Tuesday, July 19, 2005

The poor will always be with us

This is my response in part to an article that I found here: http://thepublicsquare.blogspot.com/2005/07/caring-for-least.html

In this article the writer speaks about the Catholic position regarding looking after the poor in our society. Should it be a government responsibility alone? Catholics such as Joan Chittiser and Richard McBrien obviously believe that we should have these expensive government programs that hand out welfare money without any form of responsibility. On the other side of the debate is Myron Magnet. Like Magnet, I believe that we have a social responsibility to care for people who are unable to care for themselves. I am referring to the elderly, the disabled and the mentally incapacitated in our midst.

On the other hand able bodied people should only have limited access to these resources when they become unemployed. I agree that there is a need for limited assistance because unemployment causes its own set of problems and something is needed to help a person until there is another offer of employment. An able bodied person has a better chance of finding long term employment than someone who is carrying some form of disability. The able bodied should be encouraged to find work and requires necessary incentives to work, not disincentives to work. A welfare state in the long term encourages laziness amongst those who are able bodied and unemployed. Benefits should be tied to some form of responsibility including schemes that require working for the dole.

In my comments I am probably going a lot further than the comments of Myron Magnet. I guess that is a result of my own life experiences. At this present time I, too, am unemployed. I could be accused of being picky about my location requirements for work, since I am not being as flexible as I have been in the past. The reason that I am not so flexible happens to be the result of an increase in the difficulties that I experience because of my arthritis. I have generalized osteoarthritis or at least that is one diagnosis.This has changed in recent years to Mixed Connective Tissue Disease. At the same time I had an accident and fractured my coccyx for the second time.  It is spread throughout my body, from my jaw, right down to my toes. It is in my spine and it hurts to sit for any length of time. I have a condition that is known as spondylarthrophy and I have sacroiliitis which causes stiffness in my lower back, but I do not have the more severe condition know as AS. As a result of these conditions I feel that I do not want to work in a location that causes me to take hours to get to and from work. In reality it means that my opportunities for work are limited. Yet, there are people out there who are worse off than myself, and they do need some form of care.

My concern therefore, is not for myself but for the little people whose disabilities are so bad that they need constant care. I do believe that the government should provide some assistance for their care. However, the danger of allowing government to have total control over the care of the disabled is that eventually that care will be compromised by cost cutting measures.

What are we supposed to do? I believe that a major issue that has not been addressed is that of abandonment of the profoundly disabled in nursing homes. Instead of caring for their loved ones who have been born with conditions that cause disability, many families abandon them and leave them to rot in orphanages and nursing homes. The primary responsibility for a profoundly disabled child rests with the family and not the government. What if the family is not able to cope? This is the area where I believe that there needs to be government intervention. The family of the profoundly disabled sometimes needs respite from those concerns. This respite can be provided by either a government agency or by other family and friends. The family needs to know that it has the support of the community as a whole. This support will not happen so long as a community continues to have prejudices against those who have a disability.

 There are different levels of disability and in most cases the physical disability does not affect the brain. When Judas got snotty over Mary of Bethany pouring oil over Jesus, he was given a reminder: "The poor will always be with us.". This is a truth that we should not forget. It does not mean that we should abandon the poor because they will always be around, but it does mean that the poor in society need to take some form of responsibility for their position in life. The welfare state has caused the abandonment of the disabled and the elderly.

At one time the elderly knew that they had an insurance policy because their children would look after them, however, now they face abandonment as they are increasingly being placed in nursing homes with the members of the family rarely coming near them. This is certainly true for a minority of the elderly of our society. I should point out that there are times when placement in a nursing home becomes necessary because the care needs of the elderly person are beyond the personal resources of the family members. These are people who require special care because of Alzheimer's disease or other similar conditions including patients who have been severely affected through brain damage brought on by a stroke. There is good and bad in a welfare state.

 I need to point out that I am not against the use of welfare payments in cases of necessity. What if the parents of a young family are killed in a car accident? Who is to take responsibillity for the surviving family members? There is a divine requirement to care for the widow and the orphans. In such a case the children should not be abandoned into the streets; neither should they have to confront the wicked who would try to take everything away from them. We have a better society today than the society of the nineteenth century when poor houses or work houses were all the rage. Such Christian institutions were used to create a group of second class citizens who were used as "slaves" by those who were running the workhouses. The owners of such establishments were very cruel to the inmates. A welfare state has meant the end of such abuse of those who are poor.

The institution of a welfare state has in fact created a new crisis in the twenty first century. This time the crisis revolves around the dollars available for health matters. A lot of the health dollars are being channelled into non-productive purposes such as abortion on demand. At the other end of the scale, funds are being denied to people who are facing life and death issues. What is driving the push for euthanasia? Is it just that people do not understand that it is God who determines when we will live and die? Or is it a result of poor policy and health budget planning? What of the money that is being wasted on embryonic stem cell research? I am sure that this money could be more wisely spent in other fields within medicine and be more productive as far as outcome is concerned than by wasting even more health dollars on research in an area that has so far produced nothing but problems associated with tumors from the use of embryonic stem cells.

We can continue to care for the least amongst us whilst looking at where the health dollars are being spent. This is an area that needs to be thought about now, not even in five years time when the health budget will have soared again because of the abuse of those who are requesting health dollars today. Now more than ever, there is a crisis in our hospitals, as the hospital waiting lists for surgery continue to increase. I cannot fathom why this has been allowed to occur. Obviously, there is a problem within the health industry due to faulty budget management. Having dealt with the finance departments of various hospitals here in Australia, I find that I do have a little bit of insight into the problem that has arisen. One of the reasons that we have this problem stems from the over-reliance upon government to provide the health dollars. If the government of the day is not able to produce a wise budget and is wasting money in various ways (including wastage due to generous superannuation funding of parliamentarians) then other areas that need those dollars in order to operate sufficiently will be left under resourced.

The health crisis in Australia, for example, stems from the egalitarian push for universal medical coverage via government funding. It does not work to a satisfactory level. The emergency departments of the public hospitals have become full of people requiring the kind of medical attention that can be satisfied by the local GP. The attraction of the emergency department is the promise of free health, whereas the local GP now charges a very high fee for a 15 minute appointment. Medicare and its predecessor, Medibank have been total disasters. Prior to the introduction of this attempt to socialize medicine, we had a system where people were encouraged to save for that rainy day by having medical health insurance.

 The introduction of Medibank, and then the introduction of Medicare meant that thousands of people opted out of the scheme. It was only natural that the fees of the funds would increase, and not decrease as membership levels fell to all time low levels. At the same time there was a renewed pressure upon the public system, to the point that public health is now in crisis. There are many who are employed and who have good salaries who should be participating in a health fund, but who prefer to have only the universal PAYE style of cover (PAYE is the Medicare levy through taxation).

The levy itself can be quite inequitable for families where there is more than one income, since they are the ones who bear the full burden over those who are without income. Under the old system the household paid into the fund at one family level only. These are the same people who clog the public schools with their children and who literally refuse to pay anything towards their children's education. Again, this attitude means that there is a drain upon the budgetary funds that are available within the ecomony. There is a constant level of competition for the Budget dollars and more often than not, one area has its funding increased at the expense of another area.

There is a lot of waste at the public service level of government. Whilst most public servants really do work very hard, the fact remains that there is too much fat and bloat at every level of government that is served by the public service. Why for example, is it necessary for either federal or state governments to be involved in the provision of health benefits for the general public? The fact that Medibank Private operates as a private insurance fund but remains a part of government is an indicator that there is too much bloat. Government should not be poking itself into this particular area. On the other hand, the government needs to ensure that doctors and other professionals are paid for their services to the poor. Of course, in the days that are pre-Medibank, the poor were always treated "pro bono". This means that the introduction of the scheme has brought forth a whole raft of other problems such as fraudulent claiming payment for services that have not been provided by a doctor or other professional. Some areas within the health industry have remained neglected. For example, why is it that a podiatrist is not recognized under Medicare? Why is it that physiotherapy and exercise therapy is not recognized under Medicare? If these things were recognized then other forms of costs could be reduced, because patients would seek alternatives to drugs for their illnesses.

The answer then, is that the whole system needs an overhaul and the government role in health should be reduced. There has been too much government interference and that has impacted upon the standard of care that is offered in our health system.