Since it’s political season, let’s talk politics. I’m sure what I’m about to say will infuriate both sides.
I think we should be tough on crime. ALL crime. The guys who lined their pockets while running Lehman Brothers, AIG, etc. into the ground should be doing hard time. No, not sharing cells with murderers at San Quentin, but not at some country club, either. At the other end of the economic spectrum, illegal immigrants should get a one-way ticket home, paid for by fines on their employers; don’t just dump them a mile over the border in Tijuana where they can beat the Immigration agents back to downtown San Diego, but take them back to Central or Southern Mexico (or the major airport nearest wherever they came from originally).
Doctors who cause serious injury should be sentenced under the same guidelines as any criminal who causes Great Bodily Injury: earlier this year, I worked on a case where a criminal got 25 years for rendering someone permanently disabled. Why shouldn’t my doctors serve that same amount of time for leaving me permanently disabled? Oh, I’d give them some special privileges that the shooter didn’t get – they would spend their sentence working in the prison’s sick bay instead of making little rocks from big rocks – but they’d wind up paying for their malpractice in the same way I’m paying for their malpractice: by losing their ability to earn a living and their ability to come and go as they please.
I also think that we need to be more charitable to our brothers and sisters who have fallen on hard times. When a company shuts down, such that it’s readily determinable that people did not become unemployed through anything they themselves did wrong, let’s offer them "living wage" unemployment benefits and for a longer period, say 12 months instead of 6. And if an entire industry goes under, making it harder for people to find work in their field, make it 18 months. There are not many people who will choose to collect $1500 a month ($8.66/hour) for the full 18 months when they’ve been offered a job paying $3500 a month ($20/hour) with medical/dental and other benefits.
It’s been repeatedly determined that it’s impossible to survive on minimum wage, yet some of our disabled are expected to scrape along on less than half that pittance! Again, a tiered system should be put in place: those who are permanently disabled or temporarily 100% disabled should get enough to reflect that they cannot work part-time to supplement their benefits – someone who is only partially disabled is allowed to earn about $900 a month without losing their benefits, so someone who absolutely can’t work should get that extra amount to reach income parity with the partially disabled.
I can understand the logic of avoiding potential fraud by making disability benefits less than a minimum wage paycheck, but let’s be reasonable. Make it $50 or $100 less per month, not $500 or $800 less. Someone who became disabled through no fault of their own should not be reduced to sleeping in the gutter because their disability check is less than the rent/utilities on a studio apartment. (In this area, the waiting list for subsidized housing is about 10 years.)
And, on that subject, how many disabled people could go back to work with proper treatment? Penny wise and pound foolish, some treatments are denied as "too expensive" when it’s even more expensive to keep the person on Disability benefits for years than to front the money necessary to get them back to work. For example, Ampligen, which has been shown to work for CFS, costs $20,000/year. Although other countries have approved it, the US has not. And it’s been insinuated to activists that even if it were FDA-approved, government health care programs would not pay for it because it’s too expensive. Which, in the long run, makes no sense. Pay for the first year of what patients have called a miracle cure, so that I get well enough to return to work, and I’ll earn enough to continue paying for it myself. And I’ll be paying taxes, too. Or refuse to help patients bootstrap themselves and they’ll never go back to work because after years off work, they don’t have $20,000 to pay for the first year of treatment themselves.
It’s also been determined by several of our Congresspersons who tried it that it is impossible to eat well on the amount provided by food stamps. A friend who was temporarily not working after surgery had a choice: follow the doctor-recommended diet that would get him healthy enough to return to work, and run out of food after the first week of the month, or eat the things the doctor specifically told him to avoid because they were cheap and he could stretch his food stamps to eat for the whole month.
We can make sure that our less-fortunate are able to eat a healthy diet by allowing them to spend more each month on food, which should result in spending less on medical care. If anyone is concerned about them spending their additional food stamps unwisely, then set it up like the WIC program, where only certain items are on the approved list. Give them coupons that are good only for milk/cheese (including the lactose-free varieties for those with allergies), only for fresh produce, only for lean protein.... and in the quantities indicated on the government’s food pyramid. Don’t tell people they should eat 3 ounces of lean protein, but then provide them only with enough food stamps to buy the cheapest, fattiest cuts of meat. Don’t tell them to drink 3 glasses of milk if the food stamps will only cover the cost of 1 glass a day.
Now that grocery stores have computerized cash registers, and food stamp usage is also computerized, it should be easy to conduct spot checks – occasionally ask someone to produce a specific receipt ("we see that you spent $65.11 at Safeway on September 15, please mail in that receipt or sign here to authorize us to obtain a computer printout from Safeway") and offer nutrition counseling if it’s noted that the person regularly spends most of their food stamps on unhealthful foods.
And let’s talk medical insurance. Ideally, the for-profit insurance companies would be gotten out of the picture so that insurance is available to EVERYONE, not cherry-picking the healthy and leaving the sick/disabled uninsured (or offered insurance only at premiums that far exceed their income). No more of these policies, like the one I now have, that take your money every month and quibble over paying for anything at all, but real medical insurance that covers every doctor visit, every test, every prescription. Those who can afford it would pay for it much the same as they do now, with deductions from their paychecks – employers who had been paying for the insurance would be expected to increase their employees’ paychecks to reflect the expense which is no longer on the employer but on the employee. Those with incomes below a certain level would pay on a sliding scale, say 5% of their income, whether that income is earned, pension, SSDI or self-employment, but receive the same basic policy as those who can afford to pay more.
This is the richest country in the world, why can we not provide our citizens something that is provided even in some Third World countries? Granted, the local witch doctor in the backwoods of some of those countries is no Sloan Kettering, but he’s also more medical care than many of America’s poor and disabled can currently afford, and their citizens who can make it to a hospital are cared for, not first asked "how do you plan to pay for this?" and then threatened with lawsuits and homelessness while still too sick to work in order to pay the bill.
How do we pay for this? Charity begins at home. Dip into the amounts spent on foreign aid – only when every one of our own citizens has what they need, should we feel that we have money to spend improving the quality of life in other countries.
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