“Where Is The Love?”: Compassion Isn’t A Sign Of Weakness, But A Mark Of Civilization
When I’ve written recently about food stamp recipients, the uninsured and prison inmates, I’ve had plenty of pushback from readers.
A reader named Keith reflected a coruscating chorus when he protested: “If kids are going hungry, it is because of the parents not upholding their responsibilities.”
A reader in Washington bluntly suggested taking children from parents and putting them in orphanages.
Jim asked: “Why should I have to subsidize someone else’s child? How about personal responsibility? If you procreate, you provide.”
After a recent column about an uninsured man who delayed seeing a doctor about a condition that turned out to be colon cancer, many readers noted that he is a lifelong smoker and said he had it coming.
“What kind of a lame brain doofus is this guy?” one reader asked. “And like it’s our fault that he couldn’t afford to have himself checked out?”
Such scorn seems widespread, based on the comments I get on my blog and Facebook page — as well as on polling and on government policy. At root, these attitudes reflect a profound lack of empathy.
A Princeton University psychology professor, Susan Fiske, has found that when research subjects hooked up to neuro-imaging machines look at photos of the poor and homeless, their brains often react as if they are seeing things, not people. Her analysis suggests that Americans sometimes react to poverty not with sympathy but with revulsion.
So, on Thanksgiving, maybe we need a conversation about empathy for fellow humans in distress.
Let’s acknowledge one point made by these modern social Darwinists: It’s true that some people in poverty do suffer in part because of irresponsible behavior, from abuse of narcotics to criminality to laziness at school or jobs. But remember also that many of today’s poor are small children who have done nothing wrong.
Some 45 percent of food stamp recipients are children, for example. Do we really think that kids should go hungry if they have criminal parents? Should a little boy not get a curved spine treated properly because his dad is a deadbeat? Should a girl not be able to go to preschool because her mom is an alcoholic?
Successful people tend to see in themselves a simple narrative: You study hard, work long hours, obey the law and create your own good fortune. Well, yes. That often works fine in middle-class families.
But if you’re conceived by a teenage mom who drinks during pregnancy so that you’re born with fetal alcohol effects, the odds are overwhelmingly stacked against you from before birth. You’ll perhaps never get traction.
Likewise, if you’re born in a high-poverty neighborhood to a stressed-out single mom who doesn’t read to you and slaps you more than hugs you, you’ll face a huge handicap. One University of Minnesota study found that the kind of parenting a child receives in the first 3.5 years is a better predictor of high school graduation than I.Q.
All this helps explain why one of the strongest determinants of ending up poor is being born poor. As Warren Buffett puts it, our life outcomes often depend on the “ovarian lottery.” Sure, some people transcend their circumstances, but it’s callous for those born on second or third base to denounce the poor for failing to hit home runs.
John Rawls, the brilliant 20th-century philosopher, argued for a society that seems fair if we consider it from behind a “veil of ignorance” — meaning we don’t know whether we’ll be born to an investment banker or a teenage mom, in a leafy suburb or a gang-ridden inner city, healthy or disabled, smart or struggling, privileged or disadvantaged. That’s a shrewd analytical tool — and who among us would argue for food stamp cuts if we thought we might be among the hungry children?
As we celebrate Thanksgiving, let’s remember that the difference between being surrounded by a loving family or being homeless on the street is determined not just by our own level of virtue or self-discipline, but also by an inextricable mix of luck, biography, brain chemistry and genetics.
For those who are well-off, it may be easier to castigate the irresponsibility of the poor than to recognize that success in life is a reflection not only of enterprise and willpower, but also of random chance and early upbringing.
Low-income Americans, who actually encounter the needy in daily life, understand this complexity and respond with empathy. Researchers say that’s why the poorest 20 percent of Americans donate more to charity, as a fraction of their incomes, than the richest 20 percent. Meet those who need help, especially children, and you become less judgmental and more compassionate.
And compassion isn’t a sign of weakness, but a mark of civilization.
By: Nicholas D. Kristof, Op-Ed Columnist, The New York Times, November 27, 2013
“The GOP Blocking Of Medicaid Expansion”: The Huge Obamacare Story You Aren’t Reading About That Could Help Even More People
Today it’s a few hundred thousand people. By next year, it will be at least a few million. Their health insurance status is changing dramatically: What they have in 2014 and beyond will look nothing like what they had in 2013 and before. For many of these people, the difference will be hundreds or even thousands of dollars a year. In a few cases, it may be the difference between life and death.
You probably think I’m talking about the people getting cancellation notices about their private insurance policies. I’m not. I’m talking about the people getting Medicaid. Both stories are consequences of the Affordable Care Act. But one is getting way, way more attention than the other.
It’s no mystery why. Stories of people losing something are more compelling than stories of people gaining something. The policy cancellation story is also newsier, because fewer people expected it to happen. Obamacare’s expansion of Medicaid was something the advocates of reform advertised. Reform’s effect on people with skimpy or medically underwritten insurance policies they liked was something that few advocates, including the president, even acknowledged. Had Obama pointed out, all along, that some people might lose existing plans or pay more for coverage in 2014, it would seem a lot less shocking.
But there is also a class element to the way this debate has evolved. By and large, the people receiving those cancellation notices and facing large premium increases are at least reasonably affluent. They’re not necessarily rich, particularly if they live in higher cost areas of the country. Many of them sweat monthly bills just like most of the country does. But, by definition, they don’t qualify for huge subsidies that would offset premium increases mostly or completely. By contrast, the people getting Medicaid are poor. They have to be, because it’s the only way to sign up for the program. And as political scientists have shown, the poor don’t command the same kind of attention from politicians that the middle class—and particularly the upper middle class—does.
And this fact, I suspect, is also magnifying the impact of those cancellation letters. The best estimates suggest that 12 to 15 million people currently buy coverage on their own—i.e, in what’s known as the non-group market. It appears that only a fraction of them will get to keep their current policies. The rest will end up having to get new coverage, or updated versions of their old coverage, that offers greater benefits and/or is available to everybody, regardless of pre-existing condition. That will drive up the price of insurance.
But when you take into account the subsidies, which for many people will knock the price of insurance right back down, and the number of people who would gladly pay more for insurance that offers real protection from financial shock, the number of people who truly end up feeling worse off ends up a lot smaller than 12 or 15 million. And even those people will end up with good health insurance, though they’ll be paying more for it and may not want it.
Meanwhile, the best available projections suggest that 13 million people will eventually sign up for Medicaid. That’s a much larger number of people, most of whom had no insurance—none—before. That doesn’t even include more than ten million presently uninsured people expected to get insurance through employers and the new marketplaces, assuming all of the websites start working better, or the millions of seniors getting extra help with their prescrpition drugs.
Of course, the story of the Medicaid expansion is also one of suffering. But that’s because Republicans governors and lawmakers are blocking expansion of Medicaid in their states. About 5 million people who would be eligible for Medicaid under Obamacare’s new guidelines won’t be getting it. Here’s a mental exercise. How many stories have cable news and the networks run about people with private insurance getting cancellation notices? And how many have they run about people who would be getting Medicaid if only their state lawmakers would stop blocking expansion?
You can find examples. My colleague Alec MacGillis has waged a lonely crusade to remind people about this situation. The New York Times had a terrific front-page story on this in early October. In the Washington Post, Ruth Marcus on Friday wrote about Paul Tumulty, in Texas, who can’t get insurance because Governor Rick Perry has blocked that state’s Medicaid expansion. Tumulty, who is the brother of Post staff writer Karen, has kidney disease. Wiithout Medicaid he can’t get comprehensive coverage, because, as Karen put it, “he is, paradoxically, too poor for subsidies.”
But these articles are the exception more than the rule. Obama tried to draw attention to the issue last week, when he visited Texas. But the trip didn’t generate much in the way of new coverage of Medicaid.
Should the president have been more candid about the impact his plan would have on people buying their own coverage? Yes. Should we pay attention to those people, particularly when they must now pay more for equivalent coverage? Definitely. Should this put extra pressure on the administration and some states to fix their websites? You bet. But that’s not the only Obamacare news right now. The law is making life better for a great many people—and would help even more if only Republican lawmakers would relent. Those stories need attention, too.
By: Jonathan Cohn, the New Republic, November 10, 2013
“The Middle Class Doesn’t Write Big Checks”: The Bottom 90 Percent Have Disappeared And Have No Voice In Washington
So how to explain this paradox?
As of November 1 more than 47 million Americans have lost some or all of their food stamp benefits. House Republicans are pushing for further cuts. If the sequester isn’t stopped everything else poor and working-class Americans depend on will be further squeezed.
We’re not talking about a small sliver of America here. Half of all children get food stamps at some point during their childhood. Half of all adults get them sometime between ages 18 and 65. Many employers – including the nation’s largest, Walmart – now pay so little that food stamps are necessary in order to keep food on the family table, and other forms of assistance are required to keep a roof overhead.
The larger reality is that most Americans are still living in the Great Recession. Median household income continues to drop. In last week’s Washington Post-ABC poll, 75 percent rated the state of the economy as “negative” or “poor.”
So why is Washington whacking safety nets and services that a large portion of Americans need, when we still very much need them?
It’s easy to blame Republicans and the rightwing billionaires that bankroll them, and their unceasing demonization of “big government” as well as deficits. But Democrats in Washington bear some of the responsibility. In last year’s fiscal cliff debate neither party pushed to extend the payroll tax holiday or find other ways to help the working middle class and poor.
Here’s a clue: A new survey of families in the top 10 percent of net worth (done by the American Affluence Research Center) shows they’re feeling better than they’ve felt since 2007, before the Great Recession.
It’s not just that the top 10 percent have jobs and their wages are rising. The top 10 percent also owns 80 percent of the stock market. And the stock market is up a whopping 24 percent this year.
The stock market is up even though most Americans are down for two big reasons.
First, businesses are busily handing their cash back to their shareholders – buying back their stock and thereby boosting share prices – rather than using the cash to expand and hire. It makes no sense to expand and hire when most Americans don’t have the money to buy.
The S&P 500 “Buyback Index,” which measures the 100 stocks with the highest buyback ratios, has surged 40 percent this year, compared with a 24% rally for the S&P 500.
IBM has just approved another $15 billion for share buybacks on top of about $5.6 billion it set aside previously, thereby boosting its share prices even though business is sluggish. In April, Apple announced a $50 billion increase in buybacks plus a 15% rise in dividends, but even this wasn’t enough for multi-billionaire Carl Icahn, who’s now demanding that Apple use more of its $170 billion cash stash to buy back its stock and make Ichan even richer.
Big corporations can also borrow at rock-bottom rates these days in order to buy back even more of their stock — courtesy of the Fed’s $85 billion a month bond-buying program. (Ichan also wants Apple to borrow $150 billion at 3 percent interest, in order to buy back more stock and further enrich himself.)
The second big reason why shares are up while most Americans are down is corporations continue to find new ways to boost profits and share prices by cutting their labor costs – substituting software for people, cutting wages and benefits, andpiling more responsibilities on each of the employees that remain.
Neither of these two strategies – buying back stock and paring payrolls – can be sustained over the long run (so you have every right to worry about another Wall Street bubble). They don’t improve a company’s products or customer service.
But in an era of sluggish sales – when the vast American middle class lacks the purchasing power to keep the economy going – these two strategies at least keep shareholders happy. And that means they keep the top 10 percent happy.
Congress, meanwhile, doesn’t know much about the bottom 90 percent. The top 10 percent provide almost all campaign contributions and funding of “independent” ads.
Moreover, just about all members of Congress are drawn from the same top 10 percent – as are almost all their friends and associates, and even the media who report on them.
Get it? The bottom 90 percent of Americans — most of whom are still suffering from the Great Recession, most of whom have been on a downward escalator for decades — have disappeared from official Washington.
By: Robert Reich, RobertReich.org, Published in Salon, November 1, 2013
“Happiness Today, Bankruptcy Tomorrow”: Why Letting Everyone Keep Their Health-Care Plan Is A Terrible Idea
The current furor over President Obama’s broken “keep your plan” promise confusingly melds together two very different claims. The first is a simple question of accuracy and honesty: Obama made a promise about his legislation, the promise has not come true, and a certain level of abuse is deserved. (Karl Rove huffs, “This is a serious breach of trust with the American people.” And you know that Karl Rove takes breaches of presidential trust with the utmost seriousness.)
The justifiable scrutiny of Obama’s veracity has melded seamlessly into a second and very different claim: That Obama’s broken promise is not merely a violation of trust, a fair enough charge, but an act of unfairness to those who have lost their plans.
The health-care debate has suddenly come to focus almost obsessively on the alleged victims of Obamacare, who have lost their cheap individual insurance. Here’s Matthew Fleischer mourning the loss of his bare-bones plan in the Los Angeles Times; here’s David Frum doing the same for the Daily Beast. Mary Landrieu, a vulnerable red-state Democrat, is introducing legislation to ensure that nobody can lose their individual health-care plan.
The idea underlying this notion, while facially appealing, is in fact misguided and morally perverse. No decent health-care reform can keep in place every currently existing private plan.
The New York Times has a helpful graphic displaying the structure of the insurance market:
The left and top-right squares show the four fifths of Americans who get coverage through the government. Those on the left who get covered through their employer get tax-subsidized insurance, and those in the top right get insured by the government directly. Obamacare leaves that structure in place (though it has a series of mechanisms designed to hold down their cost inflation).
The main coverage provisions affect the people in the bottom right quadrant. Most of that quadrant lacks any insurance at all, which points to the dysfunctionality of buying individual insurance before Obamacare. Some of them — 5 percent of the population — have a health-insurance plan. Health-care reforms have always thought of the people within that segment as being essentially the same group of people. Those are mainly healthy, non-poor people who have been skimmed out of the insurance pool, leaving behind those too poor, or too likely to need medical care.
Obamacare is designed to pool the bottom-right quadrant into risk pools, somewhat like the people on the left and the upper right. The poorest of the uninsured are eligible for Medicaid, though a Republican Supreme Court and Republican state governments collectively decided to leave them uninsured. The rest have coverage through the new health exchanges. By design, those exchanges prevent insurers from skimming out the healthy and excluding the sick. Some of the 5 percenters will get less expensive health care, mainly because they qualify for tax credits. Others think they will have to pay higher costs but, upon inspection, will be getting cheaper coverage on the exchanges.
But some other portion — an as-yet-undefined fraction of the 5 percent — will actually be paying higher insurance premiums in the exchanges, and their complaints are echoing across the land. Should we feel concerned for their plight? No, we should not, for three reasons.
First, a great many of the people who are happy with their individual health-insurance plan are happy only because they are unaware of its actual value. This sounds patronizing, but it also happens to be demonstrably true. Even highly educated consumers within this market were frequently snookered by insurance plans that turned out to leave them exposed to surprise costs — they incur a sudden high medical cost and discover their plan does not actually cover them. The fine print is a game of wits between insurer and customer that the insurer always wins. A large share of the people telling us now they’re happy with their individual insurance simply haven’t been exposed to a negative surprise. The handful of reporters who closely followed the individual-insurance market before last week are all watching the eulogies for the lost individual plans and having their brains explode.
Second, it is true that some people actually are getting decent individual health insurance, and have to pay more under Obamacare. Before, insurers could charge them a rate based on their individual likelihood of needing medical care, and some people are lucky enough to present a very low actuarial health risk. Now those people will have to pay a rate averaging in the cost of others who are less medically fortunate.
Have those healthy 5 percenters who do have decent insurance “lost” under Obamacare? In the very immediate sense, yes. That is what Obamacare advocate Jon Gruber is getting at when he concedes that 3 percent of Americans will be worse off under the new law. They’ll be paying higher rates in 2014 than they would have.
Yet this takes an oddly narrow view of their self-interest. You may pose a low actuarial risk today, but you cannot be certain your luck will continue for the rest of your life (or until you qualify for Medicare). Even people living the healthiest lifestyles suffer illnesses and accidents, or marry people who have a uterus. Those who are paying a higher rate are getting something for their money: a guarantee that some future misfortune won’t lock them out of the market. You might call such a guarantee “insurance.”
So some of the 5 percenters are wrong, some of them are short-sighted, but they have identified a basic moral principle: Why is it fair to steal from them, the healthy, and give to others, who are sick? If they have truly mastered the fine print of the individual insurance market and want to gamble on remaining a good actuarial risk forever, should they be permitted to keep their winnings? Having drilled down through the practical arguments, here we get to the final reason, the moral bedrock of the issue.
Their objection has an intuitive, libertarian appeal that obscures the fact that the vast majority of insured Americans already submit to this form of redistribution. Indeed, they’re submitting to a much more stringent form of this redistribution. The exchanges are allowed to charge older people up to three times the premium they charge the young. But in the employer system, they’re not allowed to charge older people any higher rate at all. The shift from healthy to sick in the employer insurance pool is massive. Adrianna McIntyre, a 24-year-old wonk prodigy, notes that her employer-based coverage charges her more than three times the rate she could get in the new exchanges.
People accept this transfer from the healthy to the sick because it is the only way to make medical care affordable to the sick. This is a simple mathematical truism. If your medical care costs more than you can afford to pay, the difference must be borne by those whose medical care costs less than they can afford to pay. There are any number of ways to handle this transfer. One is taxes, and Obamacare does use taxes to make insurance more affordable for many of its recipients. There are other potential methods — conservatives like to tout high-risk pools, at least in the abstract — but none escape the basic math.
The healthy 5 percenters do recognize that Obamacare carries out this transfer. Fleischer complains he is “being taken advantage of.” Frum, writing in the same spirit, complains that he must pay $200 more now that insurers can no longer reward him for his excellent health:
That $200 a month differential seems to be the cost of community rating: I had to answer a bunch of questions about my health before qualifying for my prior plan; the new plan will be issued, no questions asked. Presumably somewhere there is a D.C. resident who smokes or who has some pre-existing condition who will receive a corresponding $200 a month windfall.
The complainers are right. But they won’t quite face up to the full implications of their complaint. If you believe the healthy are entitled to keep the financial benefits of their good health, then you must also believe the sick must be denied medical care. Should that principle be the foundation of our health-care system?
By: Jonathan Chait, New York Magazine, November 1, 2013
“Poverty In America Is Mainstream”: It’s An Issue Of Us, Rather Than An Issue Of Them
Few topics in American society have more myths and stereotypes surrounding them than poverty, misconceptions that distort both our politics and our domestic policy making.
They include the notion that poverty affects a relatively small number of Americans, that the poor are impoverished for years at a time, that most of those in poverty live in inner cities, that too much welfare assistance is provided and that poverty is ultimately a result of not working hard enough. Although pervasive, each assumption is flat-out wrong.
Contrary to popular belief, the percentage of the population that directly encounters poverty is exceedingly high. My research indicates that nearly 40 percent of Americans between the ages of 25 and 60 will experience at least one year below the official poverty line during that period ($23,492 for a family of four), and 54 percent will spend a year in poverty or near poverty (below 150 percent of the poverty line).
Even more astounding, if we add in related conditions like welfare use, near-poverty and unemployment, four out of five Americans will encounter one or more of these events.
In addition, half of all American children will at some point during their childhood reside in a household that uses food stamps for a period of time.
Put simply, poverty is a mainstream event experienced by a majority of Americans. For most of us, the question is not whether we will experience poverty, but when.
But while poverty strikes a majority of the population, the average time most people spend in poverty is relatively short. The standard image of the poor has been that of an entrenched underclass, impoverished for years at a time. While this captures a small and important slice of poverty, it is also a highly misleading picture of its more widespread and dynamic nature.
The typical pattern is for an individual to experience poverty for a year or two, get above the poverty line for an extended period of time, and then perhaps encounter another spell at some later point. Events like losing a job, having work hours cut back, experiencing a family split or developing a serious medical problem all have the potential to throw households into poverty.
Just as poverty is widely dispersed with respect to time, it is also widely dispersed with respect to place. Only approximately 10 percent of those in poverty live in extremely poor urban neighborhoods. Households in poverty can be found throughout a variety of urban and suburban landscapes, as well as in small towns and communities across rural America. This dispersion of poverty has been increasing over the past 20 years, particularly within suburban areas.
Along with the image of inner-city poverty, there is also a widespread perception that most individuals in poverty are nonwhite. This is another myth: According to the latest Census Bureau numbers, two-thirds of those below the poverty line identified themselves as white — a number that has held rather steady over the past several decades.
What about the generous assistance we provide to the poor? Contrary to political rhetoric, the American social safety net is extremely weak and filled with gaping holes. Furthermore, it has become even weaker over the past 40 years because of various welfare reform and budget cutting measures.
We currently expend among the fewest resources within the industrialized countries in terms of pulling families out of poverty and protecting them from falling into it. And the United States is one of the few developed nations that does not provide universal health care, affordable child care, or reasonably priced low-income housing. As a result, our poverty rate is approximately twice the European average.
Whether we examine childhood poverty, poverty among working-age adults, poverty within single-parent families or overall rates of poverty, the story is much the same — the United States has exceedingly high levels of impoverishment. The many who find themselves in poverty are often shocked at how little assistance the government actually provides to help them through tough times.
Finally, the common explanation for poverty has emphasized a lack of motivation, the failure to work hard enough and poor decision making in life.
Yet my research and that of others has consistently found that the behaviors and attitudes of those in poverty basically mirror those of mainstream America. Likewise, a vast majority of the poor have worked extensively and will do so again. Poverty is ultimately a result of failings at economic and political levels rather than individual shortcomings.
The solutions to poverty are to be found in what is important for the health of any family — having a job that pays a decent wage, having the support of good health and child care and having access to a first-rate education. Yet these policies will become a reality only when we begin to truly understand that poverty is an issue of us, rather than an issue of them.
By: Mark R. Rank, The New York Times, November 2, 2013
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