Archive for Tuesday, January 17, 2012

No safety net

January 17, 2012

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To the editor:

Once again I read, in Scott Rothschild’s article, that Medicaid provides services for low-income Kansas residents. This is actually less than half true and misleads people into thinking that all poor Kansans have some sort of safety net. Kansas provides Medicaid to only 44 percent of those adults who live in poverty, (families with children and those over 65). For the 152,000 other adults under 65, who are impoverished without children, there is no safety net.

If you’re a victim of the latest recession and have medical problems, your choices are few. You can ignore the problem until it disables you, kills you or goes away on its own. You can go to the emergency room, rack up a huge debt and then go bankrupt when they sue you, or you can try to find a doctor who will treat you even though they know they may not get paid. Here in Lawrence, we are fortunate to have some compassionate doctors and Health Care Access. Not all communities are so lucky.

Unfortunately there is only one political party that cares enough to stand up for the disadvantaged and try to provide an option other than “no health care at all.” It baffles me how the other party prides itself on their Christian values on one hand but, when it comes to helping the 35,810,200 people living in poverty in the U.S. (“the least among us”), their answer is “Let them suffer.” Compassionate conservatism must no longer exist.

Comments

Ragingbear 3 years, 3 months ago

Medicaid is a joke as well. They won't cover migraine medication that cost about $75 a month, but will cover the $2500 ER bill when a sufferer is in day 4 of a migraine. They won't cover dental other than extractions. Heck, there are antibiotics that Kansas Medicaid won't cover as well. Not until you try the "cheaper" medications first. By which time your MRSA infection has turned into VRE.

Oh, and get this. Medicare will cover up to %80 of the expenses for gastric bypass surgery (if you have a BMI of 50 or higher and have weight related health conditions) and Kansas Medicaid will cover none of it. But for those that receive Medicaid and Medicare (which are quite a few), they are forbidden from getting the surgery unless they pay the entire bill themselves. Not the amount that Kansas Medicaid won't pay. Not the 20%. The entire bill. This is the only state that practices this idiotic system and they see nothing wrong with it.

George Lippencott 3 years, 3 months ago

Medicare is available to everybody 65 and over including you. Medicaid is not meant as everyday insurance but as an emergency solution for those who have experienced some form of financial diaster.

Comparing the two is like comparing apples and oranges. Perhaps Obama care will addessu your challenge. Of course those of us with an income will have to pay for you. Thanks.

gudpoynt 3 years, 3 months ago

God used to run housing, food, health care, and energy? I never knew.

gudpoynt 3 years, 3 months ago

Imaginary gods, with their invisible hands?

gudpoynt 3 years, 3 months ago

And what conditions are required for spontaneous order prevent price distortion?

somedude20 3 years, 3 months ago

When did this "god" you speak of become real?

Armstrong 3 years, 3 months ago

You don't need to read many of Rothschild's articles to find they without exception lean heavily to the far left . Kind of like Pitts anymore, just read for the W T F factor

Armstrong 3 years, 3 months ago

It' all about the presentation and packaging, that's been a successful formula for the media for years. Putting lipstick on a pig may make it look better but it's still a pig.

just_another_bozo_on_this_bus 3 years, 3 months ago

"It' all about the presentation and packaging,"

And nowhere is that more true than on Fox News and the rightwing wackosphere-- all very allergic to facts (and science.)

Armstrong 3 years, 3 months ago

This comment was removed by the site staff for violation of the usage agreement.

just_another_bozo_on_this_bus 3 years, 3 months ago

If you don't like the facts that Rothshild reports, you're free to make up your own-- oops, no, you can't make up your own facts, and repeating said efforts still doesn't make it factual. And complaining about the facts he reports doesn't make them otherwise.

Armstrong 3 years, 3 months ago

This comment was removed by the site staff for violation of the usage agreement.

skinny 3 years, 3 months ago

Ya, next everyone will be complaining that they are entitled to free housing! If you want something pay for it yourself! Somebody has to pay for it and it and you should not expect your next door neighbor to pay your bills!~

George Lippencott 3 years, 3 months ago

To cut Medicare you have to actually cut services. Tho e cuts have to be done in law or in some cases by policy changes. Obama care actually expanded Medicare by include new preventive services.

Apparently the cuts were just a manipulation to meet Congressional rules.

BigDog 3 years, 3 months ago

Once again I read, in Scott Rothschild’s article, that Medicaid provides services for low-income Kansas residents. This is actually less than half true and misleads people into thinking that all poor Kansans have some sort of safety net. Kansas provides Medicaid to only 44 percent of those adults who live in poverty, (families with children and those over 65). For the 152,000 other adults under 65, who are impoverished without children, there is no safety net.

Stephen your statement is also not true and misleads. There are tens of thousands of adults in Kansas, who are under 65 and have no children, who receive Medicaid. They are those we call people with disabilities whether they be those who received it because of developmental disabilities, mental illness or physical disabilities.

And many over 65 do not receive Medicaid unless they are disabled .... they receive Medicare.

Yes there is not a safety net for everyone but your statement left out a large number of people who receive Medicaid services who are under 65 and have no children.

jhawkinsf 3 years, 3 months ago

When does a safety net become a trampoline? Fall won, pick 'em up. Fall down, pick 'em up. Fall down, pick 'em up......

just_another_bozo_on_this_bus 3 years, 3 months ago

This is the mantra of those who want to eliminate the safety net, not improve it.

jhawkinsf 3 years, 3 months ago

There is an intergenerational welfare system that encourages an intergenerational welfare system. Calling it a safety set is like saying a gentle breeze and a tornado are both wind. While nominally true, such a comparison is very misleading. The question is, does the system need to be tweaked a little or does it need radical restructuring. Feel free to believe the former. I believe the latter.

just_another_bozo_on_this_bus 3 years, 3 months ago

"radical restructuring."

And what would that entail?

jhawkinsf 3 years, 3 months ago

What was once known as charity came with certain expectations. One of those expectations was that the charity was conditional upon the receiver behaving in a certain way, not the least of which that the receiver make every attempt to limit the amount of charity received. The receiver was expected to conform to societal norms of getting a job and not engaging in activities that would jeopardize getting employed and housed, things like using drugs, alcohol, gambling, etc. Once charity evolved into an entitlement, the expectations put on the receiver became much less. It became society's obligation to get them a job, get them housing, provide them food, etc.
Overall, receiving an entitlement came with less expectations and less stigma than when it was charity. With that came entitlements that lasted longer and little or no incentive to change one's behavior.
The radical restructuring would be a demand that in return for getting the charity for which they ask, they behave in a manner consistent with the expectations of the giver.

jhawkinsf 3 years, 3 months ago

And that's the problem with the safety net. It gives to those that genuinely need as well as those who don't. It treat those that try hard the same as those who don't.
Do you recall the outrage when the American Red Cross received more money they could possibly use in the days after 9-11. They decided to defer some of that money for future events. Well, the public went ballistic. They gave for the purpose of 9-11 and they wanted that money spent on 9-11. That's my point, how the money is used is determined by the intent of the giver, not on the circumstance of the receiver. If I give money for reason "A", the charity may not make the determination that reason"B" is more worthwhile. And that's what is happening with the "safety net". It's become so overgeneralized that every sob story gets rewarded. And those in the best position to determine which story is legitimate and which is not are the very people with the least incentive to make that determination. If they did, they might lose their job, or the guy at the next desk loses his, or their secretary, etc. Yes, my response is very general. Just like the safety net.

jafs 3 years, 3 months ago

That's fine on an individual level, if you give money to a charity.

But, it's much more difficult on a communal level, wherein we're all paying taxes, and all deciding communally how they're spent.

There is little agreement about the things you discuss on that level.

jhawkinsf 3 years, 3 months ago

Is it really that difficult? The government is constantly funding things for which there is little support by the people. Do you recall when Dick Cheney brought in a bunch of oil company execs. and set America's energy policy. Everyone cried foul because there was such a large conflict of interest. The same is true when you bring in a bunch of poverty pimps to set policy about social services. they too have a huge conflict of interest.
The thing is, maybe they are right. Maybe not. But with the conflict of interest, we'll never know.

just_another_bozo_on_this_bus 3 years, 3 months ago

"The same is true when you bring in a bunch of poverty pimps"

Please identify these "pimps," and explain how their conflict of interest is even remotely comparable to that of billionaire oil execs.

jhawkinsf 3 years, 3 months ago

Any agency that has X number of people it needs to serve will have a budget based on that number. If that number is reduced, so will their budget be reduced. If the number goes up, so too will their budget (or at least their request will go up, based on an increased number). They have an interest in keeping those numbers up. They have a disincentive to solve problems. Solving problems means a reduced number of people served and a reduced budget.
Look to the issue of addiction. Just a couple of decades ago, it was not even defined as a disease. Now it is. And it's being defined as such by the very people who are profiting from what has become a multi-billion dollar industry. And of course, now that it's a disease, it's being expanded all the time. One can be addicted to chocolate, sex, porn, almost everything. It's defined as a disease because it's then reimbursable. Expanding the disease model expands the industry itself. It seems like a clear conflict of interest to me.

jafs 3 years, 3 months ago

That's true of any and all government agencies as far as I know, and it's problematic.

Agencies always have their budgets adjusted based on what they spent the last year, so if they spend less, their budget gets cut.

It's not a great way to do it, since it does little/nothing to encourage efficiency.

jhawkinsf 3 years, 3 months ago

Pretty soon we'll all be classified as addicted to something. I'll have the disease of being addicted to writing post on the LJW, but that classification will happen only when it becomes reimbursable to some 28 day treatment facility. Relapse will be built in to the disease model. And the people running the treatment facilities are the same people who will be defining the behavior as a disease in the first place. And rather than run the risk that someone might be cured, the disease never goes away. The need for treatment never ends, unless reimbursement ends, at which time you're cast away. Ponzi couldn't have thought of a better scheme. No wonder "health" care costs are skyrocketing.

just_another_bozo_on_this_bus 3 years, 3 months ago

Do agencies need to submit budget requests to legislatures in order to get the funding to required to do their jobs? Of course they do. But they don't have $billions to hire lobbyists or contribute to political candidates and campaigns.

But they are at a huge disadvantage in competing with interest groups (well funded by folks like the Kochs) who lobby for the defunding of these agencies. And there are also millions of folks like you who have bought into the stereotypes of poor/disabled/addicted folks that folks like the Kochs have spent $million creating.

Making sure tax dollars are spent wisely and effectively requires due diligence on the part of all citizens, but we really don't get that-- all too often, what we get instead is a hysterical vilification of those who find themselves in need of assistance.

jhawkinsf 3 years, 3 months ago

If the Koch brothers, and people like them really spent so much money to lobby for the defunding of the safety net, yet that safety net still exists, then they are spending their money unwisely. Unless of course the arts are a part of the safety net.
The fact is the safety net is really big, yet the problems never go away. There is no incentive to solve problems, only to manage them with two very equal goals; the first goal is that the jobs of the problem managers are protected. And that goal can only be achieved by goal number two, managing the problem while simultaneously not solving the problem.

jafs 3 years, 3 months ago

I think that's a bit overstated.

You can see that they are being successful in KS at decreasing funding for education and social services, and if either of the two current tax proposals succeed, that will be further achieved.

Don't worry - the big money will undoubtedly win, now that corporations can spend unlimited amounts of money on political ads - that decision is recent - give it a few years.

And, although people may have a vested interest in keeping their jobs, I believe that those in social services are genuinely concerned with helping others.

How would you solve poverty? It's not a simple thing to figure out.

jhawkinsf 3 years, 3 months ago

A couple of quick thoughts. Spending for the safety net has increased over the years. If say something goes from 10 to 100 and then is reduced to 90, has it really been reduced? That's a matter of perspective. Compare spending say 100 years ago to today. Heck, compare 100 years ago to whatever number would result if every single cutback were enacted. You'll still see increased spending levels. I worked in social services for many years. And I know you've spoken about your wife doing the same. What i can say is that the people in social services are just like people everywhere. No one wants to see jobs eliminated. Those are their co-workers, their friends. So they come up with reasons why jobs should not be eliminated. Good reasons. It's called enlightened self interest. It's the same reasoning that the very rich use to justify their wealth. It's the same reasoning the very poor use to justify welfare. Everyone does it. Social service workers are no different.

jafs 3 years, 3 months ago

Of course it's difficult.

On these threads, we see a wide variety of opinions and feelings about levels/kinds of taxation, and how the government spends tax revenue.

So there's no consensus about the "correct" level/kind of taxes, or the "correct" way for the government to spend the revenue.

Even if our government was sincerely interested in following the will of the people, how would they do it, given these wide disagreements?

jhawkinsf 3 years, 3 months ago

I understood a very different message. Maybe if you took off those rose colored glasses, you'd see the true meaning.

Armstrong 3 years, 3 months ago

That would mean getting rid of the victim card. Can't have that.

Kirk Larson 3 years, 3 months ago

Give a man a fish and he'll eat for a day. Teach a man to fish and he'll spend the day on his butt drinking beer.

jafs 3 years, 3 months ago

I'm still waiting for your list of actions you consider "teaching someone to fish".

The only one you mentioned was public education - are you now a supporter of adequate funding and quality public education?

George Lippencott 3 years, 3 months ago

I can not claim to understand the social safety net as I can not even find all the pieces. It does appear that if you are low income and have no children or disabilities you are on your own. I do note that associated with the system are relatively low cost insurance programs. Whether one cans AFFORD THEM DEPENDS ON whatever other assistance is available.

If you are unemployed and not disabled it does look like you do not want to get seriously sick. Of course there is charity. Has anybody become aware of someone here in Kansas who while unemployed died or suffered long term because of a serious medical condition that was not treated by a hospital or clinic regardless of ability to pay?

Kirk Larson 3 years, 3 months ago

I've got something. A co-worker of mine at a previous job's wife was expecting. We were laid off and lost our health coverage. He kept his up through COBRA at a cost of about $450 a month. They had to induce labor in order to have the baby while they still could afford coverage. Everything came out OK, but I thought it horrific that they had to go to such lengths, not for health reasons, but to appease the bean counters.

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