People in the United States can look forward to a future of ill health. I say this not because the medical care system, euphemistically yet universally referred to as the health care system, is failing under the weight of overdiagnosis and overtreatment but because our political culture has, for quite some time now, entirely abandoned caring for those least capable of caring for themselves. Mostly children.
Last week the McClatchy Newspapers published an analysis of recent census data on poverty here in the land of opportunity. Poverty is increasing. In fact, it’s been increasing for almost three decades. Despite economic growth and increased worker productivity the fruits of that growth have been harvested almost exclusively by the owning classes. Meanwhile, the number of people in severe poverty (with half the income of the official poverty level) has increased steadily and the number of people with an income greater than twice the poverty level has steadily declined.
What’s being done to alleviate this suffering? Perhaps you will remember the Welfare Reform Act of 1996, championed by then-President Bill Clinton and happily passed by a Republican Congress. It’s ostensible purpose was to reduce welfare expenditures and get people into the workforce where they could build their self-esteem on a minimum wage that becomes smaller each year in real buying power. Yesterday, the Associated Press reported on how this happy scheme is working. It’s failing. Although cash payments have declined, spending on other programs like Medical and food stamps have more than compensated so that total spending is higher than the old welfare system would have been. What’s more, that spending would explode if all the people who are eligible participated. One study estimates that only 10% of eligible people apply for these supplemental programs.
As to entering the happy world of the workforce, “struggle” is as good as it gets. “Grim” and “stuck” are more accurate descriptions of the descent into poverty experienced by, mostly, single mothers and their children.
The economics is quite plain: tax dollars are subsidizing businesses in yet another way by creating an underclass forced to work for dirt. Instead of enforcing a living wage, people (again, mostly single mothers) are forced to struggle with a combination of low wages at jobs without benefits and little security while various government programs provide them with food, shelter, and medical care.
There are some obvious effects on health. For example, being forced to choose between medical care and some necessity like rent and heat.
There are less obvious and much longer term effects from this abandonment. There’s a well-documented relationship between income security and health. In a nutshell, the stress of insecurity promotes inflammation that in turn promotes illness. But it goes beyond that. Children who experience stress are more likely to have pro-inflammatory health effects as adults regardless of the stressors they experience as adults. Recent research has identified the process that causes this. Our abandonment of children and their mothers to poverty is cursing their future. And their numbers are growing.
The old welfare program was called Aid to Families with Dependent Children. The idea was that children, particularly preschoolers, should have a full-time parent at home with them. Typically, that meant the child’s mother. The science supports that as very desirable for everyone. All gone now. And by and large due to the same people who espouse family values.
Many years ago I was enjoying lunch at Cowell College on the UC Santa Cruz campus with some faculty members. The family-values crowd came up and someone captured their ideology by saying, “Life is sacred before birth. After that, you’re on your own.”
Welcome to the land of opportunity. Get ready for a whopper of a medical bill.
