I’ve been kicking this issue around mentally ever since I first applied for my Clark County Social Services medical card. I have to go down to the office every couple of months and reapply, with proof of my income and expenses, in order to receive the most basic health care. I need this. I am unable to work more than part-time because of severe chronic back pain, which is from an undiagnosed cause. It"s a lot of fun- there is only one clinic in the entire county which is covered by the county. I have to wait six weeks for an appointment, and right now I’m trying to schedule an MRI- I saw the doctor three weeks ago, and I can’t get scheduled because the person in charge of scheduling doesn’t have my chart yet. I don’t see why, she’s in the same building as the doctor’s office, but I digress.
The thing that appalls me the most about the way the system is set up is that it is on a first-come, first-serve basis. No appointments accepted. This means that a low-income working person or a struggling student will most likely have to miss work or class in order to get any help, and may sit in that office for eight hours. Supposedly, this is to make sure “everyone has a chance”, and to make it as difficult as possible to get help in order to discourage people who might abuse the system.
My feeling is that this set-up biases the system in favor of abusers. The working people, or students, people who are trying to make an honest go of it but are unable to make ends meet often end up giving up and leaving the office, hoping to pick up that extra half-day’s worth of income from work, or not wanting to miss two classes instead of just one. Also, many people are turned away when the daily schedule is filled, so they have to come back the next day, and the next… which makes things difficult for the unemployed who are genuinely looking for jobs- valuable job-hunting time lost while you’re trying to get access to health care, and maybe some help with the rent. This leaves the disabled and the “professional aid-seekers”. I have no problem helping the disabled. But they are in the minority. The people who are most likely to receive help are the ones who have nothing better to do than sit in an office for hours a couple of days each week. By making receiving aid a full-time job, it makes aid most available to people who are willing to make a full-time job of it. And really, it isn’t a full-time job. Sit in a waiting room a few days out of a month, do the same at the food stamp office, the utility aid office… you’re talking maybe “working” forty hours out of the month.
I don’t know much about the federal welfare system, but from what I do know, it seems to be similarly biased in favor of the indolent and irresponsible. A woman who has had children out of wedlock by a man who won’t help support his children can have her education paid for at gummint expense and receive welfare while she’s in school, but someone who has never had kids but can’t earn enough income to make ends meet by working can get a Pell Grant, which will cover tuition, books, and maybe have a thousand dollars left over to help with living expenses (and that thousand doesn’t go far if you live in Vegas, where the cost of living/wage ratio is incredibly skewed), and it is very difficult to qualify for aid such as food stamps. Mom and I both applied, and nada… So, you can’t reduce your hours to accomodate school and the time you need to spend on homework and studying, because you can’t afford to live on less than what you’re making, and someone who is older and doesn’t have the physcal stamina of a twenty-year-old, or, like me, has chronic physical problems that make it difficult to maintain such a schedule, are basically screwed. If I wasn’t living with my mother, I wouldn’t be able to survive. A displaced worker who has been forced to take a low wage job out of desparation and want to try to get an education to enter a new occupation has a much tougher row to hoe than someone who popped out a baby at eighteen, and another one at nineteen… and has been living on the government dime ever since.
I think the whole social services/welfare system needs to be retooled. The “system” should make a priority of giving aid to working people who are having problems making ends meet, and make it easier for working folks to qualify for and receive aid, or to be able to reduce their working hours (maybe even quit work altogether) to receive vocational training so they can enter higher-income occupations, and thus, over the long haul, be able to contribute more in the way of tax revenues. There should be job training and placement assistance easily available for those who are unemployed and genuinely seeking work (and no, I don’t mean the “welfare to work” kick 'em to a minimum wage, no benefits job). It should be more difficult, or downright impossible, for those who choose to make welfare a lifestyle to receive aid.