“Keep your Socialist hands
off my Medicare!”
--Sign I saw at a Tea Party
rally, Nashville, Tenn.
“We’re a capitalistic
society, OK? I go into business, I don’t make it, I go bankrupt. They’re not
gonna bail me out. I’ve been on food stamps and welfare. Anybody help me out?
No.”
I offer these quotes not to
criticize but to illustrate how little most of us know about the hot-button
topic of “welfare.” Even though Mr. Nelson was ridiculed widely because he
apparently does not know that food stamps, welfare, and bankruptcy are forms of
being “bailed out” by someone else—namely taxpayers and solvent consumers—I
don’t think we should judge him too harshly.
In fact, I would argue that,
while some people may be better informed than others, it is human nature to
downplay our own weaknesses while we pin societal ills on the perceived
weaknesses of other people.
The subject of public
benefits fascinates me, in part because no two of us can agree on who should
get benefits, in what form, under what conditions, for how long, and for what
purpose. Even though it’s an intensely political issue, I hope to make a few
well-reasoned points based on facts and not just feelings.
If we want good answers, we
must ask good questions.
1) What do you mean,
“benefits”?
Broadly defined, just about
everything the government does confers some sort of public benefit. Most of us
drive on public roads, send kids to public schools, rely on the military,
police, fire department. Most of us pay taxes, too, but of course the amount
varies, as does how much benefit we receive. This is not what usually comes to
mind when we say “benefits,” though, although many argue that it should.
Everyone draws the line in a
different place, but I think we’re talking about:
a)
Social Security (including OASDI, SSDI, and SSI)
b)
Medicare
c)
Medicaid
d)
Food stamps (Supplemental Nutrition Assistance Program—SNAP)
e)
Cash assistance (Temporary Assistance to Needy Families—TANF)
It’s a lot of information,
so I made this table to cover the broad points:
Program
|
Wait, what?
|
Agency
|
Who funds it?
|
Who gets it?
|
Conditions?
|
How much?
|
Social
Security--OASDI
|
Retirement
|
SSA
(federal govt.)
|
Payroll
taxes (FICA)
|
Retired
people
|
Must have
worked 40 quarters, must have paid into system, must be a certain age
(varies)
|
Based on
how much you made and when you retired
|
SSDI
|
Disability
insurance
|
SSA
(federal govt.)
|
Payroll
taxes (FICA)
|
Disabled
people
|
Must meet
SSA’s definition of “disabled,” must have paid into system and worked
required number of quarters based on age when disabled
|
Based on
how much you made and your age
|
SSI
|
Disability
insurance
|
SSA
(federal govt.)
|
Payroll
taxes (FICA)
|
Disabled
people
|
Must meet
SSA’s definition of “disabled,” need not have paid into system or worked for
any length of time, but must have limited means
|
Up to $698
for a single person; $1048 for a married couple
|
Medicare
|
Health
insurance
|
Dept. of
Health and Human Services (federal govt.)
|
Payroll
taxes; also, premiums taken from the insured’s SSA check
|
OASDI
recipients; SSDI recipients who have been on SSDI for 2 years
|
|
|
Medicaid
|
Health
insurance
|
Dept. of
Health and Human Services (federal govt.) with each state’s Department of
Human Services
|
State pays
part; fed govt. pays part
(in richer
states, it’s close to 50/50)
|
People who
fit into certain categories only and then meet income and resource limits
|
Numerous
|
|
Food
stamps
|
Used to
buy food at the grocery store
|
Department
of Agriculture (federal)
|
Fed govt.
|
Households
under a certain income limit, once household size and certain expenses are
counted
|
Numerous
|
Varies
based on HH size, income, expenses, etc.; HH average is $133/mo.
|
Cash
payments
|
TANF, a
vestige of “welfare”
|
Dept. of
Health and Human Services (federal govt.) with each state’s Department of
Human Services
|
Mix of
state and fed govt.
|
Families
with children; must be under the income limit
|
5 year
lifetime limit; work requirement; family planning requirement
|
Varies
based on many factors
|
2) If we have Medicare and
Medicaid, why are people uninsured?
You’re eligible for Medicare
only if you receive OASDI (Social Security for the aged) or if you’ve been on
SSDI for two years.
You’re eligible for Medicaid
only if you fit into one of the categories that Medicaid covers AND you have
very low income and few assets. (Generally speaking, the categories are poor
single-parent families, nursing home residents, pregnant women, some children,
and people who receive SSI. Also, poor people on Medicare sometimes qualify to
have their premiums and some other costs paid by Medicaid.)
To qualify for Medicaid, for
example, a single parent with one child must have a net household income of
$896 per month and have assets (such as a bank balance) of less than $2,000.
So… unless you’re very poor
AND you fit into one of the categories, you can’t get Medicaid. A 36-year-old
single man, for example, cannot get Medicaid no matter how poor or sick he is.
Also, many employers don’t
offer health insurance, and those who do must ask workers to pay part or all of
the premiums, co-pays, and a deductible. One of my relatives works at a large,
established company and pays $350 per month in premiums with a $7,500
deductible for her health insurance.
Also, in this economy, it
can be a challenge to find any job, let alone one with health insurance.
Medicaid, Medicare, and
private group health insurance cover only part of the population. This leaves a
lot of people uninsured (or under-insured).
3) Why do illegal immigrants
get benefits?
In general, they don’t.
In order to get the benefits
listed above, you must prove that you are a U.S. citizen and that you have a
valid Social Security number. In some cases, non-citizens who have permission
to live and work in this country can apply for limited benefits after they’ve
been here for a set amount of time. (Five years of legal residency is common.)
This is not to say that
illegal immigrants don’t use some public benefits. They drive on public roads,
for example, and send their children to public schools. While even those who
don’t pay payroll or income taxes pay SOME taxes (gas tax at the pump, sales
tax, etc.) and contribute to the economy as a whole, I don’t know if it’s
“enough” to cover services received. Also, I’ll concede that it’s possible for
someone who is eligible for food stamps to buy food and then, for example,
prepare a meal for people who are not eligible for food stamps. Further, there
is a limited type of Medicaid that covers illegal immigrants: Certain hospitals
must accept anyone who suffers from a life-threatening emergency, such as a
heart attack or childbirth. The hospital must (very generally speaking) treat
the person until they are stable. These hospitals receive some Medicaid funds
to cover their expenses.
4) Are benefits a right—or a
privilege?
The Supreme Court held in
Goldberg v. Kelly 397 U.S. 254 (1970)
that
welfare benefits are a personal property right. This means that everyone who is
entitled to benefits has the right to receive them, and if the benefits are to
be terminated, Due Process is required: a written notice and the opportunity
for a hearing.
Under the Fifth and
Fourteenth Amendments of the U.S. Constitution, then, public assistance is a
Constitutional right.
The federal government and
the state governments (when the state is involved) can pass laws and make
rules, but they must not infringe on the recipient’s constitutional property
rights.
5) What about drug testing?
I think drug testing laws
can be written to pass Constitutional muster, but drug testing doesn’t seem to
be cost effective.
In jurisdictions where a
clean drug test is required before benefits are issued, an overwhelming
majority of recipients pass the drug test. (In Florida, over 98% of welfare
recipients passed).
There’s a confound here, of
course: People who are on drugs are not likely to take the test, which would
then remove them from the welfare rolls—but would also remove their children
from the welfare rolls, and some would argue that the child of a drug user
needs help just as much as (or more than) any other child.
Also, the modest savings
wouldn’t seem to justify the expense of administering and tracking the test,
processing the appeals for those who failed, re-testing, etc. Some states have responded
to this by making the welfare recipient pay for the test. The problem with this
is: If you’re needy, you won’t be able to afford the test. Also, many states
reimburse the cost of the test to those who pass, and taxpayers must pay the
administrative expenses, which puts us back to square one, cost-wise (except
for some of the failing 2%).
Still others have argued:
Why illegal drugs? You can’t test for other wastes of money, such as alcohol,
entertainment, some prescription drug abuse, tattoos, etc.
6) Why should people who
don’t work get benefits while I work and don’t get anything?
I think good arguments can
be made here.
It’s true that many people
who receive benefits DO work (or worked for many years until they could no
longer work). Some recipients work more than one job.
It would be disingenuous,
though, to say that everyone who gets benefits accepts them only as long as
they need them and uses the boost to get back to being a productive member of
society, as Craig T. Nelson apparently did.
To be honest, this is an
issue with which I wrestle. Morally speaking, what is society’s duty here? I’d
be very interested to hear everyone’s thoughts on this.
7) There’s a difference: I
worked and paid into the system in order to receive Social Security and
Medicare.
This is true—partially.
While a person (or their
spouse) must work 40 quarters and pay payroll taxes, in order to get Social
Security and Medicare, it’s not exactly like we’re all paying into a fund and
then getting back only what we paid into it.
I don’t wish to dishonor my
parents’ memory, but I’ll submit my own family as an example.
My father died in 2004, and
my mother died recently. My parents were decent, hard-working people. I believe
that they did their best to be honest, responsible citizens.
For much of her adult life,
my mother was a stay-at-home mother. My father was the sole breadwinner. He was
a veteran of two foreign wars and was a smart man, but we were not rich.
I don’t know how much my
father paid into the Social Security and Medicare coffers, but I am certain
that it was not enough to pay for his end-of-life care, which was well over $500,000,
nor was it enough to pay for my mother’s many years of experimental cancer
treatments and end-of-life care—to say nothing of their Social Security income.
While my parents were
responsible and worked hard, in this case, we took more than we gave—and other
people paid the rest.
8) Benefits help the poor at
the expense of everyone else.
Benefits do help the poor,
but they also help the rich and middle-class. Here’s how:
Food stamps began during the
Great Depression to help both poor people and struggling farmers. Still, when
you buy food with food stamps or your own money, you help farmers, grocery
stores, food companies, etc.
If you notice, it is not
poor people who lobby to have food stamps pay for more and more items
(including fast food!), it is corporate interests such as restaurants, large
grocery store companies, and large food companies.
People often complain that
food stamps should not be used for junk food. What do you think Monsanto, the
Coca-Cola company, retail chains such as Wal-Mart, and Dollar General Market
(which sells no fresh food) would say about that? Please note that J.P. Chase
Morgan is paid hundreds of millions of dollars to administer the food stamp
program in several states. When you consider who has the political power—hungry
poor people or wealthy large corporations—it is no surprise that efforts to
limit the scope of the food stamps program don’t get very far.
Similarly, efforts to cut
Medicaid and/or Medicare don’t just upset sick, poor people. Hospitals and
doctors and their related organizations, who hold considerable political power,
need to be able to treat more patients with more expensive treatments. The rest
of us benefit from having these hospitals, doctors, nurses, technicians,
research, MRI machines, etc., available to us, too.
My point is: These programs
are so far-reaching and are so intertwined with the economy that it’s not so
simple to cut benefits for anyone.
9) “I know someone who gets
food stamps and…”
Despite the efforts of the
federal and state governments, there is fraud.
Some possible scams:
Buying groceries with food
stamps and selling them to someone else for cash.
Faking a painful condition
and selling your Medicaid-sponsored prescription pain pills for cash.
Making money under the table
and then lying to your caseworker about it, thus qualifying you for food stamps
or maybe Medicaid.
If you know someone who is
doing this, report it! (Your state’s website has the phone number.) Someone is
stealing YOUR money and preventing an honest, needy family from getting help.
