Social Service Blues

Posted: September 15, 2009 in Threat Quality

social services partnersA little while back, I hung out with a guy who – in justifying his habit of watching “Real Time with Bill Maher” – described himself as “an independent, not a Republican,” explaining that he was a die-hard atheist and believed in legalizing pot. “But, y’know, I don’t like big government or high taxes, and I’m against social programs.”

Our mutual friend (possibly seeing how visibly my skin was crawling) gestured at me and chuckled to his buddy, “Man, you are preaching to the wrong church.”

I smiled half-heartedly and listened to him yammer on about the Maher sketch, all the while wondering, “Am I just really naïve?”

I mean, I get the first two parts – I don’t agree, but I get it. Nobody wants “big government,” but that implies there are ways to make the government smaller somehow, and as far as I can tell, that ship has fucking sailed. (And it was a Republican president who created a whole new Department of Homeland Security to coordinate the efforts of all our other national security agencies – which has mostly served to add more complications, as I understand it.)

And I get not wanting higher taxes – I’m on the low end of the pay scale myself, and wouldn’t mind having an extra $20 on my paycheck every two weeks. But…taxes pay for a LOT of things. Things I want – rebuilt roadways, health care for the elderly, and things I don’t – like, say, massive military spending for fighter jets that never see action. I accept it as part of Where the Money Goes. And I don’t bitch. I’d like to see it go to more things I actually care about – just off the top of my head, public education, maybe? – but I also recognize it’s still gonna come out of my pocket. I am okay with this.

But being “against social programs”…this is where I get confused.

When conservatives say “social programs,” they usually mean “welfare.” But bundled up in there are things like “unemployment,” and “disability” and “Medicaid.” And while I don’t deny a lot of these programs get abused, I can’t see why anyone would deem them as unnecessary.

Because the fact of the matter is, people break. I’m a guy with a steady job, health insurance, all that. But let’s say I lose that job. I still need to live, while I’m looking for a job. So I’m going to apply for unemployment. You can’t judge me for that, right?

Let’s say I get whacked on the head on the job (less likely now than when I was climbing racks at Home Depot, I’ll admit) and can’t work to capacity anymore. I’m going to apply for disability.

Let’s say I go nuts. The generally faltering brain chemistry god gave me has gone just a tic too far to the unusable. Assuming I’ve got enough of my marbles left to keep off the streets, I’m going to need Medicaid.

These aren’t programs that are DESIGNED for useless people. They’re there so people have a safety net in case their lives are irrevocably fucked over. Which is, sadly, something that happens to people EVERY FUCKING DAY. And I am okay with part of my taxes funding programs that build that safety net.

(And I can pretty much guarantee that if the guy I was talking to that night loses his job or gets whacked on the head or goes kooky, he’s going to apply for those same programs. I’m not going to hear any pull-yourself-up-from-your-bootstraps crap out of him then.)

My jobs over the last few years may have colored my thinking on the matter. When I pushed carts at Home Depot, I ran into a lot of folks whose jobs had kinda crippled them. When I did research for an employee assistance program, I constantly answered desperate requests for info on food banks, state-run mental health, job training centers and other programs designed to help people who needed

In every job, I learned the helpful responses come from two fields – nonprofit organizations that were fighting like hell to survive, and government-funded programs.

Right now I write a newsletter that helps nonprofits find funding – in a time when the call for their services has never been higher, and resources have never been lower.

So maybe I’m a bit addle-minded, but considering the need for community-aid programs is greater than ever (I think the economy might have something to do with it), there are two ways to combat the problem – prevention and treatment. And assuming the people calling for an end to social programs aren’t donating a sizeable chunk of their paychecks to charities, the only other venue to receive such help is from government-assisted social services.

Okay. So that’s why I’m for government-aided social service programs. I’ve outlined my logic as clearly and simply as I can. And with this as my reasoning, I have to ask, how can anyone NOT be for these programs?

What am I missing?

  1. Lisa says:

    You must realize that these are the same people who advocate abstinence only sex education and then their teenage daughters get pregnant. These are the same people that call themselves “Pro-Life” and then advocate murder. These are the same people that say homosexuality is the most base of sins and are then arrested for solicitation in the men’s room.

    These people are averse to logic.

  2. V.I.P. Referee says:

    Yeah, it can be difficult to explain to people who are well and baseline stable, as far as survival goes, that there are some people who really aren’t and it’s not just a matter of wishing hard enough for a change to happen. “Society” is an arrangement built upon the ideal of: “Stay put, wait it out–don’t steal, don’t hoard, don’t kill if you deem it justified. Just be patient–we’ve got your back.”

    Misunderstandings about social programs often occur when people are, either, too isolated from or overexposed to social problems. In urban areas, where more assistance facilities are housed, there are concentrated numbers of people seeking or required to engage in social assistance programs, so the likelihood of seeing someone take advantage of these programs is higher. Like anything else, though, mythological glamour can distort perception; even the few (very infuriating, frustrating) who do abuse social service programs, are not getting much out of it. Maybe a flashy car or some other shiny trinkets to keep them distracted. Maybe they’re able to buy fast-food or expensive sneakers. Anything too obvious or traceable—like major purchases on cards, an illegal source of income—brings too much attention to their ways, so they have to live in the shadows of their own lives. They’ve traded their power in society for some cheap junk and shoddy, insecure housing. While that’s still enough to make most “hard-working” people angry, it’s easy to forget how sad that really is; why don’t people who abuse social programs want more–not just more junk, but more in terms of social legitimacy? Why do they socially “cheap-out” on themselves and their children? And I’m not talking about the percentage of people on social programs who’ve killed or raped or abused kids because they wanted to and then felt entitled to social support, I mean people who are otherwise not sociopaths, yet consciously make the choice of abusing people’s trust, setting them up for a lifetime of skulking around in their own lives. You have to believe there’s something unwell in that choice–some kind of message that’s not properly transmitting upstairs–and that attaining food stamps and free socks, is not just an establishment of “victory!” in some master plan. For the other 3/4 of people who utilize social service programs, temporary help is enough to set them in a more stable direction and the assistance is used to move toward goals—those elusive things that empower us.

    Social program “fatigue” happens, when the bulk of their burden is place on the backs of too few places; when everyone doesn’t carry a little piece of the “blanket”, it’s bound to engulf the few that do. Many people have heard the phrase “not in my backyard” and it’s very applicable here; if only one is doing all the work, when that bough breaks, everything falls. This very problem was recognized and addressed in medieval poor laws, in Europe (maybe not as nicely as it’s addressed now, but the same basic principles): The few places that offer the most assistance, cannot carry the entire burden of every village’s “beggars”. Towns can’t just send their unwell away–“out of sight, out of mind”–and expect someone else to foot the entire bill. I’ll bet some of the very people who are against any “Big Government” involvement in such matters, would also be against what would result from “Big Government” having no power over social assistance: Small, local government would be left entirely responsible for unwell locals. But, isn’t that what big cities are for–to care for sick or “problem” people that others don’t want to care for?

  3. braak says:

    The problem I suffer is, how do you explain this to the Ayn Rand guys–the ones that believe that everyone is accountable to themselves, and only themselves, and if you can’t make it on your own then you probably should die, and decrease the surplus population?

    It’s really hard to get people to believe you when you say to them, “Look, unless you grow your own food and spin your own fiber for clothes, you’re NOT self-sufficient. Your survival is utterly dependent on the survival of thousands of farmers and cheap day-laborers and unemployed autoworkers, most of whom you’ll never meet. No matter how great you think you are as an individual, YOU CANNOT SURVIVE WITHOUT THESE PEOPLE.”

    No one believes me when I point this out, even though it seems obvious to me. Sure you make a great salary, and you can afford a nice house. But where does your salary come from? Who is buying your product or your service? If THOSE people lose their jobs, where will you get your money? But, more importantly, where do your customers make THEIR money? What if THEIR customers lose their jobs?

    How the shit did you think this was going to work?

  4. V.I.P. Referee says:

    It is quite hilarious to think of some of those same, comfortable, armchair philosophers, chasing after sheep, working in fields, rendering fats and beeswaxes for candles and soaps (one of the greatest public health tools ever invented), milking cows, carving staves, digging wells—oh, that’s right! The magical gnomes emerge from their cozy burrows at night and do all that for us. That leaves so much time to think and ponder by daylight–or by lightbulb (magic–again!) during the night! I think it’s safe to say, that we’ve long since traded total, individual independence, for the possiblity of not spending the bulk of our lives just eeking-out a survival. That sort of thing can wear a body out and shorten our lifespans. It all goes back to the positive aspects of many, sharing in the burdens of living–humanity…

  5. V.I.P. Referee says:

    …and I’d be very surprised to find-out, that all those means of making life easier (plowing, carving, rendering), originated from the mind of one person, who’d never been influenced by any others’ discoveries…

  6. V.I.P. Referee says:

    …and Ayn Rand-ers should realize, that “biology” might not smile as kindly on them, in the event their hopes and dreams for humanity ever materialized. Just as strong a case can be made for the people deemed ill or “misfits” (by current standards and social circumstances) having an advantage over others, if social tides were to shift.

  7. V.I.P. Referee says:

    …channeling or transporting the water needed, to grow the crops used for food and fiber; the list goes on and on—how life can be made more bearable, even enjoyable, by sharing in its burdens with many. Even the most scaled-down, nomadic societies, understand the value of more-than-one. Sure, we can survive without casks and shoes, but we already know about that stuff. Now, we’d know what we were missing, while sitting and shivering, under a canopy of sticks covered in snow.

  8. braak says:

    @VIP: Milking cows? Making candles? These are the moronic activities of the intellectually inferior and incompetent labourers. Without wealthy industrialists, like Donald Trump, all those candle-makers would starve in a pit of their own imbecilic incompetence.

    Jeez, VIP, it’s like you’ve never even READ Atlas Shrugged.

  9. braak says:

    Pursuant to this, Jefferson Robbins has served up this neat little article on Ayn Rand.

  10. V.I.P. Referee says:

    Reading is for lazies.

  11. Megan says:

    The thing I like about things failing right now are things are becoming more affordable. I can start thinking I maybe a homeowner some point in my life. Yet here a case that the government is again catering to the wealthy. There are a lot of apartments up for rent in New York City. So you would think they would go down in price right? If the demands less the prices should go down and there are some places that is happening. Yet many landlords are keeping things more profitable by not renting the spaces because there is a huge tax break if you can not find someone to rent your space. Keeping the rent high is keeping your taxes low. So instead of having essential service people readily available by living in the city they work they have to commute into it. What property owner payed what politician to let that tax break pass?

  12. braak says:

    Well, I don’t know how it is in New York, but in Philadelphia you also get a similar tax break if you rent out the space at below the estimated value–so, it’s actually still in your interests, in many cases, to fill those spaces at the reduced rent value.

    Of course, property taxes are a function of the city government, not the federal government, so they don’t have a huge bearing on medicaid, unemployment, &c.

    Not only that, but cities are in a much rough spot when it comes to establishing progressive taxes. Wealthy people seem disinclined to move out of America (which still has the lowest taxes of any industrialized nation), but a wealthy person could easily move out of New York, or Philadelphia, or Norristown if the property taxes were too high, leaving the tax burden to fall primarily on those people least able to bear it.

  13. Jeff Holland says:

    That Rand article was very good, and does clarify what I was wondering about. In the end, it all boils down to opposing two schools of thought:

    We Are All In This Together
    I Am NOT in This With You People, Kindly Get Away From Me

  14. braak says:

    Also, here’s how you can tell if a philosophy is good or not. The philosophy that tells you to do the things you’ve always been doing, exactly the way you’ve been doing them? That is a bad philosophy. That is how you know you’re being scammed.

    If you read a book and it just confirms everything you’ve always believed, it is a trick.

    The other way is this: imagine the main proponent of a philosophy. Now, imagine a world occupied entirely by people exactly like that. Would you want to live in this world? After reading many interviews with Ayn Rand, I have determined that no, I do not want to live in a world of Ayn Rands.

  15. Erin says:

    Ayn Rand’s followers are particularly conservative libertarians: I don’t think they represent the majority of the party (though I’m not entirely sure about that: libertarian demographics change so rapidly, it’s hard to keep track).

    I’ve known a lot of libertarians over the years; some struck me as intelligent, others did not. In my experience, most tend to live outside of big cities, where government involvement is visible on a day to day basis. Also, they either tend to have REALLY good jobs (allowing them to set aside money), or have rich families they can fall back on.

    Personally, my biggest gripe is that most of them have no grasp how the world around them effects their lives. Even close friends I respect sometimes strike me as naive on this point. Social Darwinism, in addition to being morally disturbing, presupposes an equal playing field, and that just doesn’t exist. The government tends to act as an equalizer – admittedly an imperfect one.

    Philosophically, they reject any government interference. I’ve seen a lot of libertarian literature stressing that theirs is the most “American” (i.e.: the closest to what the founding fathers preached). To be fair, they’re probably right about this. Never mind the fact their beliefs are horribly outdated.

    Politically, the libertarians I’ve met occupy a weird middle ground: they’re far right on economic issues – I’ve heard them go so far as to call for a dissolution of police and fire departments (they want these funded privately by non-profits).

    At the same time, they’re far left on social issues: abortion, gay rights, and drug control (farther than me on drug control, actually: I’m open to discussing the legalization of marijuana, but I’ve known a lot of libertarians who wanted to legalize ALL drugs: cocaine, heroine; you name it). The exception is gun control, which they’re almost always against.

  16. braak says:

    I think that one of the problems that the conservative party has nowadays is that no one is sure who IS supposed to represent the majority of the party. It’s always had this schism between social conservativism and economic conservativism that, to my eye, is basically unsupportable. Glenn Beck is a really good example of this, actually, with his 9 principles or whatever, and they are mutually contradictory.

    But I’m not sure that there’s really is the most “American” of principles, since it’s clear that the one thing the “Founding Fathers” agreed on was the need for a flexible system of practical–not moral or philosophical–governance. Ayn Rand’s followers aren’t opposed to taxes on a functional or practical basis, but morally.

    And i don’t know how you can call that American. The first power awarded to Congress, by the US Constitution, is the power to tax the shit out of whatever it wants in order to provide for the general welfare.

  17. Lindsay says:

    Vaguely related anecdote: An actor that I’m working with now was telling a story the other day. He used to explain his disbelief that anyone could be against a single-payer health care system (back in the days when the clintons were going to fix it) thusly:

    Say you need to go to the doctor. You have a card, your personal card with your name on it. You go to the office, give them this card, and you get what you need. You get the care, the surgery, the specialist you need. You pay nothing, receive no invoice. Just hand them your card. Isn’t that worth 2% higher income tax?

    He claimed that even fucking stupid people can follow that.

  18. Moff says:

    What I can understand is an aversion and opposition to inefficient government. Like, I worked for a USDA subsidiary organization in college, and our Internet worked like this:

    – Our offices were on a university campus with superfast T1 access.

    – But because we were a federal agency, our Internet bypassed the university’s access entirely, traveled downtown to the federal building, and then from Lincoln, Nebraska, 500 miles to Colorado to a Forest Service headquarters, and then back to the federal building, and back to us.

    – This was for security purposes. The place I worked was the National Agroforestry Center. Whose problem, believe me, was not that people were dying to find out more about it.

    – As a result, it took every employee a full 30 minutes, at best, to fill out our online timesheets. Sometimes it took 45. Because we were on terribly old PCs using the above-mentioned Internet setup. Again, this was just to fill out a little form that said how many hours we’d worked the previous two weeks.

    It wasn’t quite, like, Kafka absurd, but it was totally annoying. And it was just how things were done. And this is just an anecdote, but my sense is that my brief experience with the government was hardly unique.

    I would have no problem with a major overhaul and streamlining of government programs. (I mean, who would — right?) And I guess I don’t understand why more libertarians and conservatives aren’t pushing more for that sort of thing, rather than just arguing that said programs should be flat-out eliminated. Would it take too much careful thought and nuance or something?

  19. V.I.P. Referee says:

    Ayn Rand’s work reminds me of Philip Johnson designs or other relics of the 1930’s (and I love me some “Art Deco” something fierce, so I’m not knocking everything the 30’s produced); elegant, gracefully stylized lines of beauty—and totally incompatible with humanity. Sacrifice any human touch and “Voila!”: Streamlined design. Ethereal, beautiful dreams that you have no desire to actually live in.

  20. V.I.P. Referee says:

    Moff – …and I’d bet their “security” measures were still lacking, when compared to what was protecting the university systems.

  21. V.I.P. Referee says:

    Lindsay – That’s how Norway does it. Need a heart transplant? It costs the equivalent of a $20 co-pay, up-front—and that’s simply because it’s one of the priciest procedures. Norway also happens to have one of the healthiest populations in the world, by all measures. Simple coincidence? ABSOLUTELY!

  22. braak says:

    @Moff: Yeah, it’s kind of amazing. It’s like, corporations are good not because they are efficient, but because they’re more efficient than the government. Because the market forces efficiency on a corporation, but the voting population has to force efficiency on the government, and i guess they don’t want to do that.

    I’m always struck by this idea that a privately-run healthcare system is going to be miraculously more efficient. I used to work for a company that was a healthcare broker, and let me describe how this works:

    When your company wants health insurance, it does not go to a health insurance provider. It hires a health insurance advocate, like an agent, to find a good healthcare program for them.

    That company does not go to a health insurance provider. They go to a SECOND broker, whose job it is to go to the healthcare companies, figure out which ones are best for you, and take a commission on you healthcare that you pay forever.

    This is because actual healthcare insurance contracts are purposefully too long and complicated for people to read, and are often not fully-distributed to private individuals, anyway. Go, as an experiment, and try and get a complete explication of an Aetna healthcare program without having to have to buy something. See if it’s easy.

    Anyway, you’re actually paying three companies when you get health insurance, each of whom has their own marketing departments, administrative departments, &c. &c., every time you make a health insurance payment.

    Is this…could this be…one of the few times that complexity actually serves to make things INefficient? IMPOSSIBLE!

  23. Erin says:

    There are cases where health insurance companies denied benefits due to typos, mistakes, or unrelated conditions, and the patient died as a result.

    Why aren’t these prosecuted as murder?

  24. braak says:

    Hm. I would be surprised if, at least some of the time, there were no civil wrongful death lawsuits in such cases.

    But who knows? Probably, part of it is that if you don’t get your health insurance money, you’re fucking broke.

  25. Erin says:

    Oh, I suspect there have been civil suits. In fact, I assume that health insurance companies have calculated the average annual loss due to wrongful death suits and compared that to savings from recision: these people are clearly brilliant economists.

    But, regardless of how a civil lawsuit turned out, I would think that denying someone a life saving service they paid for on a technicality would constitute premeditated murder, motivated by money.

  26. braak says:

    At the very least, it ought to constitute criminal negligence.

    I’ll bet if we look around, there’s a Law and Order episode where McCoy tried to prosecute a doctor, hospital, and health insurance company on criminal negligence and conspiracy.

  27. Jeff Holland says:

    I believe this is actually the motivation for Timothy Hutton’s character on “Leverage.”

    Ahh, fiction. Eases the pain.

  28. Erin says:

    @Braak: Criminal negligence would make sense for the CEO’s and executives (assuming you couldn’t find a more direct link). But, somewhere in the organization (or an outside law agency), there’s a lawyer who is locating a loophole and telling the agency to deny the claim because of it.

    That lawyer must know the consequences: they’ve presumably got all the patient’s information in front of them. They’re making the decision, because it’ll get them a better job review or, in many cases, an immediate bonus.

    They’re making a premeditated decision, motivated by concrete monetary advantage, that will kill someone. If the contractual loophole used can later be shown to be frivolous, trivial, or even illegal, then the crime committed – at least to my understanding – is not negligence, incompetence, or even manslaughter: it’s first degree murder.

    I doubt many cases of recision would work out that way: most probably involve gray areas, legal ambiguity, and other issues. But, based on some of the horror stories getting tossed around, it sounds like there are some that are that clear. I’d really like to see some of these investigated and prosecuted.

  29. V.I.P. Referee says:

    Well, Erin, you know how laws get made—always after something awful has occured and everyone looks around sadly or embarassingly and says something like: “Um, this is what was supposed to happen. So, uh, obviously this law was broken or not a good law because it didn’t serve to protect person and/or property.” It’s very sad. Laws are meant to serve as an instructional primer for avoiding potential disaster, but even masses of people sometimes don’t see it coming.

  30. braak says:

    @Erin: no, I guess you could make a pretty strong case that way. Though it would probably be hard to show the difference between premeditated action and simple incompetence. I mean, no one WANTS to defend themselves by saying, “Yeah, I guess I’m just a huge fucking moron!” But you could make a reasonable case that the actuaries, not being doctors, don’t have full knowledge of the potential consequences of their decisions.

    Of course, that’s something for the court to decide, as obviously it OUGHT to be doing.

  31. V.I.P. Referee says:

    Also, certain roles in a scenario dictate responsibility and blame is assigned/scaled accordingly. A doctor has an certain obligation to treat a sick patient. Hospitals have certain obligations to greenlight emergency surgeries and other immediately lifesaving procedures. Often, insurance companies make it difficult to reimburse hospitals for services, but they have no rights in dictating what kind of care a patient needs—that’s for the doctor to decide and the rest of the medical staff to respond to. Here is how situations like the one you’ve mentioned, Erin, can occur:

    1. A patient doesn’t know their human rights and refuses necessary services or is confused over the services available to them (or they’ve been influenced by thinking about related health bills, refuse care and are not deemed unfit to make decisions on their own behalf, by hospital staff);

    2. A hospital, including staff, has limited resources and attempts to stretch care as far as it will go, making choices against their legal responsibilities or professional opinions (against licenses–professional, occupational, State and Federal expectations). Sometimes these choices–based on financial limitations–result in improper care of a patient. U.S. hospitals are required to treat all humans who walk through their doors needing emergency care. That’s Federal–not just State–law. But hospitals aren’t magical pots of gold. Resources can run-out and when they do, hopsitals close-down (can’t let people die by deciding who deserves to live based on $, so, sadly, they just can’t be). Obviously, society doesn’t want this to happen.

    Therein is where the real problem lies and why the current healthcare debate is such a hot number: How do we interpret products and services that allow people to live—healthcare services, medication—monetarily? How do you define life in cents and dollars? Do you want to know something sobering? By our laws, a person’s life is actually worth about $1 million. That’s based-on what the monetary loss of one working adult is in the U.S. over the course of their remaining working life. Disturbing, when you think about it.

  32. V.I.P. Referee says:

    Oh, hospitals must espcially treat humans who are too young or unable to walk through their doors ;). So basically, in an ideal world, Docs and hospitals are not supposed to be swayed by money. But they often are and shouldn’t be put in the position of taking massive losses or not existing. That’s what the universal health-plan situation is; should we invest in a big pot of gold that can be distributed depending upon need and who pays into the system?

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