Welfare Policy“Welfare is hated by those who administer it, mistrusted by those who pay for it and held in contempt by those who receive it.”

—Peter C. Goldmark, Jr.

According to the federal government, how many Americans

are poor?

In 2010, 46.2 million Americans lived in poverty—that’s 15.1% of the U.S. population.

Social Security

• Old-Age and Survivors Insurance: retirement pensions to which all Americans over 65 are entitled

• Disability Insurance / Unemployment Insurance / Health insurance

• Medicare: Medical care for the over 65

Welfare: social protection for the poor

• Medicaid: medical coverage for the poor.• Food Stamps (Vouchers that can be

exchanged for food)• Housing Assistance• Temporary Assistance for

Needy Families (most often single mothers with children)

Medical Aid Programs• Medicare

– anyone aged 65 or older who was at one time covered at work by Social Security is eligible

• Medicaid– only low-income people are eligible for this

type of assistance

Medicare

• Helps pay hospital and medical costs• Anything not paid by Medicare is often paid

through supplemental insurance– as medical costs rise the elderly are paying

more for their health care• There is no long-term care provision for in-

home assistance

Medicaid

• Pays for health care for:– low income families with children– low income elderly– people with disabilities

• 65 million Americans received Medicaid in 2014

An Imperfect safety net

• People can buy individual insurances but these are very expensive. (15% of the population without coverage).

• However when illness strikes, people postpone treatment.

Unequal health

• American medicine the most sophisticated and innovative in the world.

• But reflects growing inequalities• Disparities resulting from

– Income &– race

African Americans

• infant mortality rate is 2.4 times higher than that of white infants

• 30% higher death rate for all cancers

• Seven times more likely to die from HIV / AIDS

• Five times more likely to develop glaucoma

Hispanics and Latinos

• twice more likely to die from diabetes• 20% of new cases of TB• Higher rates of high blood pressure and

obesity

American Indians & Alaskan Natives

• Diabetes rates that are twice the national average

• Disproportionately high death rates from unintentional injuries and suicide

Soaring Costs • Prices regularly increasing (15% a year)• Malpractice suits• Insurance policies

more expensive.

Reasons Why People Sue Their Reasons Why People Sue Their DoctorsDoctors

• Advised to sue by influential otherAdvised to sue by influential other 3232• Needed moneyNeeded money 2424• Believed there was a cover-upBelieved there was a cover-up 2424• Child would have no futureChild would have no future 2323• Needed informationNeeded information 2020• Wanted revenge, licenseWanted revenge, license 1919

Percent Expressing Percent Expressing ConcernConcern

Source - Hickson, 1992

Soaring Costs (drugs)

• Drugs are 3 times higher than in Britain and 6 times higher than in Brazil

• The United States leaves pricing to market competition

Soaring Demand

• Population aging & higher life expectancy.

• By 2030 the baby boomers will be retiree• Medicare and social security place an

increasing burden on workers.• Possible solutions are to increase the

retirement age...

Other welfare programs: AFDC

• Aid to Families with Dependent Children– Temporary Assistance to Needy Families– Provides income to families with

dependent children– Generally single parent families– About 95% of single parents are women

AFDC: A Flawed System?

The system did not do enough to encourage workBy rewarding unwed mothers and pregnant teens, responsible for the breakdown of the familyThe system fostered dependencyIn 1996, AFDC was replaced by the more restrictive Temporary Assistance for Needy Families (TANF) program

Food Stamps• Paid by the U.S. Department of Agriculture• Administered by state welfare departments• Provides food for low-income people, and

subsidies to farmers.• 49 million

Americans on food stamps

“Suppose the budgets of your state and local governments have to be curtailed, which of these parts would you limit most severely?”

Public welfare programs 39%

Food stamps 35%

Welfare and Public Opinion

Why do Americans hate welfare?

Welfare has become a code word for race, tapping into latent prejudice.Americans value autonomy self-reliance and self-helpThe poor are regarded as responsible for their fate.Welfare is thought to be a wasteful program that encourages laziness and fraud. An insult to the American work ethic