Convince me that government helps the poor

In a recent thread I argued that worldwide, small governments and economic freedom correlate with low rates of poverty. Several people agreed that overbearing government harms the poor in the third world, but that in first world countries it’s possible to have a government that does positive things for the poor. The purpose of this thread is to debate that idea, as it applies only in the USA and other wealthy countries.

In the first post of that thread, I linked to graphs and studies showing that government spending (as a share of GDP) and regulation have grown quite a bit in the past few decades. At the same time, economic inequality in the USA has widened. Correlation does not imply causation, of course, but if we can find many examples of government programs that either harm the poor directly, or assist the upper income tiers without doing much for the poor, that would strongly suggest that the government itself is a cause of widening inequality. As I see it, the great majority of government programs meet that description exactly. Here’s what I see happening in many areas.

Health Care. By far the largest organization providing health care to the poor is Medicaid, which insures about 50 million people. After the PPACA goes into full effect, it will insure even more. But what good does Medicaid do for the poor? In this post I linked to a couple studies—real studies from serious sources—showing that at least in some instances, results for those on Medicaid are not only worse than results for those with private insurance, but also worse than the uninsured.

In 2007 a boy named Deamonte Driver in Maryland died from a tooth infection that could have easily been prevented if he’d gotten treatment. The Washington Post leaped on the case as an example of why we should provide government health insurance for the poor. But the Post was wrong: Driver’s mother had insurance through Medicaid, but Medicaid didn’t provide enough money to pay for the necessary dental work. While plenty of people with good intentions want the government to provide health insurance for the poor, I hear remarkably little about actually providing good health insurance for the poor. The available evidence suggests that the government is not doing so.
Retirement. Taxes associated with Social security are regressive. The poor pay a higher rate than the rich. Meanwhile, wealthier people on average live longer than poor people, so they can collect Social Security for much longer. The same is true for the lavish pensions that many government employees get.
K-12 Education. The fact that the public education system is hurting poor children is so widely known and accepted on all parts of the political spectrum that stating it again seems superfluous. We can look at any statistic: dropout rates, college attendance rates, test scores, and so forth. The results always show that poor, inner-city schools trail far behind others. Yet the same people who claim to be supporting the poor will always resist any effort to reform public schools, as they did during the recent strike by Chicago teachers.
Higher education. Another area where we routinely hear demands for more government spending is higher education. More money for federal grants and loans to students, for spending on state university systems, and for various other programs that provide money to colleges and universities.

Two groups of people benefit from this money: college students, and college professors along with the ever-growing bureaucracy on campus. Both groups skew heavily towards the upper income brackets. Rich kids are much more likely to attend college than poor kids, and professors as a group are upper-middle class.

A targeted program of financial assistance available to poor students only might actually help the poor. As it is, by picking up a large part of the tab for almost everyone, the government encourages colleges and universities to raise tuition and fees, thereby pushing some schools out of reach for poor students.
Labor law. It is often claimed that labor laws are much more generous to workers in other first-world countries than in the United States. For instance, there’s the famous 35-hour workweek in France. I’ve rarely heard anyone ask whether there’s any evidence that a shorter work week is good for the poor. Back when I washed dishes and waited tables for a living, my coworkers and I were much more liable to complain about getting too little work than too much. In my experience, poor people want to work a lot. That’s how they become less poor. Laws that restrict the hours worked per week prevent them from earning as much as they could.

Worker protections are another issue where I’ve often heard that Europe outdoes the USA. In the USA, employers can fire an employee at almost any time for almost any reason. In many European countries, the government makes it almost impossible to fire an employee or even impose any punishment on one. The end result, as even liberal publications can tell, is that employers are very reluctant to hire an employee, since hiring a person might mean getting stuck with him or her for decades. This is very bad for the poor, needless to say, and countries such as Italy have dreadful labor markets as a result.
Miscellaneous Other. Generally speaking, whenever government regulation increases the cost of something or imposes a new cost where there wasn’t one before, it’s hardest for the poor to pay it and easiest for the rich. When the government requires corn ethanol is gasoline and thereby drives up gas prices, the poor suffer more than the rich. Demands for costly safety requirements in cars hurt the poor more than the rich. Further, many government programs and interventions target things that the poor are more likely to use, such as cigarettes and soft drinks. State lotteries exploit the poor. The list goes on and on.

Other posters have told me in the past that many of these things were not done with the intention of targeting the poor. That may be true, but nonetheless if all of these government programs and actions cause financial harm to the poor, it’s useless to go on insisting that government should be automatically associated with helping the poor and that anyone who wants a smaller government must hate the poor.

You’ve listed 5 major areas and one catch-all, any one of which would required detailed debate to reach anything like a consensus.

It’s also not entirely clear what your thesis is - is it that government never helps the poor, that current levels of government involvement in the US are too high in these areas to adequately help the poor, or something else entirely?

To take just one of your categories, K-12 education, it is I think without question that the poor in countries with state-run education systems have a better shot at upward mobility than those without such systems. Are you actually arguing that the poor in the US would better if there were no public school system at all?

And it takes some rather sizable leaps of logic to state that things like WIC and TANF don’t help the poor at all (not that I haven’t seen it argued).

How often do you see the poor starve to death anymore?

Government hurts the poor.

But many people legitimately need government assistance and I sympathize with them (the mentally ill or physically handicaped).

Do you make any attempt to reconcile these two statements, or am I daft to even ask?

That is, can someone truly need something that hurts them? What would that even mean? Do you somehow mean that government in the aggregate is bad but in individual cases it is good? That would imply that it isn’t government that hurts the poor but rather too much government - a much sounder statement than the broader, and nonsensical, one you made.

Are you a stickler for examples with current governments?

If not, my farmer grandmother gave birth to two kids and was billed for doctor/hospital services. When she was 30, her government enacted universal health care, and thereafter she delivered 10 more kids into the world, costs borne by the newly minted social net. The first came into the world in 1944, the last was born in 1967.

They all grew up to be healthy productive and at times quite affluent members of society.

Starting with the third kid, all the females attended -and finished- advanced education. None of the 4 boys did; they stayed home and helped farm.

As you can imagine, 2 parents and twelve kids would incur a fair number of hospital visits over 23 years. Having access to worry and bill free medical service eased their lives. Had the same government interference been applied to higher education, all the kids would have been sent to college.

Everyone gets their own government funded dominatrix!

To paraphrase, everybody knows that our system hurts the poor, and efforts to change this are resisted by unions, a resistance supported by a majority of parents with kids in the system.

Maybe everybody doesn’t know the same things you know. Maybe you should listen to this episode of This American Life, about the neurological damage caused by the trauma of poverty, and how public educators are trying to undo this damage.

AFAICT, government spending as a share of GDP and regulation have grown quite a bit in the past few decades in other developed countries as well, even while their inequality levels have remained stable or shrunk. So your correlation doesn’t appear to be reliable.

Furthermore, while I tend to agree that high levels of economic inequality are generally bad news for the poor, most economic conservatives AFAIK don’t agree. They don’t think that there’s anything particularly wrong with inequality per se, so I’m wondering why you’re arguing that there is.

Do we generally have poor people dying in the streets from easily treatable diseases or starvation? Do we have third world slums? Are our streets filled with the sick, crippled cast-offs of society?

No? That’s Goverment in action.

If you think “yes”, then you have no idea how small the problem is now compared to centuries past.

:dubious: You seem to be ignoring the fact that many of the people on Medicaid are disabled: in fact, that’s one of the largest coverage groups. You’d have to establish that the uninsured and Medicaid-insured populations were really equivalent except for their insurance status before you could conclude that any difference in health outcomes was due to that status. (You’d also have to control for any possible discrepancy in provider quality and availability. Some uninsured patients simply die of their conditions because they can’t get treated at all, or don’t seek treatment because they believe they have no recourse.)

Your attempts to compare the outcomes of, say, a few specific operations and hospitalizations for Medicaid versus uninsured patients are very suspect, in the absence of any comparison of overall level of medical care and other health impacts for the two populations.

:dubious: And how exactly was that outcome worse for the poor kid than if he’d died of a tooth infection through having no insurance to pay for any medical treatment at all?

Most government pensions are hardly “lavish”. That’s a dog-whistle word designed to provoke resentment among private-industry employees whose own pension provisions have been whittled down or outright destroyed by their employers. The business lobby has seen the advantages of encouraging insecurely employed private-sector workers to take out their frustration on public-sector workers, instead of organizing to improve their own situation.

As for Social Security, your argument simply notes that the wealthy are better off than the poor, which everybody already knows, and fails entirely even to attempt to make any kind of case for the position that the poor would be better off if Social Security didn’t exist at all.

True, and hardly surprising. As in the case of the dental-care tragedy mentioned above, though, this in no way suggests that the plight of the poor would necessarily be better if they didn’t have government supplying this resource.

There are targeted programs of federal financial assistance available to poor students only, so your argument kind of falls apart there.

And once again, your argument is called into question by the contrary evidence from some other developed nations. Finland and Norway, for example, provide universal student benefit that effectively makes higher education free to the student. This doesn’t seem to have hurt their poor people.

:rolleyes: Ever heard of working multiple jobs? There is little practical impediment in the US to being employed practically 24/7, if the employee could endure it.

While over-restrictive labor laws and high unemployment are indeed bad for the poor, you’re way off base in suggesting that this is applicable to “Europe” overall. Many countries in Europe, including the Netherlands, Germany and Scandinavian countries, have lower unemployment rates than the US.

Again, your naive analysis is flawed by your failure to compare these apparent downsides to what the alternative would be like for the poor without such initiatives.

Yes, high safety standards for automobiles, for example, increase their price, which bears harder financially on the poor than on the rich. Guess what? Being crippled by an accident in an unsafe car also bears harder financially on the poor than on the rich.

Can’t convince somebody who’s already made up his mind not to listen. Your one-sided arguments make it pretty evident that you’re not interested in seriously comparing the effects of government initiatives on the poor with the effects of not having such initiatives in the first place.

There are several problems with third world governments. First, they inherited massive poverty from colonial days. More importantly, the governments are corrupt, and money that could be spent on improving the lot of the poor goes to Swiss Bank Accounts. No one will dispute that corrupt governments are bad for the poor - the poor have no power.

Health Care: I won’t dispute at all that private insurance today might do better than Medicaid. No one with private insurance is struggling to get on the Medicaid rolls, after all. But uninsured? Who is going to pay for necessary treatment? And if Medicaid didn’t pay for lifesaving treatment, maybe the solution is to increase funding so it does pay, not cut funding altogether. I’m sure conservatives are lining up to increase Medicaid funding, right?

Retirement: Agreed. Social Security taxes should be more progressive. I should pay them for my entire salary, for instance, not have them cut off with lots of the year left.

K-12 education. Since I’m sure you don’t mean that no education is better than state run education, I assume you mean private schools. However, just like health care, public schools are going to be optimal for providing education to everyone at the lowest cost. Sure the rich can pay more and get better schools, but we are talking the masses here. The poor - without some patron - are not going to get to the next level without good education.

Higher Education: Currently cuts in spending on state universities have caused large tuition increases, and made even community colleges, still quite affordable, harder to get into. Sure the rich send their kids to college, so do most people with college educations who appreciate the benefits. Sure professors are upper middle class - they’ve got far more education than average, and ones in technical fields could make a bundle in private industry. (And make higher salaries than those in the arts.) It is nice that poorer students are supported at private schools, but for most cheaper government run community colleges are the way to get one step up.

BTW, I am living proof that universities do not pick up the tab for the non-poor. I filled out lots of FAFSAs and got not much in return for my kids. Which is fine, I can afford it.

Labor Law - My daughter is living in Germany. They’ve got tough laws also - and lots of mandated vacation - and their labor market is pretty good. You need to find another reason.

Other: Yeah, the poor get hit harder by things like anti-pollution regulations. But they also get hit harder by pollution. Who do you think lives near that polluted lake - not John Q. Vanderfeller. And we’ve exported a lot of our pollution to China - where it can kill their poor.

The argument is set up to say: large government bad, small government good. It’s not as simple as that. Governments that are highly responsive to the wishes of their citizens do well on helping their poor, ones that are not don’t. The US government is mostly responsive to big corporations and unions and not the people, but it’s not as bad as some places. If you want things to get better you need to empower people to compete in representation with unions and corporations. This could include measures to ensure 100% voting, free college education for all (being educated empowers people and cuts the most desperate people out of the work force which makes labor mor valuable and gives it more political leverage), transparency in government and corporate behavior, proportional representation, ect. Without government powerful families and their corporations would make life a hellscape for the poor, with a good government most of the poor would have stability and be closer to the middle class of today than their current status.

Aren’t you a “less spending / less goverment” kind of guy (Forgive me if I’ve got the wrong guy)? And you’re complaining that the health insurance made available to the poor by the U.S. government isn’t good enough; and by extension, that presumably the gov’t should spend *more *on it?

I absolutely agree that they should. It’s a shame that comprehensive dental coverage is not included in Medicaid (in many states). But it would cost a lot of money to do so. Nonetheless, in many areas there are free or low-cost dental clinics where the poor can get dental care. It seems that visiting one might have saved this boys life.

In any event, I don’t think see how this is an example of the government not helping the poor. How could providing health insurance be seen in any way as not helping?

IIRC, he’s a “religion is good, secularism is bad” guy, so I suspect this is leading up to something about how we should let the churches take over aid to the poor.

Once you hit an upper middle class income, you are marginally contributing roughly twice as much to SS as you will take out. Whereas up until you hit around minimum wage you will receive more than twice as much from SS as you put in. Which more than makes up for the lifespan difference, whether or not it’s progressive enough for your tastes.

In general, the folks who are uninsured are fairly healthy. Otherwise they would be on medicaid or some other insurance.

I could fund a study that shows that people in the hospital have a much higher mortality rate than soldiers in a war zone. Therefore hospitals must be killing people.

And how would being uninsured have helped him?

The payments on social security are more than progressive enough to make up for the regressivity on the contribution side. The difference in longevity is not nearly enough to make up for this and if we had universal health care, we might be able to close some of that gap.

The federal employee pension doesn’t strike me as particularly lavish (20% of your salary after 20 years of work). Or are you talking about some township in Long Island?

Cite please.

Reforming schools is fine, get rid of public education, not so much. Are you under the impression that these kids would be better off if they had to pay for their education?

Rich kids are also less likely to need student loans.

The student loan program has made college accessible for middle class kids in a way that it was not accessible before the GI bill.

That sounds like an argument for larger Pell grants not eliminating the student loan program.

This isn’t France. There is a balancing point. We are probably closer to it than France.

I don’t know what to say about your “miscellaneous” category other than to say that you can cherry pick instances where policy is not driven by the effect it will have on the poor. Safety regulations might harm the poor but we should still have seat belts in our cars. And I’m not going to defend ethanol.

In the early 19th century England passed the Poor Laws, making sure that government was not involved. They led to untold misery. About the only good thing that came out of them was Dickens.

Just to add a data point, my wife and kids and I were on Medicaid for a while, and it was far, far superior to any private insurance we’ve ever had through an employer. The one downside was that it only covered emergency dental for adults, but it did cover pretty much everything else.

I know different states have different programs, but ours was awesome.

What part of “sucks to be you” do you not understand?