Are programs helping the disabled and others worthwhile?

Charles commented to yesterday’s post that Obamacare and Medicare were different, in that Medicare is for the elderly who, because they are bad risks, cannot get health insurance.  This is, of course, true, though there are plenty of people who are not elderly, but who are nevertheless high risk and cannot get health insurance.  I found the distinction unsatisfying, however, because I was struck by the alchemy that turned the undeniable need of seniors for affordable health care into an entitlement to a government (meaning you and me) funded program to pay for it.

In trying to think of analogies I considered things like unemployment benefits, ballots in foreign languages and the like, but the folks who benefit from these programs usually are in a position to reduce or eliminate the need for such programs.  The unemployed can get out there and get jobs, immigrants can learn English and the like.  The elderly can’t help getting old. 

But what about the disabled?  The vast majority have very real needs and, like the elderly, can do nothing to eliminate those needs.  Efforts made to accommodate the disabled (a much smaller group than seniors) have been hugely expensive.  These efforts come in two flavors.  First are government mandates that require private individuals and companies to spend huge sums for things like handicapped bathrooms and special counters.  Second are government financed programs, such as rebuilding sidewalk curbs to provide ramps at all intersections. 

I have a bit of a personal interest in this, because my wife was blinded, and both her parents killed, in a car accident when she was 15 years old.  She has benefitted greatly from programs for the blind and orphaned.  Social security allowed her to finish college at William and Mary.  She was trained at no expense at the Arkansas Enterprises for the Blind to work for the IRS, answering the public’s tax questions, which she has done for 30 years.  Even now, she receives a constant stream of braille books, books on tape and books on disc at taxpayer expense.  In a sense, she is a wonderful success story, have paid back the taxpayer’s investment in her many times over by being a productive member of society rather than a drag on it all these years (not to mention raising two fine sons and putting up with me!)  But did her need give her an entitlement to all these government funded programs?  I don’t think so.

So, that’s my question for the day.  To what extent does anyone’s need, and especially the need of the disabled, entitle them to government support?  If not entitlements, should any such programs be supported anyway, either because they are the right thing to do, or, as with my wife, because society derives benefits from them (in another area, student loans come to mind as possibly fitting this category)?  What about government programs that force private individuals to spend money on accommodations, access ramps for the handicapped, for example?  What programs would you nominate, if any, as worth spending taxpayer dollars on?

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  • Danny Lemieux

    I do believe in helping people who truly need help. Here are some of the criteria I use:
    1) Help only those that cannot help themselves (I have a very soft spot for children). Your wife, DQ, would have fallen into that category.
    2) Prove to me that it works (I am a big supporter of a religious inner city school for pre-high school kids because I have seen how well it can work).
    3) Keep the government out of running the program except as an absolute last resort and with minimum footprint. Some of this country’s  greatest and most successful charitable programs are from the private and religious sectors (Salvation Army, Chicago’s Hull House, Shriner Hospitals).
    it’s not perfect, but it would be better than what we have now. Government charities rapidly evolve into mismanaged government sinecures and feeding troughs for the politically connected.

  • Spartacus

    The more local the jurisdiction, the more relaxed I feel about such things.  Federally, correct me if I’m wrong, but I don’t believe the original intent of the general welfare clause was to enumerate such programs, and that’s as close as it gets to flirting with constitutionality.  State level is a huge improvement: fifty states compete to provide an appropriate level of services at a reasonable level of taxpayer expense — Massachusetts can build wheelchair ramps on every level surface, and Alaska can fill in the federal questionnaire with, “Wheelchair ramps?  Yes.  We’ve seen them when travelling to other states.  Thanks for asking.”  On the far end of the scale, smaller cities and counties will have the most direct knowledge of each project and recipient, and therefore accountability, although if too small, their tax base can be heavily impacted by the random addition of just a few extra cases.

  • Ymarsakar

    <B>Charles commented to yesterday’s post that Obamacare and Medicare were different, in that Medicare is for the elderly who, because they are bad risks, cannot get health insurance. </b>
    That’s like saying 16 and 20 year olds are high risk for automobile accidents so they can’t get coverage.
    The truth is, they can get coverage. It just costs more. But so long as you have a matrix that supplies money to the insurance company, it doesn’t matter. The company can absorb the costs of teenage accidents, with higher premiums and fees.
    If all the taxes extracted from the old were put into medical insurance, the medical community would have more than enough funds to provide medical insurance. A proper discrimination and profile analysis of 60s, 80s, and medical history, would allow companies to offer low cost coverage to those that are healthy and have exercised throughout their lives. Or simply have longevity genes. Those that suffer catastrophical damage cannot impede on a system that is floating on a hard stack of cash from income.
    No matter how many accidents there are in the US, and there’s a lot, insurance can cover it all because the amount of money coming in is still better than the amount of money going out in payment costs.

  • Ymarsakar

    ” What programs would you nominate, if any, as worth spending taxpayer dollars on?”
    It’s all about the money. If handicaped people want to pool their resources and pay a city tax so the city can build ramps, that is fair and just. If companies wish to offer amalgamation programs that pool the resources of thousands of residents in order to build community services, that can also work.
    Corruption happens when the money flows from Alabama into the coffers of California so that California can legalize gay marriage or BAN US military personnel from campuses or provide their public employees millionaire luxuries.
    Corruption happens because money is distributed, and thus power is distributed from the bottom to the top. Or just somewhere else nobody knows about.
    If money was spent, on site, by the people that made the money, corruption would decrease by whole magnitudes. But so long as money is distributed in a huge bureaucracy where only the “elite” knows where it goes, people can easily skim off the top. And the bottom. And the middle. For decades on end.

  • Ymarsakar

    One way you can hamstring the government is to make it harder to pass laws. Say, 10 year mandatory renewal on every law that has ever existed. If they wish to produce Big Omnibus bills, then they had better do it every 10 years. By putting a cap on how big a bill can be or on what it can cover, per vote, you can almost totally eliminate the government’s ability to function using new regulations.
    On the other hand, you can also empower the citizens by giving them cash. Instead of allowing the EPA to spend money on environmental agencies, give the money to individuals. And I don’t mean “organizations” like PETA or the ACLU masking as individuals. I mean real individuals. Let them decide who they will contribute their funds to. Like the oil payments in Iraq, everybody gets a share of the pie. And not some “elitist bureaucrat” sitting on high deciding who gets paid what.
    Oh, the government can still run things. But if citizens refuse to fund it, then the government can’t do much. Now the power is in the hands of distributed networks, not tyrannical statist elements that are based upon centralized authority and control. Allowing Congress to distribute the wealth of America, was the first fatal mistake of this Republic. But it won’t be the last one.

  • Charles

    Hey DQ, you ask some very interesting questions (But, we still miss you Book!). 

    I’m not sure that I have a set of criteria to determine if a program is worth it or not.  However, I do like the criteria that Danny has stated.  Especially the fact that private charities do a better job.  One reason for this is that private charities have to “answer” to their donors.  If donors see that a program doesn’t work or is costing too much for a small return the donors will give their money to another organization. The free-market works somewhat well in determining how money should be invested in charity.

    Government “charities” (I really don’t like to call anything the government does a charity, hence the quotemarks) don’t have to answer to anyone – they simply take the money year after year.  Often times government bureaucrats try to keep their program running as a way to keep themselves employed; I consider bilingual education to be just such a program.  They often keep students in the bilingual program for years beyond benefit to the student just to keep enrollments up to keep the money flowing in.  A private charity would lose donors if word of this got out.

    Without getting all philosophical or ideological here are just a couple of programs that I think are worth spending government money on:

    Libraries – with free access to all.  This would also include bookmobiles to rural areas.  I grew up in the country with the county library too far away.  That summer bookmobile that came to town every two weeks was a God-send to us.  Currently, libraries in NJ share resources – if my library doesn’t have a book they can order it from a neighboring libary with the transportatin cost being paid by the state (this program is currently suspended due to state budget cuts; which makes sense, if the money isn’t there it is there.  There are plans to to reinstate the funding when things get better.)

    Most education programs that have clear benefits.  Such as free English lessons to immigrants.  Low-cost student loans for college or trade school.  A better educated population is a more productive population.

    Lastly, public parks and national parks.  These are things that private organizations cannot seem to do without restricting it to the wealthy.

  • suek

    >>Lastly, public parks and national parks.  >>
    I’m leery of this one.  Check this out (this is the archives search, and probably only the first two are pertinent, but it limits the links!)
    But about those disabilities…
    This is a tough question.  First, it has to do with the money available.  To be honest, I think this is a factor in your death penalty question as well.  We’re a wealthy country…we can afford jails and guards.  If we didn’t have the money to keep killers in prison for life, the question would be “will we set him free, or put him to death”.  Most of the time, I think people would choose the latter.
    But disabilities.  There are so many and the relevant questions _have_ to be asked.  _Why_ are we spending the money?  Is it because we just want to feel good?  or maybe in the expectation that the person can contribute – as your wife has?  What about those who will never contribute to society?  My grandson is autistic.  What they consider fairly high level.  His interactional skills are nil.  His memory for details is fantastic.  Will he ever be able to contribute to society?  Frankly, I have no idea.  I’m not terribly optimistic.  I’m glad he’s been able to be educated – although I think his parents could have done a pretty good job, but to be honest, dealing with him 24/7 would have been extremely draining emotionally.  But what about those who for whatever reason will simply never be able to function?  I don’t know.  I think it just depends on whether we have the money available.  I’d divide the disabilities into those that had the probability of future contribution and those that didn’t.  Those that didn’t wouldn’t get money to support them unless we had taken care of other more demanding needs first.
    I can’t even imagine how painful that would be for parents who had no help…

  • Don Quixote

    Thanks, Charles, and I miss Book, too!  She’ll be back next week.

  • poliwog

    My understanding is that much care of the disabled provided at a state, i.e. deaf or blind schools run by many states, local or personal level until ADA brought the federal government into the mix.  Initially (sp?) ADA was meant to compel governments at all levels to be accessable to those with disabilities and I can’t really complain with that given the consequences of something like failing to appear in court when summoned.  As a mom with about eight years of stroller pushing I can also appreciate the benefits of private businesses being made accessible, while at the same time firmly believing that the ADA was expanded well beyond original intent.  Frankly a business should have the right to be impossible to access just as I have the right to not shop there, and tell all my friends how much the jerks suck.  It’s current incarnation, which seems to consist of some random lawyer sueing on behalf of unspecified “disabled” who recieve no monetary benefit from the suit even though the lawyer seems to get paid just fine, is a monster that helps no-one but the legal lobby.  Didn’t mean for this to be so long, I guess my main thought is that I, and other stroller pushing parents have probably benefited much more from ADA than those it was intended to help.  It was created to address a real need and has now grown into a monster that sucks up money and time while often not even applying to those it was originally created for and that is the problem with letting the federal government anywhere near even the most just of causes.

  • Donna B.

    Thank you suek, for at least addressing the question. I’m going to apologize first for disagreeing with a lot of what’s been written in the above comments.
    First, I agree in general with the idea that the more local the help, the better. I also know that the smaller the locality, the more likely they are going to need money help from their “parent” jurisdiction. Libraries are a good example. Even the smallest towns have a building they will gladly donate and furnish with shelves if the county or state can help them out with stocking it with books. Frankly, I think most states do a pretty good job with libraries.
    But I also know that local governments can be just as corrupt as Washington D.C., the only difference being scale.
    Second, I disagree that building wheelchair ramps, curb cuts, or handicap bathroom stalls are all that expensive in the long run. They are a worthwhile investment. It’s also not that expensive for employers to make reasonable accommodations for a handicapped employee. The fact is that I see small businesses (and local outlets of large chains) doing this more often and more reliably than large companies who could probably afford it more easily. The difference I think is in workplace culture more than $$.
    Third, in the city where I live (population ~ 200,000) I can think of only two charitable organizations that provide any kind of service year round that does NOT depend on government funding – the Shriner’s Hospital and a literacy program run by a local private university. I’m not completely sure the literacy program is still volunteer/donor financed. And frankly, I’m not that sure about Shriner’s any more… but I’d say it’s very likely.
    While a lot of charitable programs originated in private and religious sectors, most of them now depend on government grants. And this is not necessarily a bad thing, because contrary to popular opinion, the government usually holds them accountable for every dollar spent much better than unorganized donors can or do. I’m not saying that all the government funded programs are good or worthwhile, but the waste must be accounted for!
    Fourth – I disagree that government can provide education programs better than private organizations. See the literacy program I mentioned above. See (most) private and religious schools. What government can do (and I agree that it is a worthwhile good) is guarantee access to some kind of basic education — but better? No.
    As for loans for trade schools – low cost of the loan isn’t the problem, it’s the high cost of the training for relatively low paying jobs. This is actually one area where unions could do something, and at least one still does — apprenticeship programs. The apprentices don’t have to take out a loan and are paid for their classroom and OJT time. They are expected to pay for their education in dues over many years, but they can also resign from the union and stop paying.
    Unfortunately most unions don’t work that way. Even the one I’m aware of that does this suffers from massive corruption at the top.
    Frankly, one reason that trade schools are so expensive is that low-cost student loans are available, so tuition got raised without the education getting better, but the classrooms are nicer. I’d say that low-cost student loans are something the government should NOT be doing.
    Now… on to helping those who cannot help themselves. suek asks great questions. I’d like to try to answer some of them. Government should NEVER be involved in a program just because it makes us feel better. However, my take is exactly opposite of suek’s where those who can never contribute to society are concerned. I have two relatives who are so seriously developmentally disabled that it’s for sure they will not only not never be productive, but will also need near constant care/supervision. I’m not close to them, but aware of the situations.
    For our society to not provide help and support for these people amounts to a sort of retroactive abortion… or the more time-honored method of leaving them in the elements to die a more “natural” death. We need to rethink institutional care, both how it’s provided and how it’s paid for. I can see where some might say that this falls under “what makes us feel good” but I think it’s an obligation. Government has a role to play here in conjunction with private charities.
    The costs for those who are disabled in ways where they can be productive are going to be much higher simply because there are many more of them. It’s also complicated because there are so many degrees of disability involved and these change over the individual’s lifetime.
    Unlike Don Quixote wondering if his wife still needs some services provided to her, what happens more often is that services are stopped too soon. A disabled person on SSDI, for example finally gets a job and starts making money. And then (just like with welfare) he makes enough to disqualify him from any benefits before he’s making enough to buy those services himself. This has improved somewhat, but it still provides a disincentive to work and costs much much more than a more graduated way to get “out of the system”.
    Again, there’s a role for government and private charity here. We need to rethink what we want to accomplish and look at the unintended consequences that have resulted from past efforts.
    Not all the unintended consequences are bad. One result of the ADA act is that people who aren’t technically disabled now have available public conveniences that enhance their lives. Consider someone recovering from surgery who makes only temporary use of the handicapped toilet… but it lets them get out of the house sooner and more often thus recovering and returning to productivity sooner.
    While we’re rethinking those types of programs, let’s get rid of some of the things where government has absolutely NO role. The National Endowment for the Arts and Humanities comes to mind first. These are areas which should be left entirely to the private sector. The Library of Congress, the Smithsonian, and national parks are the only exceptions I would make to federal activity in this area. Those need some rethinking done too.

  • Danny Lemieux

    Charities are about charity. Government is never about charity: government is about patronage and power.

  • Mike Devx

    Don Quixote says,
    In trying to think of analogies I considered things like unemployment benefits […] but the folks who benefit from these programs usually are in a position to reduce or eliminate the need for such programs.  The unemployed can get out there and get jobs […]

    But that’s the problem: They all can’t get jobs, for one reason or another.  Many of these people are genuinely in trouble and are in fact in desperate situations.  Sometimes of their own fault, sometimes not.

    But unemployment benefits began as a temporary stopgap to give people a chance for six weeks to find work.  And then it expanded.  And then it expanded again.  And again. And again. And again.

    Now it is an almost-permanent welfare program for the unemployed.  From the modest beginnings of providing six weeks of breathing space, to what, a year and a half of benefits now, and counting?  Remember that employers pay into the unemployment benefits system, too, not just taxpayers.

    But make no mistake, ending such programs – and they must be ended – will cause true and genuine PAIN.  It’s not that the programs don’t do some “good”, because they do.  They ALL do.  The question is always whether the national government should be doing them at all.

    We recognize that all of these programs create and foster dependency.  They are destructive of self-initiative.

    In cases such as the braille program, they depress private market solutions to problems.  You cannot compete with “Free”, even though free is not free, because it is paid for by taxpayers.  But nevertheless, there’s no competing with it.  If the government footprint in support of braille materials were reduced, there *might* very well arise highly innovative solutions toward getting these materials out there for those who want them and need them.  Far more efficiently than whatever program the government has put in place.  How much of that braille material ends up sitting on stacks and stacks of shelves, unused?  Does anyone know?  If the need were there, that material could be in endless circulation around the country, to supply the wants of its limited but needy constituency.  I am willing to bet that any current programs are extraordinarily wasteful; that a small percentage of the material gets high use for a short period of time and then it all accumulates and sits there, unused.  It’s the nature of the government beast.

    Funding for libraries?  Why should Joe Schmo, who reads limited information on the internet and can’t be troubled to pick up a book more than once every five years, have his money taken to support libraries?  Those of us who love books and believe in the public institution of libraries should support libraries.

    Every single one of these government programs does “good” for someone.  I’d be more willing to support them if someone could guarantee that every single one of them wouldn’t just grow, and grow, and grow.  We all have our favorite programs that we would find uniquely worthy and virtuous.

    All these programs build into a vast mountain of insupportable debt.  I’m willing to give up MY favorite programs, if it would stop the collapse of our great country.  I’m willing to stop forcing other people to pay for what I consider the most virtuous of programs.  In the end we all just keep voting in politicians who promise us more and more of our favorite programs, at an ever higher cost to everyone.  Like Obama, we justify taking their money because it’s “for the good of us all”.

    National Taxpayer Day finally arrived this year, today.  August 19th.  I remember, it wasn’t all that many years ago,  this day of Freedom used to arrive in late June!  I remember when we crossed the six month boundary into July.  And now… it is AUGUST 19th, before the government stops seizing all of our money and leaves the rest in our pockets.  AUGUST 19th!

    It’s this favorite program, and that favorite program, etc, etc, etc, etc.

  • Mike Devx

    It’s clear to me from reading the above comments that there is no way we are going to solve our runaway debt problems, and the runaway growth in the size and power of our national government.  Here in Book’s domain things are about as conservative as you’re going to see, and even here we are tending to argue for the EXPANSION of our favorite programs, or at a minimum their preservation at their current levels.
    We’ll advocate OTHER PEOPLE’s favorite programs being reduced, gutted, or purged, but not our own.
    It’s no wonder politicians find it impossible to reduce the size of government, when there is NO CONSTITUENCY OUT THERE that will truly accept a reduction of government power.  And make no mistake: From the comments above, I doubt that even the circle of Book’s readership would, in the end, accept a REAL reduction of government power if it came down to a vote.  You won’t do it, people.  Even you, here, would not do it.
    There really isn’t any hope, is there?  It’s all going to come crashing down around our ears, because we are incapable of stopping ourselves from voting for the ever-increasing power, size and scope of the nationao government.  This is how it works; this is how it happens.  Read the paragraphs above again; remember how conserevative and fiscally prudent we would tend to be compared to your average American; ask yourselves honestly how any politician would be able, in the face of this, to advocate and proceed with cutting government programs.
    I think that we’re not all that different from Socialist Europe.  It’s just a matter of degree, and a question of how much additional time it will take until our collapse occurs compared to theirs.  Because our mindset really is the SAME as theirs, just on a somewhat smaller scale.
    I think we’re doomed