Reporting Medicare/Medicaid Abuse

[music2doc]

Has anyone here ever dealt with reporting patients who repeatedly (and expensively) abuse the Medicaid/Medicare system? I probably see at least 10 patients/wk who are obviously abusing the system (of the 100 or so I personally see each week, about 60% of whom are Medicare or Medicaid). For instance, just recently I had a patient (<64 y/o) on Medicare and Medicaid due to a supposed physical disability, yet somehow he managed to supplement his government pay-outs as a professional wrestler. He did not appear to have any other disability (i.e., his only disability was, shall we say, apparently nonexistent). Now, tell me how this is at all appropriate? Yet, I see hundreds of these patients each year who apparently defrauded and deceived their way into Medicare/Medicaid as well as those who, while marginally eligible, have milked these "free" services for all they're worth (e.g., by demanding unnecessary and costly tests of physicians and making -- and then following through with -- threats to sue whenever they don't get their way).

Since this obviously hinders our ability to provide free/charity (as well as paid) care to people who actually need it (i.e., limited resources), this is a great hindrance to access and is, therefore, unethical. (It also causes harm to the community, healthcare providers, and other patients while often providing little or no benefit to the patient being served under false pretenses.) Yet, when I looked online for fraud reporting forms on the CMS website, they do not appear to have any for reporting patient abuse! The only forms and information there are entirely centered around reporting your healthcare provider!!!

Now, just to put some numbers to this issue, if my experience (which is primarily ER but has also included in-patient work, which has generally had similar percentages) is at all representative of Medicare and Medicaid reimbursement, a whopping 1 in 6 Medicare/Medicaid reimbursements are complete fraud on the part of the patient! This means we, as taxpayers are throwing away TENS of BILLIONS of dollars toward de facto criminals! (The overall budget between these programs is around 1 TRILLION dollars, but the amount actually going to those 1 in 6 is likely <1/6 of that trillion, so to be conservative, I am estimating in the tens of billions and not >100 billion as would otherwise be expected.)

Any thoughts on this? Are there forms/resources I am missing on the CMS website or elsewhere? One would think there are ways for healthcare workers to make such reports as we are the front line. Further, what are the HIPAA implications of making such a report?

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[Celerity]

Welcome to the entitlement state.
I have seen many times where people come to the ER just to get their BP checked Bc they don't want to buy a good cuff and it's cheaper to fake a headache and come to the ER. There is really nothing you can do. Thats one reason why we have runaway national debt, Bc once you give people a handout you can't take it back.

Here is another example:
My mother is a nurse and works at a dentistry clinic that specification deals with Medicaid/Medicare. Parents of these kids that come in drive nice cars and have expensive jewelry, kids have cell phones etc. All of these kids are under ten and have at least $5k worth of work done. You wouldn't believe the amount of work that goes into these kids bc they dont brush their teeth and the parents send them to bed every night with milk.Crowns, caps, root canals all paid for by us. And they come back a year later to have the same work done again bc they still don't brush their teeth. Most of the parents don't speak English, and when you tell them if they have a health problem after the kid gets home they respond with "we go to ER?"

 

[link2swim06]

It obvious most people think health care is a right...this is the only "right" I know of which requires others knowledge, effort, and other people's money.

But that is what happens when the government starts giving out others people's money for votes...

 

[gdfernan]

How dare you Republican voting Glen Beck listening 1% criticize our entitlements to receive whatever we want from 'Big Gobmint'. We have voted for it and therefore we deserve it, and if you disagree, we will come and occupy you.

Free Healthcare becuase it is a basic right (right now), free housing because it is a basic right (tomorrow), free education because it is also a basic right (including taxpayer funded medschool, after Glorious Obamacare kicks in). Free smart phones and carib cruises because that too will be a basic right (in the future). Who decides on what is a basic right? Why it is us, the 99%. Whatever we vote on is a basic right that the Big Gobmint has to give us.

Long live the Glorious Revolution and the Dear Leader.

 

[Celerity]

It obvious most people think health care is a right...this is the only "right" I know of which requires others knowledge, effort, and other people's money.

But that is what happens when the government starts giving out others people's money for votes...

A right that requires compulsory service of another person is not a God-given right. It is a pseudo right.

 

[link2swim06]

A right that requires compulsory service of another person is not a God-given right. It is a pseudo right.

Exactly...but I think its obvious hard work is not a core value of America anymore, rather its all about some perverted sense of fairness our president loves to talk about.

 

[candav]

Exactly...but I think its obvious hard work is not a core value of America anymore, rather its all about some perverted sense of fairness our president loves to talk about.

Legitimate (hypothetical) question. Two people of equal ability in every way, one born into a wealthy, privileged family, the other born into incredible poverty. Do you believe that equal amounts of "hard work" will bring these two individuals to the same level of future attainment? If not, then how can we say the current system is "fair", or that success is based solely on the concept of "hard work"?

 

[CodeBlu]

Has anyone here ever dealt with reporting patients who repeatedly (and expensively) abuse the Medicaid/Medicare system? I probably see at least 10 patients/wk who are obviously abusing the system (of the 100 or so I personally see each week, about 60% of whom are Medicare or Medicaid). For instance, just recently I had a patient (<64 y/o) on Medicare and Medicaid due to a supposed physical disability, yet somehow he managed to supplement his government pay-outs as a professional wrestler. He did not appear to have any other disability (i.e., his only disability was, shall we say, apparently nonexistent). Now, tell me how this is at all appropriate? Yet, I see hundreds of these patients each year who apparently defrauded and deceived their way into Medicare/Medicaid as well as those who, while marginally eligible, have milked these "free" services for all they're worth (e.g., by demanding unnecessary and costly tests of physicians and making -- and then following through with -- threats to sue whenever they don't get their way).

Since this obviously hinders our ability to provide free/charity (as well as paid) care to people who actually need it (i.e., limited resources), this is a great hindrance to access and is, therefore, unethical. (It also causes harm to the community, healthcare providers, and other patients while often providing little or no benefit to the patient being served under false pretenses.) Yet, when I looked online for fraud reporting forms on the CMS website, they do not appear to have any for reporting patient abuse! The only forms and information there are entirely centered around reporting your healthcare provider!!!

Now, just to put some numbers to this issue, if my experience (which is primarily ER but has also included in-patient work, which has generally had similar percentages) is at all representative of Medicare and Medicaid reimbursement, a whopping 1 in 6 Medicare/Medicaid reimbursements are complete fraud on the part of the patient! This means we, as taxpayers are throwing away TENS of BILLIONS of dollars toward de facto criminals! (The overall budget between these programs is around 1 TRILLION dollars, but the amount actually going to those 1 in 6 is likely <1/6 of that trillion, so to be conservative, I am estimating in the tens of billions and not >100 billion as would otherwise be expected.)

Any thoughts on this? Are there forms/resources I am missing on the CMS website or elsewhere? One would think there are ways for healthcare workers to make such reports as we are the front line. Further, what are the HIPAA implications of making such a report?

The short story? No one cares enough to make that big of a fuss...

Seriously. I agree with everything you're saying. It's stupid for us to waste money and clog up our healthcare system with these people, but... the sad reality is... money is money. The hospitals care about getting paid, the doctor wants to make a living too. So if you go around soothsaying, or whistle blowing... well... you know what happens to those people.

 

[link2swim06]

Legitimate (hypothetical) question. Two people of equal ability in every way, one born into a wealthy, privileged family, the other born into incredible poverty. Do you believe that equal amounts of "hard work" will bring these two individuals to the same level of future attainment? If not, then how can we say the current system is "fair", or that success is based solely on the concept of "hard work"?

Ahh, see you are assuming a very false premise...which is welfare, free healthcare, etc is going to help the family in poverty. A large majority are in poverty not because they dont make enough, rather they have no idea how correct budget their money. Therefore how is giving them more money going to fix the problem? Currently, you give someone poor food stamps so they take their extra money and buy an iphone...how does that make sense?

If I was in poverty I would put food, education and health insurance in front of iphones, cars, cable TV, etc...however this is not the case of many of those receiving welfare.

The current system is merely a bandaid on a much larger problem and completely fails to "fix" anything except cause those receiving entitlement to want more "free money".

I agree there is a huge disparity of quality of education received across this country, which is honestly the core problem has this viscous cycle. Teach these people how to contribute to society...thats the fairest way for everybody.

 

[candav]

Ahh, see you are assuming a very false premise...which is welfare, free healthcare, etc is going to help the family in poverty. A large majority are in poverty not because they dont make enough, rather they have no idea how correct budget their money. Therefore how is giving them more money going to fix the problem? Currently, you give someone poor food stamps so they take their extra money and buy an iphone...how does that make sense?

If I was in poverty I would put food, education and health insurance in front of iphones, cars, cable TV, etc...however this is not the case of many of those receiving welfare.

The current system is merely a bandaid on a much larger problem and completely fails to "fix" anything except cause those receiving entitlement to want more "free money".

I agree there is a huge disparity of quality of education received across this country, which is honestly the core problem has this viscous cycle. Teach these people how to contribute to society...thats the fairest way for everybody.

Thanks for the response. I'm Canadian and we hold our social welfare quite closely to our national identity, so it's not often I hear this side of the argument. I suppose my follow-up question has to do with where public health insurance programs fall into this schematic -- wouldn't free health insurance for those who cannot afford it be prerequisite to their attaining the skills necessary to "contribute to society"? Do you disagree with the premise of public health insurance, or just the current implementation?

 

[link2swim06]

Thanks for the response. I'm Canadian and we hold our social welfare quite closely to our national identity, so it's not often I hear this side of the argument. I suppose my follow-up question has to do with where public health insurance programs fall into this schematic -- wouldn't free health insurance for those who cannot afford it be prerequisite to their attaining the skills necessary to "contribute to society"? Do you disagree with the premise of public health insurance, or just the current implementation?

I dont agree with public health insurance from a fundamental standpoint...imo you dont have a right to somebody's services.

I am not opposed to the government offering a low-cost insurance which is at discounted price, but it should never be free. By giving stuff away you make people forget that it is not a right. People are not going to take responsibility for themselves until they have to....

 

[V5RED]

I dont agree with public health insurance from a fundamental standpoint...imo you dont have a right to somebody's services.

I am not opposed to the government offering a low-cost insurance which is at discounted price, but it should never be free. By giving stuff away you make people forget that it is not a right. People are not going to take responsibility for themselves until they have to....

Services you currently enjoy for free:
Police-I am not simply referring to cases where they locate kidnapped children. The fact of their existence allows you to walk to the store without being robbed by whoever decides they want your things.
Fire Departments
Public Schools-maybe you went to private schools all your life, but without public schools most people could not afford an education
Roads and Highways existing and staying usable

I am sure there are many I am forgetting, but the point is that you currently enjoy many people's services for free.

If you want to make the argument that your tax dollars pay for these things, then the same argument could be made for free health care. If you want to make the argument that you should not have to pay for the health care of others since you can pay for your own, then you have to explain why tax dollars can be used to fund things like low interest college loans, college grants, scholarships, and residency programs since people not going to school do not benefit from these.

 

[stichchick]

Physician abuse of Medicare & medicaid is so much more than patient abuse. Physicians are the one who bill that extra procedure. I have seen a PCP bill 'well child' visits on patients that did not come to her office in a year....

Stop pointing fingers at the poor & let us focus on fraud & abuse of those in power....

 

[stichchick]

Also, if medicaid was to be eliminated, we all would receive only $2 (about) on our paychecks.
Medicare is based on taxes & it is very good at keeping the elderly out of poverty.

As future physicians, I think you all who critics these programs, should be a bit more ethical and sensitive to these issues. There is no need to be a greedy douchebag & we should see what underprivalged populations face.

As for those w/ nice nice cars & smartphones, we are all exposed to the same consumerism. You do not know by how many saved checks or means they acquired this.
As if you never bought a Luis Boutin bag....

 

[Morzh]

Thanks for the response. I'm Canadian and we hold our social welfare quite closely to our national identity, so it's not often I hear this side of the argument. I suppose my follow-up question has to do with where public health insurance programs fall into this schematic -- wouldn't free health insurance for those who cannot afford it be prerequisite to their attaining the skills necessary to "contribute to society"? Do you disagree with the premise of public health insurance, or just the current implementation?

Americans, culturally and constitutionally, hold "liberty and justice for all" in greater esteem than economic equity for all (at least when push comes to shove and the two are in conflict with each other, as happens occasionally). There is no such thing as free health care. Even for people who are so poor that they don't pay taxes, they still pay for it in other ways.

It's also important to differentiate between health care and health insurance. Health care is what an individual pays for out-of-pocket until they reach their deductible limit for any given year. Insurance is what you buy to protect yourself from excessively high health care bills, should you be seriously injured or become ill. You pay monthly premiums into a "risk pool" and that pool is used to cover the post-deductible/out-of-pocket costs for the unfortunate ones that have a lot of expenses. Few people are opposed to subsidizing the cost of health insurance itself for the poor. What people are opposed to is subsidizing any and all upfront health care costs, thereby removing any incentive for these people to be sensible and careful with how much they consume. We just want people to have some skin in the game and to pay, in good faith, what they are able to.

Nobody thinks that the poor should be totally left uncovered. What makes people mad is A, seeing too much much of their hard-earned income being taken away to subsidize welfare, B, seeing so many of the recipients of that welfare living wasteful, unproductive, and ungrateful lives, and C, seeing the inefficiencies of the state and federal governments.

People wouldn't be so anti-government if they felt like they could trust the government to be sensible and prudent with the funds we give them. People wouldn't speak so derogatorily of welfare recipients if they saw that they were actually hard workers and honest folks who are just in need of some extra help. The high income earners don't mind giving up 10, 15, or 20 percent of their income in taxes if they know that's it really is being put to worthwhile uses. But they get pissed and start finding ways to manipulate tax loopholes when the government starts trying to take 30, 40, or 45% of their income. That's just too much; over the line.

I'll share a personal example. My wife was on medicaid when she was pregnant. I was only able to work part-time since I was a full-time student, and we were really grateful to have medicaid because it allowed me to stay in school. We understood that these were "sacred" funds, as it were... paid for by our more secure neighbors and community members through their taxes. We made a conscious effort to never consume more than we had to. And we knew that it was only temporary help. Through our future taxes we will repay what we were given many, many times over. And I'm happy to pay those taxes to support other young, poor, and hardworking families. Unfortunately far too many people will take what they are given and waste it.

 

[link2swim06]

Services you currently enjoy for free:
Police-I am not simply referring to cases where they locate kidnapped children. The fact of their existence allows you to walk to the store without being robbed by whoever decides they want your things.
Fire Departments
Public Schools-maybe you went to private schools all your life, but without public schools most people could not afford an education
Roads and Highways existing and staying usable

I am sure there are many I am forgetting, but the point is that you currently enjoy many people's services for free.

If you want to make the argument that your tax dollars pay for these things, then the same argument could be made for free health care. If you want to make the argument that you should not have to pay for the health care of others since you can pay for your own, then you have to explain why tax dollars can be used to fund things like low interest college loans, college grants, scholarships, and residency programs since people not going to school do not benefit from these.

First there is a big difference between the police and healthcare. The police and fire dept. protect everyone's rights and liberties as a citizen. Entitlements only benefit a small portion, if I make 100K per year I cannot get the same things someone who makes 10K can get.

I already said I support education because it prevents the welfare state.

Question to all those who are for the "welfare state" explain to me why people on welfare are not drug tested in most states, are allowed to have cell phones, cable tv, cars, etc?

Also why do people NEED air conditioning? I lived without it for 4 years in college and survived fine.

 

[kduck]

Services you currently enjoy for free:
Police-I am not simply referring to cases where they locate kidnapped children. The fact of their existence allows you to walk to the store without being robbed by whoever decides they want your things.
Fire Departments
Public Schools-maybe you went to private schools all your life, but without public schools most people could not afford an education
Roads and Highways existing and staying usable

I am sure there are many I am forgetting, but the point is that you currently enjoy many people's services for free.

If you want to make the argument that your tax dollars pay for these things, then the same argument could be made for free health care. If you want to make the argument that you should not have to pay for the health care of others since you can pay for your own, then you have to explain why tax dollars can be used to fund things like low interest college loans, college grants, scholarships, and residency programs since people not going to school do not benefit from these.

I'm not sure what you mean by "enjoying services for free," but people who pay taxes are not enjoying those services for free. They are paying for them. In areas where it isn't rolled into local taxes, people actually pay out of pocket specifically for things like firefighter services, and don't have access if they don't pay.
http://thinkprogress.org/special/20...see-fire-fighters-family-home-burn/?mobile=nc
So as you can see... nothing comes for free, and neither does Medicaid/Medicare. In the cases of services supported by tax money, there has been a consensus that the societal benefits from having the service are greater than the societal costs of paying for it. What people are arguing against is a system in which benefits may be unclear, despite high costs.

 

[link2swim06]

Also, if medicaid was to be eliminated, we all would receive only $2 (about) on our paychecks.
Medicare is based on taxes & it is very good at keeping the elderly out of poverty.

As future physicians, I think you all who critics these programs, should be a bit more ethical and sensitive to these issues. There is no need to be a greedy douchebag & we should see what underprivalged populations face.

As for those w/ nice nice cars & smartphones, we are all exposed to the same consumerism. You do not know by how many saved checks or means they acquired this.
As if you never bought a Luis Boutin bag....

Oh I see its ethical for the deadbeat who sits on his ass all day to take my money that I have spent my time to work for.

You are being naive and shortsighted, the government's role isnt to take my money and give it to someone else. It is my right to donate to charity if I choose.

And pertaining to the bolded statement, you are basically telling me I should help fund someone with the means to buy a smartphone?

 

[V5RED]

I'm not sure what you mean by "enjoying services for free," but people who pay taxes are not enjoying those services for free. They are paying for them. In areas where it isn't rolled into local taxes, people actually pay out of pocket specifically for things like firefighter services, and don't have access if they don't pay.
http://thinkprogress.org/special/20...see-fire-fighters-family-home-burn/?mobile=nc
So as you can see... nothing comes for free, and neither does Medicaid/Medicare. In the cases of services supported by tax money, there has been a consensus that the societal benefits from having the service are greater than the societal costs of paying for it. What people are arguing against is a system in which benefits may be unclear, despite high costs.

You clearly did not read my entire post.

 

[kduck]

You clearly did not read my entire post.

Or maybe you didn't understand all of mine? You argued that if society pays for things that not everyone benefits from, like student loans, then healthcare for the elderly and poor should be included in that. My rebuttal to that statement was that the societal benefits of such a system are considered unclear by some people, and that this draws their worthiness of tax dollar funding into question.

 

[V5RED]

First there is a big difference between the police and healthcare. The police and fire dept. protect everyone's rights and liberties as a citizen. Entitlements only benefit a small portion, if I make 100K per year I cannot get the same things someone who makes 10K can get.

I already said I support education because it prevents the welfare state.

Question to all those who are for the "welfare state" explain to me why people on welfare are not drug tested in most states, are allowed to have cell phones, cable tv, cars, etc?

Also why do people NEED air conditioning? I lived without it for 4 years in college and survived fine.

I never made the argument that free health benefits should not apply to everyone. Your stance on entitlements is a bit of a straw man with regard to my post.

 

[Starlightembers]

OP: As a Medicaid recipient, I agree. If a patient is abusing the system, they should be reported and have their services removed. Not only is it fraud; but it harms those who access such services legitimately.

Legitimate (hypothetical) question. Two people of equal ability in every way, one born into a wealthy, privileged family, the other born into incredible poverty. Do you believe that equal amounts of "hard work" will bring these two individuals to the same level of future attainment? If not, then how can we say the current system is "fair", or that success is based solely on the concept of "hard work"?

It is possible that the person born into poverty will achieve the same level of success; however, it will require more work and struggle on the part of that person. From lack of resources to lack of role model (in one's parents), there is more to overcome. And, no, it is not fair.

Ahh, see you are assuming a very false premise...which is welfare, free healthcare, etc is going to help the family in poverty. A large majority are in poverty not because they dont make enough, rather they have no idea how correct budget their money. Therefore how is giving them more money going to fix the problem? Currently, you give someone poor food stamps so they take their extra money and buy an iphone...how does that make sense?

If you are going to make a claim like this, please cite a source.

Furthermore, eligibility for services such as Medicaid, Food Stamps, Heating Assistance, etc are based primarily upon income with some consideration to expenses (that do not include iPhones). If someone brings home an income that is above the eligibility requirements, with some exceptions (presence of a disability), they will not receive those services, no matter how poorly they manage their finances. So, yes, in this country, welfare only benefits the poor and/or disabled (and those who commit fraud; but that is not what you were referring to).

Now, a recipient may still poorly manage money and have their priorities wrong; however, if they are receiving services and not committing fraud, they would still be in poverty based upon their income.

If I was in poverty I would put food, education and health insurance in front of iphones, cars, cable TV, etc...however this is not the case of many of those receiving welfare.

Many may not do this; but many, many do. It sometimes, oftentimes, is still not enough.

The current system is merely a bandaid on a much larger problem and completely fails to "fix" anything except cause those receiving entitlement to want more "free money".

I agree that the current system fails to address a larger, sociological problem. To address that, we would need to do more that provide health care and the like, we would need to provide educational resources (beyond public education), mentoring programs and other outreach services.

That said, it does help. Had I not received Medicaid, I would be dead or severely disabled; I also would not have been able to go to college, have a chance to persue my goals, etc. Had my family not received food stamps and help from food pantries, we would not have been able to afford it many months. Had we not received heating assistance, we would have gone without. We received no housing assistance; but had our landlord not been a family friend who put up with us being months behind on rent, we would have been homeless. Had I not been lucky enough to receive numerous, free/funded enrichment resources from private sources (summer camps, etc), I likely would not have been motivated enough to pursue higher education, as I had no guidance previously and everyone -- and society -- told me that I wasn't as capable.

I agree there is a huge disparity of quality of education received across this country, which is honestly the core problem has this viscous cycle. Teach these people how to contribute to society...thats the fairest way for everybody.

First of all, "these people" are not a separate type or species of people. They are your neighbors, your classmates, your friends, etc -- they are just less fortunate.

And I agree. Improve education, support/advising for low income families, etc. Of course, that takes money, too.

First there is a big difference between the police and healthcare. The police and fire dept. protect everyone's rights and liberties as a citizen. Entitlements only benefit a small portion, if I make 100K per year I cannot get the same things someone who makes 10K can get.

By this logic, you could make an argument for universal health care. It's offered to everyone, after all.

I already said I support education because it prevents the welfare state.

As of the current time, it's not enough.

Also, having a group of people who do not have health care leads to a group of people who are ill, disabled, etc and cannot go to school or work, making it difficult to improve their lives.

Question to all those who are for the "welfare state" explain to me why people on welfare are not drug tested in most states

Innocent until proven guilty. Those on welfare are not [necessarily] criminals or licit drug users. The fourth amendment requires that you get a warrant to search and/or seize someone and also requires that you must have probable cause. "Being poor" is not probable cause and requiring this is excessive search and seizure.

are allowed to have cell phones, cable tv,

What are you going to do? Require those on welfare to have all purchases approved?

I grew up with a cell phone and cable TV. The cell-phone was non-contract, pay as you go; it cost $15 dollars to buy and was for emergencies. The phone itself was a one-time fee and the minutes were only bought when I ran out, making it an expense that was not frequent/monthly. I'm glad I had it, as there were many times -- having gotten lost, locked out of the house, was injured, my mom was injured, needed to be picked up, etc -- where it came in good use. The cable TV was something we had more sporadically and only had at all because it was discounted as we got our phone from the same company (also came in handy when my mother, more than once, almost died and 911 needed to be called); eliminating it would not have given us enough extra money to pay for any of the services we were receiving aid for (and, yes, we calculated it). Judge us for it; but it provided some entertainment for my younger self, as I lived on a main highway with no yard.

cars,

Umn. To go to work? To buy groceries/other necessities? I grew up in an area in which everything was fairly spread out. While we could have walked, I guess, it would have taken hours and, considering the hours my mom worked (longer than 9-5, every day of the week, including some under-the-table jobs that paid less than minimum wage), that would not have been an option lest she decided to only sleep two hours a night.

etc?

Microwaves: To eat. My mom worked too many hours to have time to cook.
Refrigerator: To store food.
Washer and Dryer: Didn't, initially, we just went to Laundromats. We were given one set as a gift -- it saved a lot of money.
Furniture: To sleep on. For many years, my mom didn't have a bed and, as such, actually did sleep on the floor. It wasn't good for her health.
Clothes: To wear.
Toys: For kids to play with. Family, churches, etc can be good things.

Anything else?

Also why do people NEED air conditioning? I lived without it for 4 years in college and survived fine.

I was a sick kid and, as a result, severe heat would have had a significant, negative impact on my life. The Summers where we were could get quite hot.

By the way, I don't feel entitled to these things. I am beyond grateful for each and every one of them.

 

[dr zaius]

Awesome rebuttal.

Thanks for sharing, but your story will likely be disregarded.

 

[thlaxer]

Thanks for sharing, but your story will likely be disregarded.

Hopefully it won't. Thanks for sharing starlight.

 

[Starlightembers]

Thanks for sharing, but your story will likely be disregarded.

Thank you.

It likely will by some; but it still needed to be said. My hope is that someone who is more unsure, who doesn't know and wants to learn, might not disregard it and gain some insight from it. As with most of these types of discussions, many are set thinking one way and will not change that no matter what is presented; but many others are more open.

Hopefully it won't. Thanks for sharing starlight.

And thank you.

 

[link2swim06]

OP: As a Medicaid recipient, I agree. If a patient is abusing the system, they should be reported and have their services removed. Not only is it fraud; but it harms those who access such services legitimately.


It is possible that the person born into poverty will achieve the same level of success; however, it will require more work and struggle on the part of that person. From lack of resources to lack of role model (in one's parents), there is more to overcome. And, no, it is not fair.


If you are going to make a claim like this, please cite a source.

Furthermore, eligibility for services such as Medicaid, Food Stamps, Heating Assistance, etc are based primarily upon income with some consideration to expenses (that do not include iPhones). If someone brings home an income that is above the eligibility requirements, with some exceptions (presence of a disability), they will not receive those services, no matter how poorly they manage their finances. So, yes, in this country, welfare only benefits the poor and/or disabled (and those who commit fraud; but that is not what you were referring to).

Now, a recipient may still poorly manage money and have their priorities wrong; however, if they are receiving services and not committing fraud, they would still be in poverty based upon their income.

Many may not do this; but many, many do. It sometimes, oftentimes, is still not enough.

I agree that the current system fails to address a larger, sociological problem. To address that, we would need to do more that provide health care and the like, we would need to provide educational resources (beyond public education), mentoring programs and other outreach services.

That said, it does help. Had I not received Medicaid, I would be dead or severely disabled; I also would not have been able to go to college, have a chance to persue my goals, etc. Had my family not received food stamps and help from food pantries, we would not have been able to afford it many months. Had we not received heating assistance, we would have gone without. We received no housing assistance; but had our landlord not been a family friend who put up with us being months behind on rent, we would have been homeless. Had I not been lucky enough to receive numerous, free/funded enrichment resources from private sources (summer camps, etc), I likely would not have been motivated enough to pursue higher education, as I had no guidance previously and everyone -- and society -- told me that I wasn't as capable.

First of all, "these people" are not a separate type or species of people. They are your neighbors, your classmates, your friends, etc -- they are just less fortunate.

And I agree. Improve education, support/advising for low income families, etc. Of course, that takes money, too.


By this logic, you could make an argument for universal health care. It's offered to everyone, after all.

As of the current time, it's not enough.

Also, having a group of people who do not have health care leads to a group of people who are ill, disabled, etc and cannot go to school or work, making it difficult to improve their lives.

Innocent until proven guilty. Those on welfare are not [necessarily] criminals or licit drug users. The fourth amendment requires that you get a warrant to search and/or seize someone and also requires that you must have probable cause. "Being poor" is not probable cause and requiring this is excessive search and seizure.

What are you going to do? Require those on welfare to have all purchases approved?

I grew up with a cell phone and cable TV. The cell-phone was non-contract, pay as you go; it cost $15 dollars to buy and was for emergencies. The phone itself was a one-time fee and the minutes were only bought when I ran out, making it an expense that was not frequent/monthly. I'm glad I had it, as there were many times -- having gotten lost, locked out of the house, was injured, my mom was injured, needed to be picked up, etc -- where it came in good use. The cable TV was something we had more sporadically and only had at all because it was discounted as we got our phone from the same company (also came in handy when my mother, more than once, almost died and 911 needed to be called); eliminating it would not have given us enough extra money to pay for any of the services we were receiving aid for (and, yes, we calculated it). Judge us for it; but it provided some entertainment for my younger self, as I lived on a main highway with no yard.

Umn. To go to work? To buy groceries/other necessities? I grew up in an area in which everything was fairly spread out. While we could have walked, I guess, it would have taken hours and, considering the hours my mom worked (longer than 9-5, every day of the week, including some under-the-table jobs that paid less than minimum wage), that would not have been an option lest she decided to only sleep two hours a night.

Microwaves: To eat. My mom worked too many hours to have time to cook.
Refrigerator: To store food.
Washer and Dryer: Didn't, initially, we just went to Laundromats. We were given one set as a gift -- it saved a lot of money.
Furniture: To sleep on. For many years, my mom didn't have a bed and, as such, actually did sleep on the floor. It wasn't good for her health.
Clothes: To wear.
Toys: For kids to play with. Family, churches, etc can be good things.

Anything else?

I was a sick kid and, as a result, severe heat would have had a significant, negative impact on my life. The Summers where we were could get quite hot.

By the way, I don't feel entitled to these things. I am beyond grateful for each and every one of them.

Oh if you are going to use the argument about the constitution, then where does it say anyone has the right to another persons money?

You have no right to welfare therefore any strings can be attached. Its like going on an airplane, I forfeit my right to search and seizure to board an airplane.

I dont have time to go through your whole list, but you can save money in alot of areas, i.e. replace a bicycle/ public transportation for a car.

Even lets take the cable, you said you had it for 1 year? maybe at $40 per month, thats nearly $500 that you could have used to pay bills instead of taking from society. There are lower cost ways of entertainment, i.e. books from the public library or the radio. I dont have cable, why should my tax money from when I worked go to fund someone with it?

Please explain this to me, with my current student loans I live on less than $11,000 per year, pay ALL my own bills. Yet I have enough money for luxuries like a cell phone, a car, and eating out often. YET I STILL eligible for food stamps. This is pretty screwed up for the single person limit, bc I live comfortably imo. Hell I could survive on probably less than $7000 if I needed to but yet where I live you can still get food stamps making upwards of $15,000 for a single person. This is what really makes me annoyed, I dont just claim these people dont need food stamps, I am proof since the start of med school that you can live 100% fine on a minimum wage income.

Its not that difficult it go get an associates or tech degree and obtain a job making 2-3 times that. There are MANY short degree programs where you make $15-20 per hour right out of graduation, this puts you closer to $40,000-$50,000 per year (which is alot of money compared to what I live on). It is so simple to work + go to school at night for 2 years, while living like all med students do, then go make $40,000.

 

[IMSingular]

Physician abuse of Medicare & medicaid is so much more than patient abuse. Physicians are the one who bill that extra procedure. I have seen a PCP bill 'well child' visits on patients that did not come to her office in a year....

Stop pointing fingers at the poor & let us focus on fraud & abuse of those in power....

Not an appropriate forum to raise such matters! Actually the bailout given to Wallstreet was more than all the welfare budget over the history of USA. The Golden Rule is: One who has the gold makes the rules.

 

[Starlightembers]

Oh if you are going to use the argument about the constitution, then where does it say anyone has the right to another persons money?

I never argued it was a right. See my last sentence.

You have no right to welfare therefore any strings can be attached. Its like going on an airplane, I forfeit my right to search and seizure to board an airplane.

I will disagree with you on this one.

I do not find walking through a medical detector to be excessive search and seizure. It is non-invasive, provides little extra hassle, and, up until recently, that was all you had to deal with unless something else was discovered (and, no, I do not agree with the enhanced pat downs and body scanners).

I find drug testing to be excessive and more invasive (and, depending on the form of test, actually is). It also takes time out of one's day. Most government offices and physician's offices close at night. My mom would have to miss some work, which costs us.

One also involves the safety of others, while drug testing would not protect those around the person on welfare.

And, while one could forgo services, that would mean no food, no healthcare, no heat, etc. I consider this to a much greater hardship than having to find an alternate means of transportation.

Furthermore, not any string could be attached. Taking that to its logical end, you could force quite a lot of illegal and/or unethical things.

I dont have time to go through your whole list, but you can save money in alot of areas, i.e. replace a bicycle/ public transportation for a car.

There is no public transportation in my home town. It would be difficult for us to bike due to how spread out everything was; it was not possible. Read my point on walking.

Even lets take the cable, you said you had it for 1 year? maybe at $40 per month, thats nearly $500 that you could have used to pay bills instead of taking from society.

On top of our phone bill, it was not that much. I do not recall the exact numbers; but, as stated, we did calculate this.

There are lower cost ways of entertainment, i.e. books from the public library

I could not get there. My mother had no time to drive me. Once in daycare (which was free for us due to my mom working there), I did get books from there, though. Later on, I got books from school.

or the radio.

We had this, too. It provided background noise/music, which was nice; however, I would not call it entertainment.

I dont have cable, why should my tax money from when I worked go to fund someone with it?

See above. It isn't.

Please explain this to me, with my current student loans I live on less than $11,000 per year, pay ALL my own bills. Yet I have enough money for luxuries like a cell phone, a car, and eating out often.

You also, I assume, do not have children to take care of or other major expenses, ie major medical bill, something broke that needed to be repaired, outstanding debt*, etc (beyond education, which is covered by loans).

YET I STILL eligible for food stamps. This is pretty screwed up for the single person limit, bc I live comfortably imo. Hell I could survive on probably less than $7000 if I needed to but yet where I live you can still get food stamps making upwards of $15,000 for a single person. This is what really makes me annoyed, I dont just claim these people dont need food stamps, I am proof since the start of med school that you can live 100% fine on a minimum wage income.

Then feel free to write to your government and tell them it should be lowered. As I do not know your state, I cannot comment on the specifics of eligibility. I also do not know other variables, ex does your tuition/loans cover anything (food, housing, etc. I know student loans often cover housing/rent), if you have savings, etc

My point was that poor budgeting alone is not going to make someone eligible for a government service. Even if they poorly budgeted, if they are receiving services and not committing fraud, they are still low income. In other words, poor budgeting does not effect eligibility.

Its not that difficult it go get an associates or tech degree and obtain a job making 2-3 times that.

My mom has her AA. She was unable to go further due to lack of funding (loans were not as readily available) and a mild-moderate learning disability.

She could not simply go to back to school, either, once she had married and had a kid (and then divorced). First, because there was no time -- she worked incredibly long hours, remember; second, because she had no money; third, even if she could find classes very late at night, she would have had to find someone to watch me. This is not as easy as it sounds considering the hours I would have had to be watched (never-mind paying for it -- that isn't cheap, either. And, no, the cable TV would not have covered it).

There are MANY short degree programs where you make $15-20 per hour right out of graduation, this puts you closer to $40,000-$50,000 per year (which is alot of money compared to what I live on). It is so simple to work + go to school at night for 2 years, while living like all med students do, then go make $40,000.

No, it is not simple. Not when you work long hours (that are not flexible), have a kid to take care of, etc.

*Our outstanding debts were not incurred by us. My father, back when my parents were married, began using my mom's name and information.

 

[IMSingular]

... My rebuttal to that statement was that the societal benefits of such a system are considered unclear by some people, and that this draws their worthiness of tax dollar funding into question.

I suppose wothiness is confirmed, and clatified, once the Congress passes the laws and provides the budget. For every line item in the budget there will be some one would object.

 

[IMSingular]

....

*Our outstanding debts were not incurred by us. My father, back when my parents were married, began using my mom's name and information.

It's really a problem of legacy. How much children should suffer for the deeds of their parents, and how much the children should inherit from parents.

Common sense would dictate that children should not suffer due to bad deeds of parents, and should have a fresh start. Totally free eductaion would be the solution to this. But good education needs other support such as food and shelter.

How much children should inherit? If we are arguing for meritocracy the answer iz zero.

Social Contract, that is political and economic system, should try to approximate the above as close as possible.

 

[gmcguitar4]

There will always be people that abuse the freebies our government provides. But take it away and there will be a ton of people that suffer who truly rely on these provisions. Clearly, from the debt our nation assumes, we cannot sustain such programs in the future without some major reform and it is unfair to the rest of the population who has never or will never need these programs. But it is by the right of the government to take our money as taxes and spend it however they seem fit. It seems unfair but that is the reality. It is and always has been how governments have operated. I understand we are talking about people who take advantage of government programs and drain the system of money that we worked hard for and it pisses me off too when I see it. But who knows the type of problems that would arise if these programs didn't exist.

In my view, I feel that our healthcare system along with other programs, need to take a different direction soon b/c everyone is going to suffer in the long run. We have to weigh out what is more important, and good intentions are not it.

 

[link2swim06]

I never argued it was a right. See my last sentence.

I will disagree with you on this one.

I do not find walking through a medical detector to be excessive search and seizure. It is non-invasive, provides little extra hassle, and, up until recently, that was all you had to deal with unless something else was discovered (and, no, I do not agree with the enhanced pat downs and body scanners).

I find drug testing to be excessive and more invasive (and, depending on the form of test, actually is). It also takes time out of one's day. Most government offices and physician's offices close at night. My mom would have to miss some work, which costs us.

One also involves the safety of others, while drug testing would not protect those around the person on welfare.

And, while one could forgo services, that would mean no food, no healthcare, no heat, etc. I consider this to a much greater hardship than having to find an alternate means of transportation.

Furthermore, not any string could be attached. Taking that to its logical end, you could force quite a lot of illegal and/or unethical things.

There is no public transportation in my home town. It would be difficult for us to bike due to how spread out everything was; it was not possible. Read my point on walking.

On top of our phone bill, it was not that much. I do not recall the exact numbers; but, as stated, we did calculate this.

I could not get there. My mother had no time to drive me. Once in daycare (which was free for us due to my mom working there), I did get books from there, though. Later on, I got books from school.

We had this, too. It provided background noise/music, which was nice; however, I would not call it entertainment.

See above. It isn't.

You also, I assume, do not have children to take care of or other major expenses, ie major medical bill, something broke that needed to be repaired, outstanding debt*, etc (beyond education, which is covered by loans).

Then feel free to write to your government and tell them it should be lowered. As I do not know your state, I cannot comment on the specifics of eligibility. I also do not know other variables, ex does your tuition/loans cover anything (food, housing, etc. I know student loans often cover housing/rent), if you have savings, etc

My point was that poor budgeting alone is not going to make someone eligible for a government service. Even if they poorly budgeted, if they are receiving services and not committing fraud, they are still low income. In other words, poor budgeting does not effect eligibility.

My mom has her AA. She was unable to go further due to lack of funding (loans were not as readily available) and a mild-moderate learning disability.

She could not simply go to back to school, either, once she had married and had a kid (and then divorced). First, because there was no time -- she worked incredibly long hours, remember; second, because she had no money; third, even if she could find classes very late at night, she would have had to find someone to watch me. This is not as easy as it sounds considering the hours I would have had to be watched (never-mind paying for it -- that isn't cheap, either. And, no, the cable TV would not have covered it).

No, it is not simple. Not when you work long hours (that are not flexible), have a kid to take care of, etc.

*Our outstanding debts were not incurred by us. My father, back when my parents were married, began using my mom's name and information.

See wouldn't it make more sense for the government to pay for schooling for 2 years (and maybe childcare during that time) than food stamps for 5,10,15+ years?

My entire point is minimum wage goes along way for one person, I cant speak to the family thresholds (bc I have no idea), but for a single person it is ridiculous. Yes my loans are to pay for food, but I get 2 X $5,500 payments a year amounting to $11,000 per year, less than a minimum wage person gets. Yet I could fill out the form right now and get free money because of my income.

 

[Starlightembers]

See wouldn't it make more sense for the government to pay for schooling for 2 years (and maybe childcare during that time) than food stamps for 5,10,15+ years?

Sure. I think it would be highly beneficial if the government provided more aid for education, daycare, etc. During that time, however, families still have to eat. Furthermore, there will still be people who cannot accomplish various educational milestones. My Mom got her AA; but it was something that took an incredible amount of effort to do and, with that effort, she just barely passed. And that was when she was younger. We've actually talked about her going back and pursuing more education now that I'm in college; however, we would not know where to get the funds and, even if we did, she is unsure she would be able to actually do it (learning gets harder as you get older, especially when there is a learning disability).

My entire point is minimum wage goes along way for one person, I cant speak to the family thresholds (bc I have no idea)

But that is what you were attempting to do. My story only spoke to a family situation. Though I am single now, everything -- room/board, healthcare, food, etc -- is covered under educational loans and work-study so I cannot truly speak to that situation. I will say, however, that many on Medicaid suffer from disabilities, which may make it hard to work at all or, if they do work, make it hard to work full time; others, such as a friend of mine, are unemployed despite their best efforts to find employment (sending out multiple resumes a day, has both a BS and MS in Comp Sci, etc).

, but for a single person it is ridiculous. Yes my loans are to pay for food, but I get 2 X $5,500 payments a year amounting to $11,000 per year, less than a minimum wage person gets. Yet I could fill out the form right now and get free money because of my income.

Do you get anything as part of your overall education costs, however? For example, do you have school health care, does the school provide meals, I know some schools offer cheap housing or dorms to students, etc?

If you are receiving any of these things, I do not feel you can adequately compare your situation to one who is not a student and receiving such things.

 

[link2swim06]

Sure. I think it would be highly beneficial if the government provided more aid for education, daycare, etc. During that time, however, families still have to eat. Furthermore, there will still be people who cannot accomplish various educational milestones. My Mom got her AA; but it was something that took an incredible amount of effort to do and, with that effort, she just barely passed. And that was when she was younger. We've actually talked about her going back and pursuing more education now that I'm in college; however, we would not know where to get the funds and, even if we did, she is unsure she would be able to actually do it (learning gets harder as you get older, especially when there is a learning disability).

But that is what you were attempting to do. My story only spoke to a family situation. Though I am single now, everything -- room/board, healthcare, food, etc -- is covered under educational loans and work-study so I cannot truly speak to that situation. I will say, however, that many on Medicaid suffer from disabilities, which may make it hard to work at all or, if they do work, make it hard to work full time; others, such as a friend of mine, are unemployed despite their best efforts to find employment (sending out multiple resumes a day, has both a BS and MS in Comp Sci, etc).

Do you get anything as part of your overall education costs, however? For example, do you have school health care, does the school provide meals, I know some schools offer cheap housing or dorms to students, etc?

If you are receiving any of these things, I do not feel you can adequately compare your situation to one who is not a student and receiving such things.

While your family seems to have used it most appropriately, I would go to say many dont. Even my case shows the absurdity of many of the policies where people can get funding. And for the record, the school doesnt pay for food, health, or housing for me.

Per this study, the poor have many of the things my classmates and I dont have...yet they still feel the need to use government money to live. http://www.heritage.org/research/re...d-states-surprising-facts-about-americas-poor

 

[Cornu Ammonis]

I love all the incredibly condescending and dehumanizing posts in this thread directed at welfare recipients. Perhaps you should stop to consider that if society treats welfare recipients as criminals, they are much less likely to have any respect for society. Forcing people using food stamps to pay with actual stamps or to receive drug tests is a constant reminder of how reliant on society they are, and although this may seem just to the more productive members of society, it seems awfully counterintuitive if the intention is to actually end poverty rather than humiliate the poor. I think Milton Friedman's idea of negative income taxes best avoids these problems.

Oh, and it is absolutely absurd to argue about whether welfare or health care are rights, or where such rights are outlined in the constitution. The very preamble of the constitution gives our federal government the duty of passing laws for the general welfare, and the idea of the government having the right to take from some to give to others FAR predates the existence of our country. Finally, plenty of our founding fathers stated quite explicitly that it was the government's duty to provide for the poor and infirm and to ensure success goes to those who benefit society and not those who were simply born with or conned their way into riches. If these goals are not worthy of a government, then why even have a government?

To kduck: your criterion is perfectly sound and should indeed be applied in the scrutiny of any welfare program, but as many people in this thread show, they are insulted by the mere requirement that funds are ever transferred. In fact, the first posts are insulting medicare and medicaid - the funding of which burdens the average income earner far more than the rich, and provides commensurate services. At least you recognize that there even can be societal benefits from public services - in most threads on these forums that discuss these issues, there are far more people who believe that even public schools and roads are unconscionable.

 

[music2doc]

Some great responses here! I appreciate hearing your opinions.

OP: As a Medicaid recipient, I agree. If a patient is abusing the system, they should be reported and have their services removed. Not only is it fraud; but it harms those who access such services legitimately.

Absolutely. And this is at the core of my concern. Frankly, when at least 30-50% of my Medicaid patients at any given time apparently are not taking care of their health and use our ED as nothing more than a restaurant (for food), a bus station (transport to us via AMR or away via taxi voucher), free medical advice check-ups/pharmacy, etc., it's hard to really see Medicaid patients in a positive light and that hurts the care we provide you because we begin to see you as nothing more than worthless scum (i.e., we get very jaded). You don't want us feeling that way about you and we don't really want to feel that way about you either. Unfortunately, when so many Medicaid patients do these things, it becomes a very real possibility and is something I actively work to prevent in myself and, where possible, the people with whom I work.

It is possible that the person born into poverty will achieve the same level of success; however, it will require more work and struggle on the part of that person. From lack of resources to lack of role model (in one's parents), there is more to overcome. And, no, it is not fair.

True.

If you are going to make a claim like this, please cite a source.

Furthermore, eligibility for services such as Medicaid, Food Stamps, Heating Assistance, etc are based primarily upon income with some consideration to expenses (that do not include iPhones). If someone brings home an income that is above the eligibility requirements, with some exceptions (presence of a disability), they will not receive those services, no matter how poorly they manage their finances. So, yes, in this country, welfare only benefits the poor and/or disabled (and those who commit fraud; but that is not what you were referring to).

Now, a recipient may still poorly manage money and have their priorities wrong; however, if they are receiving services and not committing fraud, they would still be in poverty based upon their income.

Couldn't it be argued that IF the money they are given is charity money it is, therefore, still owned/given by the community and IF it is given by the community, then shouldn't the community have the authority to determine whether or not these people can spend said funds on, say, entertainment? It is, after all, charity.

Many may not do this; but many, many do. It sometimes, oftentimes, is still not enough.

I agree that the current system fails to address a larger, sociological problem. To address that, we would need to do more that provide health care and the like, we would need to provide educational resources (beyond public education), mentoring programs and other outreach services.

That said, it does help. Had I not received Medicaid, I would be dead or severely disabled; I also would not have been able to go to college, have a chance to persue my goals, etc. Had my family not received food stamps and help from food pantries, we would not have been able to afford it many months. Had we not received heating assistance, we would have gone without. We received no housing assistance; but had our landlord not been a family friend who put up with us being months behind on rent, we would have been homeless. Had I not been lucky enough to receive numerous, free/funded enrichment resources from private sources (summer camps, etc), I likely would not have been motivated enough to pursue higher education, as I had no guidance previously and everyone -- and society -- told me that I wasn't as capable.

First of all, "these people" are not a separate type or species of people. They are your neighbors, your classmates, your friends, etc -- they are just less fortunate.

And I agree. Improve education, support/advising for low income families, etc. Of course, that takes money, too.


By this logic, you could make an argument for universal health care. It's offered to everyone, after all.

As of the current time, it's not enough.

Also, having a group of people who do not have health care leads to a group of people who are ill, disabled, etc and cannot go to school or work, making it difficult to improve their lives.

Innocent until proven guilty. Those on welfare are not [necessarily] criminals or licit drug users. The fourth amendment requires that you get a warrant to search and/or seize someone and also requires that you must have probable cause. "Being poor" is not probable cause and requiring this is excessive search and seizure.

While I agree that not all people receiving Medicare should not be randomly drug-tested and probably not Medicaid either. People receiving unemployment/SS checks might be best served by receiving such checks. This can be taken from the fact that people working in various jobs are often subject to random drug screening (with or without suspicion). As these people are receiving government funds as a substitute for working, it is reasonable to ask them to undergo similar testing.

What are you going to do? Require those on welfare to have all purchases approved?

Something analogous to food stamps, perhaps?

I grew up with a cell phone and cable TV. The cell-phone was non-contract, pay as you go; it cost $15 dollars to buy and was for emergencies. The phone itself was a one-time fee and the minutes were only bought when I ran out, making it an expense that was not frequent/monthly. I'm glad I had it, as there were many times -- having gotten lost, locked out of the house, was injured, my mom was injured, needed to be picked up, etc -- where it came in good use. The cable TV was something we had more sporadically and only had at all because it was discounted as we got our phone from the same company (also came in handy when my mother, more than once, almost died and 911 needed to be called); eliminating it would not have given us enough extra money to pay for any of the services we were receiving aid for (and, yes, we calculated it). Judge us for it; but it provided some entertainment for my younger self, as I lived on a main highway with no yard.

TV is one of the worst inventions of all. It is a primary cause of the obesity epidemic. Having cable was bad for you. Face it.

Umn. To go to work? To buy groceries/other necessities? I grew up in an area in which everything was fairly spread out. While we could have walked, I guess, it would have taken hours and, considering the hours my mom worked (longer than 9-5, every day of the week, including some under-the-table jobs that paid less than minimum wage), that would not have been an option lest she decided to only sleep two hours a night.

Microwaves: To eat. My mom worked too many hours to have time to cook.
Refrigerator: To store food.
Washer and Dryer: Didn't, initially, we just went to Laundromats. We were given one set as a gift -- it saved a lot of money.
Furniture: To sleep on. For many years, my mom didn't have a bed and, as such, actually did sleep on the floor. It wasn't good for her health.
Clothes: To wear.
Toys: For kids to play with. Family, churches, etc can be good things.

Anything else?

I was a sick kid and, as a result, severe heat would have had a significant, negative impact on my life. The Summers where we were could get quite hot.

By the way, I don't feel entitled to these things. I am beyond grateful for each and every one of them.

Overall, I agree with much of what you've said, but there are some things I can't really agree with it.

 

[link2swim06]

I love all the incredibly condescending and dehumanizing posts in this thread directed at welfare recipients. Perhaps you should stop to consider that if society treats welfare recipients as criminals, they are much less likely to have any respect for society. Forcing people using food stamps to pay with actual stamps or to receive drug tests is a constant reminder of how reliant on society they are, and although this may seem just to the more productive members of society, it seems awfully counterintuitive if the intention is to actually end poverty rather than humiliate the poor. I think Milton Friedman's idea of negative income taxes best avoids these problems.

Oh, and it is absolutely absurd to argue about whether welfare or health care are rights, or where such rights are outlined in the constitution. The very preamble of the constitution gives our federal government the duty of passing laws for the general welfare, and the idea of the government having the right to take from some to give to others FAR predates the existence of our country. Finally, plenty of our founding fathers stated quite explicitly that it was the government's duty to provide for the poor and infirm and to ensure success goes to those who benefit society and not those who were simply born with or conned their way into riches. If these goals are not worthy of a government, then why even have a government?

To kduck: your criterion is perfectly sound and should indeed be applied in the scrutiny of any welfare program, but as many people in this thread show, they are insulted by the mere requirement that funds are ever transferred. In fact, the first posts are insulting medicare and medicaid - the funding of which burdens the average income earner far more than the rich, and provides commensurate services. At least you recognize that there even can be societal benefits from public services - in most threads on these forums that discuss these issues, there are far more people who believe that even public schools and roads are unconscionable.

Alan Colmes is that you?

Oh how we treat cops, firefighters, public transit workers like criminals and do random drug tests with? Whats wrong with making sure public money isnt going to buy illegal drugs?

Nothing existed anywhere close to the entitlement system we have today when the country was found, the welfare clause in the constitution is much broader and very debatable on what it even means...especially what it has to do with social welfare programs today.

It is quite interesting that last generations luxuries become necessities required for living today. Its even more interesting that society is expected to fund these "necessities" to live.

 

[kduck]

Oh how we treat cops, firefighters, public transit workers like criminals and do random drug tests with? Whats wrong with making sure public money isnt going to buy illegal drugs?

I don't entirely disagree with everything you've been saying, but I do take issue with this. I think the primary impetus behind drug testing public employees is not to make sure that public money isn't going to buy illegal drugs, but rather to make sure that people under the influence of drugs aren't going around wielding guns, fighting fires, and operating vehicles like buses and trains. Because, you know, that might dangerous. Dangerous enough, in fact, to warrant imposing on people's right to privacy a bit to test them for drugs.

 

[Cornu Ammonis]

Alan Colmes is that you?

Oh how we treat cops, firefighters, public transit workers like criminals and do random drug tests with? Whats wrong with making sure public money isnt going to buy illegal drugs?

Nothing existed anywhere close to the entitlement system we have today when the country was found, the welfare clause in the constitution is much broader and very debatable on what it even means...especially what it has to do with social welfare programs today.

It is quite interesting that last generations luxuries become necessities required for living today. Its even more interesting that society is expected to fund these "necessities" to live.

Indeed, nothing resembling the current welfare state existed at the time of our founding, and the general welfare clause is debatable. In fact, it was debated just around the time it was written, and I'll leave you to guess which side won. I'm not saying that living well is every citizen's right, but simply that it is the government's duty to best protect it. Some people believe that welfare programs do no such thing, and that is a fine argument to make, but it is quite different from saying that taking more than some arbitrary percentage of the income of the rich to fund welfare (or any other) programs is unacceptable or anathema to our national spirit.

Again, I ask you what the point of a republican nation if it does not provide the greatest benefit to the greatest number of people possible. Democracy is not a priori superior to any other options, and I hate to resort to utilitarianism, but the best argument for it is that by better representing the will of the governed, their needs will be better met. If providing 'luxuries' like not dying from curable diseases (or receiving an education, or just getting to work on a public road) when the market fails to provide a reasonable or even possible option for many people is not our government's job, we sure as hell have the wrong form of government to stop it from happening.

 

[link2swim06]

Indeed, nothing resembling the current welfare state existed at the time of our founding, and the general welfare clause is debatable. In fact, it was debated just around the time it was written, and I'll leave you to guess which side won. I'm not saying that living well is every citizen's right, but simply that it is the government's duty to best protect it. Some people believe that welfare programs do no such thing, and that is a fine argument to make, but it is quite different from saying that taking more than some arbitrary percentage of the income of the rich to fund welfare (or any other) programs is unacceptable or anathema to our national spirit.

Again, I ask you what the point of a republican nation if it does not provide the greatest benefit to the greatest number of people possible. Democracy is not a priori superior to any other options, and I hate to resort to utilitarianism, but the best argument for it is that by better representing the will of the governed, their needs will be better met. If providing 'luxuries' like not dying from curable diseases (or receiving an education, or just getting to work on a public road) when the market fails to provide a reasonable or even possible option for many people is not our government's job, we sure as hell have the wrong form of government to stop it from happening.

We are really missing the elephant in the room which is corporatism's effect on democracy which is making it very difficult to change classes. Most entitlements actually go to corporations which prevent competition and an individuals ability to create a future on their own. I strongly support a strong education system because it supports people ability to mobility, healthcare should be affordable and only in dire circumstances should it be given "free" and even then if the person can return their debt to society they should.

The problem is the current attitude isnt to "fix" poverty rather just transfer wealth to make it look like the problem doesnt exist. People need to work for their money and achieve success through class mobility, isnt that the entire point of the American Dream? Shouldnt these programs set people up to achieve the American Dream instead of masking the problem? I am not saying everyone on food stamps can contribute at that moment, but nevertheless it is a debt and burden on society. Should these individuals attempt to repay their debt? On the same note, how can corporations like GE use infrastructures built by the US tax payers without pay them back for this?

Wouldn't it make sense to ensure welfare is pushing people towards a better life by stipulating requirements which would prepare them (living a drug free life, getting an education, getting use to holding a job, budgeting priorities correctly, etc)? I dont know many people on drugs and/or who are uneducated which are really "making" it in society.

Even lets take medicaid individuals, you could scale their aid with milestones involved in setting a healthier lifestyles (weight management, exercising, good nutrition, etc). Welfare isnt a right, people and corporations alike, shouldnt be getting "freebies" unless they are used to improves themselves and indirectly society. The current food stamp program does ZERO of the things I mentioned above...hell it doesn't even promote healthy eating.

I bring up the luxuries because the majority of the "poor" have luxuries like xboxs, cable, computers, air conditioning, etc...if these were given up prior to receiving government aid there would be a lesser burden on society and more importantly it shows poor priorities.

 

[deleted393595]

<Off Topic Alert>

 

[kduck]

No idea I am not a republican, we are really missing the elephant in the room which is corporatism's effect on democracy which is making it very difficult to change classes.

The U.S. is not a pure democracy. It's a republic. That's why we pledge allegiance to the republic for which our flag stands. This has nothing to do with political parties.

 

[link2swim06]

The U.S. is not a pure democracy. It's a republic. That's why we pledge allegiance to the republic for which our flag stands. This has nothing to do with political parties.

Its been a long day...my bad not reading completely, I thought he was insinuating something about a republican viewpoint.

 

[kduck]

Its been a long day...my bad not reading completely, I thought he was insinuating something about a republican viewpoint.

Sleep deprivation ftw!

 

[Cornu Ammonis]

We are really missing the elephant in the room which is corporatism's effect on democracy which is making it very difficult to change classes. Most entitlements actually go to corporations which prevent competition and an individuals ability to create a future on their own. I strongly support a strong education system because it supports people ability to mobility, healthcare should be affordable and only in dire circumstances should it be given "free" and even then if the person can return their debt to society they should.

The problem is the current attitude isnt to "fix" poverty rather just transfer wealth to make it look like the problem doesnt exist. People need to work for their money and achieve success through class mobility, isnt that the entire point of the American Dream? Shouldnt these programs set people up to achieve the American Dream instead of masking the problem? I am not saying everyone on food stamps can contribute at that moment, but nevertheless it is a debt and burden on society. Should these individuals attempt to repay their debt? On the same note, how can corporations like GE use infrastructures built by the US tax payers without pay them back for this?

Wouldn't it make sense to ensure welfare is pushing people towards a better life by stipulating requirements which would prepare them (living a drug free life, getting an education, getting use to holding a job, budgeting priorities correctly, etc)? I dont know many people on drugs and/or who are uneducated which are really "making" it in society.

Even lets take medicaid individuals, you could scale their aid with milestones involved in setting a healthier lifestyles (weight management, exercising, good nutrition, etc). Welfare isnt a right, people and corporations alike, shouldnt be getting "freebies" unless they are used to improves themselves and indirectly society. The current food stamp program does ZERO of the things I mentioned above...hell it doesn't even promote healthy eating.

I bring up the luxuries because the majority of the "poor" have luxuries like xbox's, cable, computers, air conditioning, etc...if these were given up prior to receiving government aid there would be a lesser burden on society and more importantly it shows poor priorities.

This is all wonderful, really, and I agree with almost everything you've written. The dignity conferred by working is essential to humanity, and the ultimate goal of any welfare state should be the attainment of full employment and the assurance that employment provides a decent life.

 

[stichchick]

Oh I see its ethical for the deadbeat who sits on his ass all day to take my money that I have spent my time to work for.

You are being naive and shortsighted, the government's role isnt to take my money and give it to someone else. It is my right to donate to charity if I choose.

And pertaining to the bolded statement, you are basically telling me I should help fund someone with the means to buy a smartphone?

Relax- it is only for food, housing & medical. All these factors have risen & min. wage has not. You aren;t paying for anyone's iPhone.

Your duty is to pay taxes & not b!tch.

 

[music2doc]

Relax- it is only for food, housing & medical. All these factors have risen & min. wage has not. You aren;t paying for anyone's iPhone.

Your duty is to pay taxes & not b!tch.

There is no "duty" to pay for someone else's lifestyle or even their survival. That is charity. I agree it is the right thing to do but to force others into paying your way through life lacks dignity. It wreaks of selfishness and entitlement.

 

[link2swim06]

This is all wonderful, really, and I agree with almost everything you've written. The dignity conferred by working is essential to humanity, and the ultimate goal of any welfare state should be the attainment of full employment and the assurance that employment provides a decent life.

I can agree with this, but my entire point through the past posts is the current system is all about wealth transfer. I cant really think of one social program which successfully helps the majority achieve class mobility. This is why you can finds tons of people to attack welfare and food stamps but much fewer will attack education and the alike.

I guess I just dont see how cable TV or air conditioning is going to result in helping anyone to achieve their dreams...but I do see it reduces my earnings as a future worker which isnt very fair imo. Our country was founded on giving everyone the chance to follow their own dream mantra not this transfer of wealth philosophy our president lectures us on.

 

[link2swim06]

Relax- it is only for food, housing & medical. All these factors have risen & min. wage has not. You aren;t paying for anyone's iPhone.

Your duty is to pay taxes & not b!tch.

But if they use their spare money to buy the iphone, xbox, etc... only because their food was paid for by food stamps then didn't society just buy them that luxury?

 

[Cornu Ammonis]

I can agree with this, but my entire point through the past posts is the current system is all about wealth transfer. I cant really think of one social program which successfully helps the majority achieve class mobility. This is why you can finds tons of people to attack welfare and food stamps but much fewer will attack education and the alike.

I guess I just dont see how cable TV or air conditioning is going to result in helping anyone to achieve their dreams...but I do see it reduces my earnings as a future worker which isnt very fair imo. Our country was founded on giving everyone the chance to follow their own dream mantra not this transfer of wealth philosophy our president lectures us on.

Sadly, I have to agree with you; most if not all social welfare programs are dismal failures, mostly owing to their centrally planned nature, but also due to a problem to which you alluded earlier: corporatism. There is no way to climb out of poverty if we allow and even encourage employers to remove the rungs from the bottom of the ladder, and by this I mean opening factories abroad without consequence or taxation, quashing unions at home, and trashing the environment to the point where the health of those living near factories, mines, and oil/gas extraction sites is severely jeopardized.

Obviously the solution can't be simply taxing profits, since this does nothing to discourage this behavior nor does it help the abused (although it at least would help with our budget). Still, I honestly think we have a lot of room for improvement that doesn't involve outright welfare. Things like power and transportation infrastructure, medical and scientific research, and the creation of public universities all have universal and relatively cheap benefits for everyone. Still, I wouldn't be so quick to dismiss giving at least some luxuries to the poor when there are children in the household. The effects of living without these luxuries as a child are demonstrably negative.