One of my jobs right now has me doing what (sans a smart-sounding title and a few differences) amounts to social work. I get clients who, funded by Medicaid, have a diagnosed mental illness and a host of other related problems.
It broadens my views on poverty and the welfare system.
Take Adeena*, one of my clients right now. Adeena is 30 years old, with two daughters. She dropped out of school after barely completing the eighth grade. Her mental disorder (according to the MD) is that she's bipolar. One of her six medications seems to control that just fine. Adeena lives in a rented home, with government subsidies paying all but $344 of her rent (and the gov't pays all basic utilities). The rent is split between her, her sister, and her parents, that all live in the same house (total of seven people-- her sister has a son). Each month, between the four adults, they receive a little over $700 in food stamps, and each month during the last week they get a "food donation" from a church that provides approximately $200 in groceries. That's just my guess-- the groceries filled the trunk of my Camry as well as half the back seat. Adeena's 28 year-old sister collects a few hundred dollars a month in social security. She is disabled, and constantly visiting the hospital. Her frequent use of meth, pot, crack, alcohol, and smoking does little to help her health (she is obese and recently diabetic). Adeena does housekeeping at a hotel and, at $6.50 an hour, brings home around $700 a month.
Recently she confided in me that she wasn't taking her government-provided birth control pills because she wanted a third baby. With whom? I asked, only to hear it was from a friend of her sister's, which she had no intention of becoming serious with at any point (I deduct that this friend is a drug dealer, based on his behavior and visit routine). Adeena depends on me (or friends) to drive her to work, the welfare office, the grocery store, or wherever she "needs" to go. Last week she announced a suspected pregnancy (missed period), and instead of spending five bucks on a pregnancy kit like every other potential mother would do, she visits the doctor on the Medicaid bill (no doubt the doctor charges $300 an hour) to take a pee test in his office. Doesn't cost her anything.
Adeena is not atypical. Of our ~40 clients, ~35 of them fit this bill. We are one of about twelve companies providing these types of services in the county. No desire to get on their own two feet, no efforts to further/complete basic education, an expectation of the government to provide for them, and a general lack of social skills (short temper, judgmentalism, terrible hygeine, etc). While Adeena is collecting thousands of dollars a month in welfare, my business is billing thousands of dollars a month (also to government-provided welfare) trying to help her step up. In reality, it's a lost cause.
My co-worker and I are working on a solution to this problem. First, we believe that welfare programs need to be consolidated and managed better. The system is a mess right now, and people like Adeena know exactly how to work the system. She could live like royalty on her meager income as she has no real financial responsibilities. Second, in circumstances with perpetual assistance and client apathy (not counting the elderly and disabled), help should be provided ONLY on condition of sterilization. I'm completely serious about that. The saddest thing to hear is that one of our clients are pregnant. No child should be subjected to this kind of life. Third, no progress shown = decrease in benefits. If you work for ten years making minimum wage at 25 hours a week, it's time to find another way to get by without taking handouts. If Adeena is forced to beg for food at the end of the month, she's going to learn to make her existing (and extremely generous) welfare last.
Now, this might seem contrary to statements I've made. And maybe my opinions have changed a little bit. I am not at all opposed to welfare. I'm opposed to supporting lazy people who are unwilling to better themselves. And healthcare falls into a related but different category, as it is getting to be so unaffordable to so many people. No doubt I have a skewed viewpoint because of the nature of my job. But knowing that there are people like Adeena "spending" unbelievable and irresponsible amounts of money makes me cringe.
I hope that some of you have some input on how to improve the system.
*Name changed to protect identity