I find the idea that people on Medicaid may need to work to keep their benefits very intriguing. CNN Possible Medicaid Changes And it seems aligned to this exchange from the comments here. MP ACA Replacement and Freedom As usual when I asked about what the poor should be responsible for, someone inferred that I want them to die... Life Unworthy Which is silly of course or I would not be as charitable as I am. :-) By the way, their were multiple responses and I just picked Dennis' as an example.
G2A Keep America Beautiful
"It seems that people on the Left like to make that leap...G2A Job Creation Idea
I do not deem to judge people "unworthy of life", I am asking at what point are free adults in our society responsible for the choices they make in life and the consequences that follow?
Or is it the expectation that the hard working successful people have responsibilities in our society, including that they must keep paying extra to continually clean up after the other citizens?
Do Liberals expect anything from the unsuccessful people in our society in exchange for all the gifts?" G2A
"Seems you make the false assumption that all folks have the capacity to be reasonable rational responsible thinkers, and act on that thought. Our success or failure is not a perfect platform to compare to another, What is that saying "Never criticize a man until you've walked a mile in his moccasins."
Actually I think liberals expect more out of society (successful and unsuccessful people) than conservatives. Gifts?" Dennis
"Please elaborate. What do you expect from the unsuccessful folks who receive a large investment from the tax payers?" G2A
G2A Keep America Beautiful
36 comments:
They call them entitlements for a reason. People worked for them, and are entitled to them. Don't let the politicians who just gave themselves a pay raise, by the way, no matter what the machinations, tell you otherwise.
As even Donald Trump must understand at times, words do have meaning.
--Hiram
Oh come now... Medicaid and Welfare are not earned benefits like SS & Medicare... They are simply gifts from the tax payers.
""Seems you make the false assumption that all folks have the capacity to be reasonable rational responsible thinkers,..."
And I believe you MUST make that assumption. To assume otherwise makes you responsible for them, in at least the moral sense and, according to liberals, in the financial sense as well. START with the assumption that these folks caught a bad break in life someplace along the line, and now cannot help themselves out of their situation. YOU, or maybe a bunch of us together, should try everything we can to pull them out, and then be willing to accept that a few will backslide, and we will have to let go to help somebody that DOES want to improve their lot. The problem with government "entitlement" is that there are minimal if any expectations placed on these folks, no "progress goals," or "holistic helping" as private charity does.
About 75% of Medicaid recipients are either disabled, elderly, or children, and about 60% of those who fall outside of those categories already have a job (per KFF).
"As usual when I asked about what the poor should be responsible for, someone inferred that I want them to die."
Well, when you say things like...
"I am asking at what point are free adults in our society responsible for the choices they make in life and the consequences that follow?
Or is it the expectation that the hard working successful people have responsibilities in our society, including that they must keep paying extra to continually clean up after the other citizens?"
When it comes to health insurance, we know that people who don't have health insurance die at a faster rate than people who do. So when you support policies that make it harder for people to get health insurance, you are in fact suggesting that you're willing to make that trade-off. And your continuing incoherence on what you think our nation's health care policy should look like only reinforces that point.
"policies that make it harder for people to get health insurance"
I support no such policy... I question the morality of charging Peter for Paul's insurance... Especially when our society does little to hold Paul accountable for changing, improving, making better choices, etc.
So my point as usual... What can our society do to promote:
- dual responsible Parent households who only have as many children as they can afford
- citizens having skills, knowledge and a passion for continuous learning
Just writing people checks is not cutting it. Family Facts
Platitudes aren't policy.
Platitude: "a remark or statement, especially one with a moral content, that has been used too often to be interesting or thoughtful."
I guess I agree... That is why I asked "What can our society do to promote..."?
Our current policies are failing...
Or do you see this trend line as success?
Hey, I'm the one around here who talks brass tacks about policy. You still can't articulate anything coherent about health care. How about you come up with an idea for a change?
Brass Tacks?
Your consistent policy is to:
- raise taxes on successful people...
- increase the size and complexity of government...
- provide unsuccessful people with food, housing, healthcare...
- trust the bureaucrats and recipients take only what they need...
- repeat
I don't think that is much of a policy...
How about I try to nail you down on 1 health related policy?
What policy do you support to encourage poor people to get exercising and lose weight?
Here is a link you won't like
Ah, the old tired marshmallow theory trope. Brilliant. Look up the 2012 update of the marshmallow study by the University of Rochester and see how it applies.
What you discover is, per one summary:
"But willpower, it turns out, is not just a matter of will. A new riff on the marshmallow test suggests kids will wait longer—on average twice as long—for that second marshmallow if they have good reason to believe that it will actually come. Conversely, kids who are conditioned to suspect the marshmallow might not ever get there are likely to give up in half the time."
If you apply this to people in poverty, you'll find that taking what is there now is a perfectly rational decision if they don't believe that there is truly a benefit to waiting. That's why it's important to give consistent support to families in difficult circumstances so they can build the skills they need to grow out of poverty,
"When it comes to health insurance, we know that people who don't have health insurance die at a faster rate than people who do." --Sean
I would like to see evidence of that. Studies I have seen say that folks on Medicaid do not have any better health care than those who don't.
As for policy, I would point out that Obamacare, and Medicaid before it, are geared to providing better care to more people at a lower price, which is clearly not possible. That is ESPECIALLY true considering that all of these government programs actually DECREASE the supply of care providers by lowering payment rates and regulating the practice, rather than increasing the supply and letting the marketplace lower prices and improve quality.
As for the topic question, the supposed justification for Medicaid is that it enables people to work. That's a public investment in "human resources" and it makes sense at first glance. But the problem is two-fold: First, medical insurance does not equal medical CARE, and second, so long as the insurance is "free," there is no incentive to "return" to the work force. That's why refundable tax credits make a lot more sense, assuming that we can help people make the transition out of that entitlement mentality, and finding some sort of employment for them. My belief is that almost anybody can do /something/ to help themselves. And many still want to do that.
Sean,
Was there a policy in there that would help pressure folks to live better and lose weight?
From what I gather, what Sean is saying is that people make the decision to "accept" welfare on a rational basis. They are capable of deciding what is the best choice of those choices placed before them. It is simply a matter of offering them better choices and respecting their human dignity enough to make those choices. The current welfare system doesn't even begin to do that.
I really am not sure...
If you start with 320,000,000 Americans, some are going to be:
1. highly motivated doers
2. normal people
3. low motivation people
4. free loaders
Now any of them may land in the welfare hammock due to bad luck, however the folks near the bottom of the list will find it harder to escape. I am not sure what carrots / sticks it would take to get them going?
I have met enough people who seem fine living a minimalist (poor) life style as long as they get to do their own thing on their own schedule. So if someone is willing to pay their healthcare, food and housing, and they can make a little cash on the side... Life's good...
What I continue to propose is that we start out with the assumption that everyone wants the human dignity of making their own way, and the ability and desire to move toward that goal. We offer them the opportunities that their circumstances, from whatever derived, have prevented them from accessing, and then EXPECT that they will grab hold of those opportunities. Only when we are certain they understand the opportunity and reject it, do we abandon them to the "education" of the "real world." Again, I go back to Wisconsin for the example. When "workfare" was first introduced-- you had to sign up for job training or placement to get your welfare check-- 20% of recipients simply refused and were dropped from the welfare rolls. What happened to them? Nobody knows, but it is assumed they did not need it, somehow. The problem solves itself; the trick is in making the opportunities truly available and connecting these folks to them. Like holding a school voucher lottery where everybody wins, not just 1 out of 100.
The point on the marshmallow test is that your past experience impacts the decision you make. For a person who doesn't trust that you can get two marshamallows for waiting, taking the first marshmallow now and figuring out the rest later is a rational choice. If you apply that to folks who in particular are born into poverty, they're ingrained with that short-term mindset essentially from birth. That's why we need to support poor families, so we can give them the space they need to develop the skills and judgement needed to truly escape poverty. It's not as simple as saying poor people are stupid or irrational or lacking in virtue.
"Was there a policy in there that would help pressure folks to live better and lose weight?"
Nope. Because it's not one of top pressing issues as it relates to health care right now for me.
But I'd be fine with applying some form of wellness programs within our existing government-run programs -- from a carrot-only perspective where people who participate in the program could get reduced out-of-pocket costs.
Sean, I think we are saying the same thing as the experts, that you have to start with assuming these folks are NOT stupid or irrational or lacking in virtue, but rather these things are the results of the situation "society" has put them in, or allowed them to fall into. That is the assumption. What then has to follow is that you must offer these people better choices. One of those might be "wellness programs" on the public dime, but wouldn't it be better to give these folks economic opportunity and let the economic success that follows bring them to these better behaviors? After all, most of the people on diets and determined to eat healthy are those in the higher economic strata. They also have fewer children. Trying to coerce or cajole these behaviors is difficult, but allowing them to happen naturally as a result of solving the basic underlying problem of poverty is a much easier way.
To a certain point I agree. But the reality is that their knowledge, development and beliefs can and likely are very flawed and/or incomplete. And yet like normal humans they are confident that they are capable and knowledgeable. (ie I do not need to listen to "you".)
The above are learned from Parents and Peers... And unfortunately the knowledge, development and beliefs of baby makers is likely flawed and/or incomplete. So it is very challenging for the student to exceed the capabilities of the mentor.
That is why HCZ Programs have to surround the Parents, Neighborhood and Kids.
By the way, this is not "offering them and opportunity"
"When "workfare" was first introduced-- you had to sign up for job training or placement to get your welfare check-- 20% of recipients simply refused and were dropped from the welfare rolls."
This is forcing them to do something if they want to keep getting their checks. I highly approve.
Sean,
If you don't think stopping obesity among poor people and everyone is highly related to controlling health care costs. I think you will need to do some more research. :-)
As for...
"But I'd be fine with applying some form of wellness programs within our existing government-run programs -- from a carrot-only perspective where people who participate in the program could get reduced out-of-pocket costs."
That makes me think of my company's wellness program... They try to spin it as a carrot program. On my full family low deductible program they say "I can save $250/mth if mine and my wife's blood work and blood pressure stays good..."
Of course many see it as "you will pay $250/mth more if you don't control your blood pressure, cholesterols, sugars, etc".
Apparently carrots and sticks are in the eye of the beholder.
"By the way, this is not 'offering them and opportunity'..."
Yes and no. Some of the 80% got jobs, and for them it was an opportunity. Some of those would have accepted the carrot without the stick, others might not, but apparently 20% didn't want the carrot at all, in spite of the stick. Best to have eliminated those folks early in the process, and since they didn't die in the streets, it seems they really didn't need the help offered. Isn't this exactly, in very broad terms, how government welfare needs to work?
Granted that changing long-standing attitudes and behaviors is going to be difficult, and is not going to get done with 100% carrots, but that is where we ought to start, taking the "cream" of welfare recipients, the easy cases, and helping them first.
As you noted... We do not know what happened to them... Maybe they did die pre-maturely? Just noting... :-)
You can preach carrots all day long... But I think you are a stick guy... Most older Conservatives are.
Cutting benefits in order to force people towards making a good decision is a stick according to most Liberals. I call it logical, caring and productive.
If my children are wasting family money, sitting on their phones a lot and not being active in getting side jobs. I sure don't motivate them by giving them more cash. Unfortunately too many Parents do and their kids struggle when real life hits.
My guess is that those who were cheating the welfare department were probably leading dissolute lives in other ways so, yes, they probably did die prematurely. It's not the fault of the system, nor of those who set the "strings" that accompany public money. They were handed the responsibility for managing their own lives, they chose their path and paid whatever consequences followed. Too much "guilt-tripping" to the welfare funding mechanism, resulting in "misplaced compassion" at least, if not waste, fraud and abuse.
What liberals choose to call a stick does not much concern me. They would call it a magic wand if it suited their political purposes. To me we are not cutting benefits or "forcing" anybody to do anything so long as we present them an completely reasonable and attainable opportunity to continue to receive them. Granted that a government bureaucracy is a poor and imperfect way to do it, it still needs to be done. Working for Medicaid, if you have no job, seems a reasonable place to start.
They had responsibility for their lives before the benefits were cut also...
They didn't take on the responsibility then either...
As I said, reducing benefits and making people work for a living is in no way a carrot.
And I am fine with that.
I'm not proposing a cut in benefits, just to be clear. They were NOT, IMHO, "responsible for their lives" if someone else is giving them money for nothing. Letting people take back that responsibility by giving them an opportunity to earn those benefits may not be a carrot, but it isn't exactly a stick, either. How the individual perceives the work requirement is a big clue as to whether they are willing to accept that personal responsibility necessary to be given the freedom associated with NOT being on the public dole.
And it doesn't work when applied by force:
http://dailysignal.com/2017/03/17/work-requirements-in-medicaid-wont-work-heres-a-serious-alternative/?utm_source=TDS_Email&utm_medium=email&utm_campaign=MorningBell&mkt_tok=eyJpIjoiWVRGalptUXhZV1psWkRaaSIsInQiOiI2M2wxTFhiYzZ6VVp4S0o1N1lIVEkzMEE0dmtEajhsSUhoZXhqaEN6T0xnREpjM2QwaG1NZGFEN3NWYTMxY3JadTNQTG5NXC82RTNhK1ZcL283UzBjS2lReENoRll3QTliN0NXNVZteWlhUUE0UDlHcmpNZWY3MmtiTmlyTTgwdVNRIn0%3D
DS Work Reqts will Not Work
That's not what I got out of the link...
I read that force works for cash benefits but not medical benefits.
"While work requirements in Medicaid would be theoretical and symbolic, a serious work requirement for ABAWDs receiving food stamps has already been implemented with great success."
I (and the article cited) agree that "force" does not work for medical benefits, either politically or as a matter of actually achieving the stated goals. Apparently it works wonders for cash or for food stamps. Remember I said that WI workfare shed 20% off the rolls immediately? And Maine achieved 80%?? Wow. I think they're on to something.
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