The Audacity of Voters: Who 'Deserves' Medicaid?

Sometimes friends send me articles they think might be blog fodder. Sometimes multiple friends send the same article. That happened 2 weeks ago with a New York Times article called “Who’s Able-Bodied Anyway?” If you would like to check it out before I rip on things I read in it, here’s the link.

The article discusses the early intent of the Medicaid and other social welfare programs, and the progressive inclusion of more categories of people over time. In the beginning, such programs were for use only by people who could not otherwise provide for themselves—obviously disabled people. People with missing limbs or people who used wheelchairs, that sort of thing. The definition of disabled gradually came to include some people like us, whose issues are not so evident. Some of us do just fine out in the mainstream labor market; others not so much. When you have an issue your caseworker can’t plainly see, it makes it harder to prove the correlation between your problem and your productivity.

There are people out there who think that the expansion of Medicaid benefits to cover more categories of people was not a good thing. They think we are like people trying to board aircraft with an emotional support peacock. There’s someone sitting in my office chair right now who thinks pretty dimly of those people—people who go to the judgment place rather than the empathy place. Health privilege can manifest in ugly ways.

Conversations I’ve had with other people, and ones I’ve overheard recently, hit me differently now that I’ve had some exposure to the social safety net. People love to talk about who they think deserves help. People believe they’re entitled to judge that, at least in part because it’s “their money” that is paying for that help.

Debunking point:  In many cases, it’s not your money. In many cases, the people who need help already put in years on the work force and have front-loaded their participation in the safety net program by paying more taxes than they will ever withdraw from it.

Most people have no idea what the safety net programs are and how they work. They still think there is such a thing as “welfare.” When you don’t make enough money to live, you “go on welfare.” Welfare isn’t a thing, it’s a catch-all word for a variety of safety net programs, none of which result in monthly payments to able-bodied people who choose not to work.

The most commonly discussed of these programs is “food stamps.” First of all, it hasn’t been called that since the 1980s; update your language. It’s SNAP, the Supplemental Nutrition Assistance Program, also often referred to as EBT, for the Electronic Benefits Transfer card you use at the grocery checkout. It was designed to eliminate the books of actual stamps people once had to carry around. If you’re as old as I am, and haven’t spent your whole life sheltered in the suburbs, you remember waiting in line while the cashier matched up the stamps to the items on the belt and stuck them in the client’s stamp book to indicate that they had been used. It was cumbersome and stigmatizing to the people whose plight was on display.

Later, they used “funny money” certificates that worked like cash but were evident to anyone who looked. It’s much better now; you just use your EBT card like your debit card. Lawmakers have not adjusted to the name change; SNAP just doesn’t carry the Grapes-of-Wrath pathos that “food stamps” does.

Still, I don’t think the majority of people, including politicians, even know that’s what they’re doing; they honestly don’t know the name of the program they’re debating about. Some people don’t think that’s a big deal; it’s still evolved from the program that Kennedy started in 1964, but I think it’s a huge deal. Those people are only discussing the concept of food aid and not the specific program by which it’s delivered, or they would know what it’s called and how it works. It bothers me that people are allowed to vote on the program when they know so little about it. This affects the lives of real people; it’s not okay to half-ass your ballot, whether you are a Senator or Joe Plumber.

The notion that people with privilege think they get to decide whether or not someone like me deserves food or medical aid is just plain offensive. What do you know about my life? How are you so much better than me when we both did all the right things and I just happened to meet up with an inattentive driver a while back? Such hubris! American culture is built on the notion that you get to keep what you “earn” (Trustafarians:  inheritance is not earned!) and don’t have to share. This notion is in direct contradiction with the majority religion, a dissonance that Americans have worn comfortably for generations. Social media is full of memes reminding us that “the world” doesn’t owe us anything. I disagree. Economies are social constructs, designed to control distribution of scarce resources. Human beings do owe it to one another to cooperate and survive together. Look at our history so far—how’s competition working out for us? Housing, food, and health care are human rights. Everyone deserves those things, even my small-time former-drug-dealer neighbor. Once he tapped into those basics, he cleaned up and turned his life around.

Until we as a society decide that basic dignity is for everyone, and there is no “deserving class,” The Poor will be with us. I skated away from the original theme here, but my friends wanted me to comment on this article and this is where I went. To quote Dennis Miller, “That’s just my opinion; I could be wrong.” But despite what’s happening in DC, I think the tide is turning in my direction.