Medicaid and
the rest:
Let’s start with Medicaid which is
currently the most costly component of the Social Security legislation and the
other social welfare programs like unemployment, or aid to needy children,
which are also bogged down by politics and bureaucracy. The best way to solve the cost dilemma at the
Federal level, and even the State level for they are obligated to provide
matching funds for Medicaid, is to turn over all of these programs to the
States. All of these programs primarily
deal with the impoverished, save unemployment which is aimed at preventing a
family from descending into poverty. The
reason these should be turned over to the States is because they have a vested
interest to aid the poor within their own jurisdiction. It benefits the States community for it
removes unfunded mandates and allows States to customize benefits and aid based
on such things as a recipient’s income through the lens of what it takes to
live in a certain area. If an area
requires less money to live their then the recipient will receive less benefits
while an area which is more expensive to live in a recipient will get more
benefits. This is a major improvement
over the one size fits all approach of the Federal Government which may be
giving too little to some and too much to others. Without all of the mandates and the Federal
bureaucracy States can provide adequate welfare in the form of health benefits,
unemployment and financial assistance to those who need it with less waste
fraud and abuse.
Addressing fears:
The fear with States taking over for
the Federal Government is that people will move around to States that provide
the best benefits which in turn overloads the States welfare system. It is doubtful that such a situation will
come to pass however as in addition to the recipients’ income, the amount of
benefits is also limited by the expense it takes to live in a given area. If your income is high, but it does not cost
much to live in the area you live in, you will receive little to no
benefits. If your income is low, but the
area you moved to is more expensive you will receive more benefits. That is safety net number one to stave off
the nightmare scenario. Safety net
number two is the amount of money it takes to live in a specific area. If a bunch of welfare families move into an
expensive area, the cost of living in that area will go down because the
existence of a welfare family has a negative impact on property values which
also affects the prices of goods and services.
Therefore if enough people welfare families move causing a negative
impact on prices of a giving area, then a lot of individuals will have their
benefits reduced or eliminated because the area is now more affordable to live
in. If for some reason the reverse
happens with non-welfare families and the like move in raising property values
and increasing the costs in the area, people who are on welfare already will
have their benefits increased instead.
Medicaid and unemployment will be generally
unaffected. Unemployment will more than
likely be based on a separate set of criteria while means testing in
combination with living expenses will ensure only those who need it get the
medical coverage they need. What those
medical benefits are will vary from State to State as they add and subtract
benefits based on need and affordability.
However it can be for certain that all will include some form of
hospital coverage and more than likely recovery from traumatic accidents. Unemployment may also vary in what benefits
are provided. My modification to
unemployment would be limiting where the money can be spent to food, clothing
under a certain price, medical bills, debt and utilities. In this way, food stamps and unemployment can
actually be combined; while the restrictions ensure people only spend money on
the essentials.
Dealing with those who slip through:
For those that have an even harder
time getting the treatments they need, the States can establish special clinics
to care for the poor who are enrolled in their Medicaid system. These clinics can be staffed by a combination
of volunteers and paid specialists to treat the ailments of the poor. The benefit of this is it is harder to game
the system when those who are enrolled must receive treatment at a government
sponsored clinic where their doctors can check if benefits beyond surgical and
recovery are actually necessary. For
those with disabilities they could get a voucher with the same limitation on
food clothing, medicine debt and utilities, which will allow for them or their
care takers to spend on their needs only.
Also, special government run homes or even private ones sponsored by the
government that are staffed by professionals can be used to take care of the
disabled.
Conclusion:
This together fixes one of the
biggest burdens of the Federal budget.
It provides a platform for innovation in the welfare sector of
government as States copy from each other what works and gets rid of what
doesn’t. Stricter criteria from what it
takes to get on welfare to what benefits you receive ensure that less people
are able to game the system. Additional,
criteria can be placed on recipients like drug testing and welfare to work
programs can be put into place to ensure our tax payer dollars are being well
spent. Welcome to the future of Medicaid
and welfare benefits, customized State welfare.
see you tomorrow for part 3.
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