Let’s Tell The Truth About Entitlements

“We have a welfare system that's trapping people in poverty and effectively paying people not to work,”House Speaker Paul D. Ryan (R-Wis.). Speaker Ryan continues to perpetuate the myth of the “welfare queen,” the lazy, mostly likely black or brown woman, popping out babies and gobbling up our hard earned tax dollars. Nothing could be farther from the truth. That is not to say that there are no lazy people collecting means tested benefits. But the poor do not have a monopoly on lazy people. Poverty in the U.S. is a complex phenomenon that has been orchestrated by a variety of policies that segregated large masses of immigrants as well as black and brown people and limited their access to opportunities that might otherwise help lift them out of poverty, such as quality schools, well-paying jobs, affordable housing and blatant discrimination. But the greatest determinant has to do with where you live. If you are born and raised in a high poverty area, you are more likely to remain in poverty, than not. So, contrary to Speaker Ryan’s demagoguery, welfare is not a permanent prison, but more of a temporary safety net to help low income people endure difficult periods of their lives. Moreover, the average participant, almost 40%, is a child.

Former presidential candidate, Mit Romney stated that 47% of Americans paid no federal income tax, implying a parasitic lifestyle, sucking away again, at our hard earned tax dollars. But he never mentioned that three quarters of those individuals simply benefited from tax provisions that benefit senior citizens and low-income working families with children.

Only 21.3 percent of the U.S. population participates in government assistance programs on any given month. Over 90% of these benefits go to the elderly, disabled or working class families. Another key fact that those, scheming to cut taxes to benefit the wealthy, won’t tell you is that for many participants, it’s a temporary visit.

According to the U.S. Census:

• Of people enrolled in Medicaid, 35.6 percent participated between one and 12 months and 35.3 percent participated between 37 and 48 months.

• At 38.6 percent, the largest share of SNAP (Food Stamps) recipients participated between 37 and 48 months.

• At 49.4 percent, the largest share of people receiving housing assistance benefits participated between 37 and 48 months.

• Of people enrolled in the Supplemental Security Income (SSI) program, 35.6 percent participated between one and 12 months, while 38.2 percent participated between 37 and 48 months.

• At 62.9 percent, the largest share of people participating in Temporary Assistance for Needy Families (TANF) participated between one and 12 months.

Cutting these vital programs won’t solve the poverty. Rather, it will deepen the struggle of the disabled and elderly. Moreover, if working class people don’t receive that extra help when they need it the most, they may be more likely to end up in poverty, with fewer options to help them escape it.

They still don't get it! Lessons not learned for the Indiana HIV/AIDS Outbreak

In early 2015, news began to spread about an outbreak of HIV infections in rural Scott County in Indiana, eventually becoming an international story. Dozens of intravenous drug users in the county's tiny city of Austin (population 2,500) became infected with HIV, primarily from sharing and reusing dirty needles to inject opiates. Since the start of the outbreak, over 210 in the county have been diagnosed with HIV, most in Austin. Moreover, almost 95 percent of those infected with HIV were also infected with Hepatitis C. Prior to the outbreak, Scott County had fewer than five new cases of HIV each year. The IV drug use did not come as a surprise to public health officials. Hep C rates had been on the rise in Scott County for years and it was widely assumed that it was linked to IV drugs.

The outbreak was fanned by the flames of ignorance. Former Governor (now Vice President) Mike Pence's policies helped degrade the public health capacity to prevent and respond to this growing epidemic through limited funding and an actual shutdown of Planned Parenthood offices that offered HIV and Hep C testing. Eventually, with more than a little nudging from the Indiana Health Commissioner (and now US Surgeon General) Dr. Jerome Adams, and a lot of pressure from the CDC, Pence grudgingly declared a public health emergency and authorized a short-term needle exchange program as a part of a multi-pronged approach to contain the outbreak.

Now, just two years later and despite demonstrated progress in reducing new HIV and Hep C infection, some of the Indiana counties are closing their needle exchange programs. Some of the politicians voting to close the programs defined it as a "moral" issue. Other complained that not enough users actually entered treatment programs. Bottom line: the programs worked. But now, despite lower rates of HIV and Hep C, it’s easy to declare victory and close the programs.

There is an important lesson to be learned from this situation. It seems clear that this was never about addressing a public health crisis as much as it was about saving face. Having HIV infection rates in a predominately white, rural town in a predominately white state that mirrored and, in some cases exceeded, some areas of Sub Saharan Africa just looked bad! Rather than merely being reactive, it was an opportunity to learn more about the intersections of opioid addiction, poverty and HIV/Hep C infection. It was also an opportunity to develop an infrastructure of prevention and treatment programs that would, over time, lesson the economic burden and human toll extracted by these twin epidemics. Without that infrastructure (which should also include safe injection sites) we will see more of these outbreaks, and not just in small rust belt towns.