might be our own someday.  So yes, in this instance we do it to ourselves, and that’s what really hurts the most.  And we do it by not recognizing that it is within our power to treat the cause of the problem, much like medicine would in counteracting a disease.  For example, one can treat strep throat with an aspirin, but that only takes into account the effect.  Treating the cause often requires a shot of penicillin, and once it has made its way through the blood stream, healing begins and pain ends.  Aspirin might be far cheaper than a cost of a doctor’s visit without insurance,  but it will merely mask or temporarily delay the pain of the sore throat.  With time, it wear off, the pain returns, and the need to take more returns.  The disease itself remains and will remain until it is properly treated.          

If conservatives are so indebted to scripture and to their assertion that we ought to be a Christian nation, I wish they’d keep these passages below in mind.

For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’  

“Then the people who have God’s approval will reply to him, ‘Lord, when did we see you hungry and feed you or see you thirsty and give you something to drink?  When did we see you a stranger and invite you in, or needing clothes and clothe you?  When did we see you sick or in prison and go to visit you?’  “And the King will say, ‘I tell you the truth, when you did it to one of the least of these my brothers and sisters, you were doing it to me!’

Recently I have been giving much thought to why Progressives and Democrats can’t seem to accomplish more than the bare minimum regarding desperately needed reform measures, even when they have the luxury of substantial majorities in both public favor and legislative representation.  The answer may lie in the prevalence of pointless, unwieldy levels of stratification.  With these comes an isolating sense of separation—individual elements of the base often have a problem pulling together with one voice, and, for that matter, do all who would deign to fit underneath the big tent.  

To many liberals, life must be overly complicated:  specialized committees, committees within committees, identity groups, splinter identity groups from larger ones, rules for the sake of rules, rules set in place when one unforeseen problem creates friction with anyone for whatever reason, exacting policies based on good intentions that soon become headaches for all, and many other examples.  It doesn’t have to be this way.  Overlap is sometimes a good thing.  

As such, the true failing lies in the absolutely ridiculous complexity of how structure ourselves and how we have in many ways forgotten how to communicate with each other.  For too long, information and strategies that could be used for the benefit of all have been isolated within specific single-issue oriented groups, each with its own nomenclature and particular phraseology.  For too long, so-called experts carrying a briefcase, a PowerPoint slide, and a hefty speaking fee have been employed to enlighten other people of an unknown universe, when with major modification, we could easily understand the intersections and common ground which links us together, not the great unknown that keeps us at arm’s length from each other.  

This sort of set up directly reflects the nature of academia, since the merits, weaknesses, and structure of pertinent concepts are hatched there and exhaustively vetted.  Just as I have recently discovered that the health care system available to low-income and disabled residents of Washington, DC, was written to be understood and effectively managed by policy wonks and the highly educated, not the poor and under-educated, so do I realize that so many of our grand goals are thwarted when they are neither designed, nor framed so that all might easily comprehend them.  

To cite a related example, when I am speaking within Feminist circles, I know that there are certain terms, overarching concepts, and abstract notions that one needs a thorough education, keen mind, and a willingness to research on one’s own time to grasp sufficiently.  Much emphasis is given to an everlasting critique of Patriarchy and cultural practices which place women in a subordinate role, and from these comes a thousand deep conversations and leitmotifs.  I can speak this language competently, with much practice, I might add, but I often can’t help but wonder if any of these worthwhile ideas and highly involved strategies ever get out to the working class battered housewife or to the sex worker standing on the corner of a bus terminal, prepared for another night of a dangerous way to make a living.

In my own life, part of the reason I have been able to keep my health from being as debilitating as it could be is that I had access through education and relative affluence to know how and where I could do my own research about the condition.  Now, years later, I can hold my own with any psychiatrist because I know and understand terms like selective serotonin re-uptake inhibitor, titration, GABA, dopamine agonist, and efficacy.  However, these terms mean absolutely nothing to the average person, who must trust fully in a psychiatrist who then must translate their needs, their symptoms, and their expectations for treatment into a regimen of medications that is inexact even in the best of circumstances.  

The likely outcome with anyone diagnosed with a psychiatric disorder is a tremendous amount of constant modifications, some slight, some major, and frequently a need to try an altogether new combination of medications, all of this in the hopes that one will stumble across the proper drugs in the proper proportion, eventually.          

We humans are a peculiar breed.  In the animal kingdom, one could argue that the average mammal attends to its own more readily and with less reservations than we do.  Without romanticizing the primitive, it would seem that no other species on Earth usually has such profound reservations about reaching out to assist others.  Though certainly other animals fight within themselves for food, mates, and resources, I often wonder if we are perhaps the most self-absorbed creatures the world has ever known.  

We are given the gift, by God or by whichever belief or unbelief you espouse, to have the gift of a very complex, and very advanced organ at our disposal known as the brain.  Yet, it seems to me sometimes that this supposed great gift can dispense evil and great suffering as easily as it gives rise to good and with it great gain for all.  

As a person of faith, I sometimes wonder if this basic concept is a credible interpretation of the beginning of time as expressed in the Book of Genesis.  So long as man and woman weren’t aware of the greater complexity of all things, they lived nakedly, blissfully in paradise.  But once temptation arrived in serpent form, suddenly they recognized that reality was not nearly so simplistic and easy to swallow.  Christianity and other religions teach that humanity was created in God’s image, and if that is the case, perhaps we are caught in some still unresolved eternal polar tension between our ability to sense and structure things in advanced shades of grey versus our relatively straightforward mammalian biological imperatives and compulsions.  Some have even implied that the human condition is imperfect particularly because we have divine elements seeking to function within imperfect organs, namely our brain.  

While on the subject, I am reminded St. Paul’s second letter to the Corinthian church.  It seems that the church had fallen prey to smooth talk, false teachings, and a distortion of the faith itself.  Much of the passage I am about to cite, as you will see, is written quite sarcastically, its target primarily those who deceive others, not those who had been unwittingly deceived.

However, I am afraid that just as the serpent deceived Eve by its tricks, so your minds may somehow be lured away from sincere and pure devotion to the Messiah.  When someone comes to you telling about another Jesus whom we didn’t tell you about, you’re willing to put up with it.  When you receive a spirit that is different from the Spirit you received earlier, you’re also willing to put up with that. When someone tells you good news that is different from the Good News you already accepted, you’re willing to put up with that too.  

I do not think I’m inferior in any way to those “super-apostles.”  Even though I may be untrained as an orator, I am not so in the field of knowledge. We have made this clear to all of you in every possible way.  Was it a sin for me to lower myself in order to elevate you by preaching the gospel of God to you free of charge?  (Italics mine) I took money from other churches as payment for my work, so that I might be your servant [at no cost to you].  And I will keep on doing what I am doing in order to cut the ground from under those who want an opportunity to be considered equal with us in the things they boast about.  You gladly put up with fools since you are so wise!

Even those who do not believe in a higher power or in Christian terminology can understand the general message here.  To get down to the heart of the matter, our own selfish goals, ego, and pride are largely responsible for the complications that separate us from others.  When we throw up barriers for whatever reason, we cause others who might use our knowledge and insight as a helpful resource to stumble or to fail outright. The intent initially may not be to isolate information inside very specific spheres of influence or schools of thought, but very soon this is its inevitable end result.  

If we were speaking of a purely Christian point of view, we would concede that no believer should be discouraged from taking an active role in the faith, nor turned away from membership in the body as a whole based on any perceived deficiency or lacking of any kind.  Sometimes putting walls up is an unconscious decision made out of a desire for protection, sometimes it is a response to feeling unappreciated and discounted by society as a whole, and often it is a reactive measure that replicates itself a thousand times once established.  Like some untreated cancerous cell, walls and barriers become duplicated a thousand times over, leading to factionalism within factionalism, specificity within specificity, and minutia within minutia.  

The Left has adopted this formula time and time again under the pretense of being sensitive and accommodating to every possible group with a semi-unifying basic agenda.  But what this ends up doing is placing the individual concern first, and ignoring the basic humanity that draws us together.  The current generation in power embraced post-modernism with open arms, not recognizing that simply denoting a specific circle of influence means also that one ought to get to take the time to understand its core philosophy as part of the bargain.  

We can advance LGBT rights, for example, but if we don’t really make an attempt to listen, really listen to LGBT citizens and to their reflections and concerns, we are wasting our time.  Recently, a controversy has sprung up within Feminist spaces that criticizes men who make very ill-informed, very glib pronouncements of what the greater movement (and women themselves) needs to do.  These forceful pronouncements are almost always set out in condescending fashion, without, of course, truly understanding where women are coming from and without much specific understanding their particular grievances.  Some have denoted this as “mansplaining”.  

I do know the resolution of this issue ought be a two-way street, since any exchange of information needs both a talker and a hearer.  Though some may disagree with me, I also assert that Feminist circles would be wise to modify, but not water-down, nor soften their message to reach maximum exposure with the world outside of it.  This might be accomplished by consciously seeking to move away from the complications of heady terminology and abstract discussions.  This doesn’t mean voices should be silenced for any reason or that women ought not speak first and speak often in so doing.  Nor does this mean that the dialogue must be dumbed down.  What it does mean, however, is that that communication requires an equal sense of that which must be said and that which must be comprehended.  

I sincerely believe that women’s rights have a relevance and a pertinence which needs to be added to the daily discourse, but I do also know that doing so requires that it keep the extensive cerebration within itself and the cut-and-dry to those outside.  But lest one feel like I am picking on Feminists (which I am honestly not), this goes for every single-issue, shared identity, or niche group with liberal sensibilities.  Just because we seem to enjoy making things complicated for perverse reasons as yet unknown, doesn’t mean that we should.                  

The true failing in all of these cases lies in the absolutely ridiculous complexity of how we structure ourselves.  To reiterate once  more, for too long, information and strategies that could be to the benefit of all has been isolated within specific issue-oriented groups, each with its own nomenclature and particular phraseology.  This directly reflects the nature of academia, since these concepts are hatched there and exhaustively vetted.  In that profession, segregated subject areas and ultra-specific foci are considered necessities within a field of study to encourage subsequent analysis.  However, this particular structure is anathema to greater progress beyond the world of professors, scholars, and students.

The circular firing squad over the defeat of Martha Coakley and what this means for the Democratic Party and Health Care Reform got underway a couple days ago.  I’ve said my bit, and have nothing further to add, but I’d rather address the potential challenges facing reform aside from the loss of a seemingly filibuster-proof majority.  It is now absolutely imperative we push forward and bring a bill to President Obama’s desk.  Our backs may be against the wall, but perhaps it will take abject panic and fear to rouse our complacent, weak-kneed Democratic legislators towards the goal.  If it takes the shock and dismay of a humiliating defeat to break the logjam, then so be it.  I’m not concerned with speculating as to how we got here; I am instead consumed with what we learned from it and how we will use this tough lesson to think of others and their needs rather than ourselves.  

What I have noticed in my own struggles to obtain low-income health insurance is how class and race ensure that government subsidized plans are underfunded and often dysfunctional, but money (or the lack of it) seems to be the most powerful determinant of all.  What many have noted is that basic selfishness is what threatens to derail any efforts towards changing the existing system—namely that people who have always had sufficient coverage do not understand the limitations faced by those who do not.  We can call that privilege if we wish, but that term has always seemed accusatory to no good end to me, and my intent is not to chastise anyone but to make many aware of the challenges in front of us that never get much in the way of attention.  In my own life, I can say that I have now seen how the other half lives for the first time ever, and I noted that they live lives severely impeded by the tremendous limitations and senseless complications of the existing system.

I have been unemployed or at least severely underemployed for several months.  As a result, I had no choice but to file for government assistance.  When I was finally granted food stamps I signed up as well for a local DC funded health insurance plan.  What I have discovered in the process is that since the Recession hit, social service agencies in DC have been swamped by new applications for every existing option currently offered.  According to one worker with whom I spoke, claims have tripled since the bottom began to fall out of the economy.  The system was barely able to manage the number of filings in more stable times, and now it has in large part ground to a halt if not slowed to a trickle.  New claims are supposed to be processed in no more then 30 days from approval, and I was forced to make several time-consuming, additional calls to the proper department to even get the coverage activated.  Those without the time or without the persistence likely will be granted nothing at all and this simply should not happen.  

My great point is that without the infrastructure in place, it doesn’t matter how many people to whom we grant coverage.  Ensuring that everyone can get their teeth cleaned, fillings filled, broken bones set, flu-like symptoms properly treated, diabetes regulated, or depression adequately under control is the ultimate goal, but we must also be sure to build a sufficient number of clinics, medical centers, doctor’s offices, dental hygiene practices, well-stocked pharmacies and all the rest.  They must be built in proper proportion to need and since humankind has never been able to curtail its zeal for making money at the expense of the health of the financial system, we need to devise strategies to build these things for both good times and bad.

In DC, the low-income, government-funded system forces the poor and/or disabled to a handful of centers scattered across the District itself.  Visiting a private doctor or specialist is not an option, since coverage is only granted to those who use these designated centers.  Likewise, pharmacies and medication dispensation function under the same parameters.  Using Walgreens, CVS, Rite Aid, or other commercial medication fillers is not allowed under the plan.  Though there are a score of specific pharmacies which take the DC plan, in my case, there is only one pharmacy in the entire District that fills psychiatric medication, and for me it is a 35 minute trip, one-way via public transportation and then by foot.  The pharmacy itself is attached to a Mental Health services clinic which is the sole site whereby psychiatric care is provided for a city of roughly 600,000 people.

Without enough workers to process claims, grant coverage, manage medical records, or attend to even the most basic of needs the system is essentially worthless or at least incredibly inefficient.  Without enough revenue allocated by governments from taxation or other means, it doesn’t matter how snazzy or up-to-date is any system designed to speed up or modernize the system.  Window dressing is window dressing.  Without the money to properly stock a pharmacy, medications will be obtained on a priority system and as such, meds that are rarely prescribed or are very expensive will rarely be on hand when needed.  For example, one of my medications, Parnate, is an MAOI inhibitor.  Parnate is a very powerful anti-depressant that is infrequently prescribed because with it comes potentially dangerous, even deadly side effects if I do not take care to abstain from eating certain foods.  As you might expect, it is not one of the more common prescriptions, but it is essential to my lasting health and quality of life.  A commercial pharmacy usually has it in stock, or if it does not, it can be quickly ordered or is certainly in stock at some other store in the immediate area.  With the government-subsidized pharmacy I must use, if that particular drug is available at all it is due purely to chance and luck, and if it needs to be ordered, it may be a week or more before they have it in stock.      

Regarding visits with a GP, specialist, or other specific health practitioner, some clinics and centers accept walk-ins or schedule appointments within a reasonable time frame.  Some do not.  For those who need surgical procedures or more invasive treatment, one might be expected to wait months.  When I still lived in Alabama, there was approximately one Medicaid-accepting clinic for the entire state that performed the procedure, and as such when it came time for me to have a very routine, non-invasive treatment, I was booked four whole months in advance.  In more affluent, usually blue cities and states, the wait time is often less, but it can still be a bit on the lengthy side.  As for me, I found to my utter dismay that my coverage was terminated before the procedure could be even performed after the clinic filed and billed Medicaid for the cost of the preliminary screening.  Someone must have realized that to save cost I was not what they deemed a “high-priority” need and thus I could be safely removed from the rolls to save money in what was a system already in danger of being completely depleted of funds.    

An important distinction needs to be drawn here.  The DC-based coverage I have been talking about is different from Medicaid or, for that matter, Medicare.  This coverage augments or seeks to provide coverage to those who either have Medicaid/Medicare or cannot get approved for it.  This is why the rules, parameters, and hoops to jump through are more severe.  Medicaid usually allows a person to pursue more orthodox means of seeking treatment.  Though some medical practitioners do not accept it because it usually pays out less than a gold standard coverage plan through a private insurer, many do.  Again, money is a big factor at play.  If Medicaid were capable of paying out at a sufficient rate, everyone would take it.  If it wasn’t at times forced to pay out much later than a private carrier or even being forced to issue IOU’s when monetary shortfalls and partisan bickering delayed enactment of a satisfactory state budget, then it certainly would be on par with usually employer-based coverage.

Yet, it is very disingenuous at best for those who oppose health care reform to stubbornly dig in their heels and express haughty indignation that they are NOT going to have “the government” take away their right to choose their doctor.  The only way this would ever happen for most is if they lost their insurance altogether, lost all their personal savings, and lost the ability to come up with the money to see a well-compensated physician and/or specialist.  Their worst-case-scenarios and numerous reservations are true only for those living in abject poverty, or at or below the poverty line.  The wealthier among us have any number of lifelines, be they family, co-workers, friends, fellow members of a particular group or club, or other sufficient means.  Those at the bottom have none of this upon which to rely.  Friends, family, and others are just as impoverished and less fortunate as they are, and they have no choice but to take and use what they can get.  And taking what they can get means dealing with a system that is convoluted, needlessly complex, inconvenient at best, and regimented to such an authoritarian degree that even obtaining the minimum often is an exercise in debasement.

If ever we had a need for revolutionary reform and change, now would be it.  Decades after a declared War on Poverty, we still have many battles ahead of us.  We haven’t really given this matter anything more than perfunctory attention, and we haven’t really allocated resources of any significant means to this very pertinent cause.  Doing so would require us to understand exactly how fortunate we are to have been granted, by complete luck and chance, the socio-economic status of which we were born.  For some quirk of God, fate, or nature we do not get the right to choose our parents or to choose our upbringing.  But we do have the obligation to see to it that those for whom daily adversity is not an abstraction have the same rights that we frequently take for granted.  I am not seeking to lecture, nor to hector anyone, but rather to strongly emphasize that our continued success as a people, a party, and a movement demands that we seek to assist the poor and the less fortunate.  Our wallets, billfolds, and bank accounts couldn’t open fast enough to provide aid to suffering Haitians.  If only this were possible for our own poverty-stricken citizens, many of whom struggle through conditions not that dissimilar to those we now view through heart-wrenching news reports and graphic photographs.  After all, it might be you someday who faces the disquieting realization that our health care system is designed for the wealthy, by the wealthy, and in so doing realizes just how much you took it for granted.

A few weeks back, I wrote about my trials, travails, and tribulations achieving food stamps.  I am pleased to report that due to my own persistence and the fantastic support of an advocacy agency, I was granted an EBT card.  Earlier today I trudged through areas of town which have not seen much in the way of a plow or a shovel.  I literally did have to walk a half a mile uphill in the snow both ways to arrive at the proper place, though I’ll save that lecture for another time.  Since I have joined the ranks of the unemployed, I’ve had to swallow quite a bit of pride, which isn’t always a bad thing, all told.  The complications that went into obtaining food stamps were easily explained, once I met with the proper person, and with resolution I have no further griping to share on that matter.  

A well-designed website imploring those wishing to apply for food stamps to submit their claim by mail, after, of course, entering pertinent information and printing out several pages of a lengthy form sounds attractive enough.  However, I learned that while the mechanism may exist, budget shortfalls prevented the DC government from being able to hire the workers needed to process internet-based claims.  It would not be much of a stretch to deem this situation an glaring example of an unfunded mandate.  Reform cannot proceed without the allocation of funds and while we often are curtly dismissive of throwing money at a problem, granting low income citizens the ability to feed themselves somehow doesn’t seem to be on par with all of these anti-underclass talking points that find their way into the mouths of Republicans and Republican politicians.

If one considers Maslow’s famous hierarchy of needs, then food falls right down there at the bottom of the pyramid.  Without the literal requirements for human survival, it’s tough to be a Welfare Queen or milker of the system.  According to Maslow, it’s only after our base needs for survival are met that anyone could ever even entertain the notion to willfully freeload.

With their physical needs relatively satisfied, the individual’s safety needs take precedence and dominate behavior. These needs have to do with people’s yearning for a predictable, orderly world in which injustice and inconsistency are under control, the familiar frequent and the unfamiliar rare. In the world of work, these safety needs manifest themselves in such things as a preference for job security, grievance procedures for protecting the individual from unilateral authority, savings accounts, insurance policies, and the like.

But until one has the security of knowing he or she will be fed on a daily basis without having to worry about potential financial famine, safety is not a concern.

As for my own situation, my packet of information sat on a desk for over a month, unprocessed.  Because a meeting with a claims associate regarding whether or not food stamps will be granted or denied must, by rule, be granted and scheduled within 30 days, once I was approved I was given a month and one week’s worth of groceries I should have received earlier had everything proceeded in a timely fashion.  Though I received only $200 a month in food stamps, which is approximately half of what my grocery bill is for the same period, I am not about to look a gift horse in the mouth.  In all fairness to the DC Food Stamp program, it has won awards for how promptly and effectively it processes claims and while my situation is uncommon, it is hardly unusual when one considers the food stamp programs in other states.  In a fairer society, I would have had my entire food budget subsidized, saving me from having to rob Peter to pay Paul as so many of us have to do these days, but perhaps someday we will learn that though we have a tremendous amount of financial resources in this country to go round, even in times of recession, we spread them around unequally and in so doing shortchange the least among us.          

Part of the problem is the stigma and the misinformation that still persists regarding accepting government aid of any kind, food stamps being merely one example.  One would think that welfare cheats salivate at the very idea of eating from the public trough, if you’d believe the stereotype.  DC Hunger Solutions, the advocacy agency who so kindly went to bat for me and got my situation resolved, corrects many of the myths and stigmas surrounding food stamps.  

Only 83% of eligible District residents, and 36% of eligible low-income working families, receive food stamps. Every $1 of food stamps spent in the community generates $1.85 in local economic activity. D.C. would gain millions in federal funds by signing up eligible households – funds that would stimulate the local economy. People who work sometimes assume they are not eligible for food stamps, or that time-off from work is required to apply. This is not true. A family of 3 with a minimum wage earner could be eligible for over $3,000 annually in benefits, and working families can complete phone interviews rather than go to the food stamp office in-person.

The true impact of the Economic Stimulus Package has become a political football of sorts, in part because what it promised could not be easily measured or highlighted in concrete detail.  If, however, we shifted at least some of the focus towards fully funding both the programs that provide food to the poor and the monies necessary to provide more assistance, then these would be highly visible symbols of what good government is capable of if it puts its mind to it and does not get distracted with superficial squabbling or red tape disasters.  When close to two dollars worth of gain comes as a result of every one dollar spent, one cannot overlook the overall benefit.  We often believe that reform of any sort ought to be an awe inspiring and highly complicated matter, when sometimes the simplest solutions are the best.  Blessed are those who hunger and thirst for righteousness, for they will be filled.