Reflections on Kinship Care

 “According to the Illinois Children and Family Services Act (20 ILCS 505/7), when DCFS takes custody of a child, the Department must make reasonable efforts to find and notify all adult relatives who are ready, willing, and able to care for the child. DCFS should place the child with a relative if that relative can adequately provide for the child’s safety and welfare and it is consistent with the child’s best interests.” https://law.justia.com/codes/illinois/2015/chapter-20/act-20-ilcs-505/?utm_source

Sometimes I think about how the child welfare system is supposed to protect kids, but it doesn’t always protect them from everything. In Illinois, when kids get taken away from their parents, they can be placed with relatives instead of strangers, and on the surface that sounds like a good thing. Being with family feels safer than being with people you don’t know. But just because someone is family doesn’t automatically mean the home is healthy.

I’ve heard real stories around me that make this complicated. A girl in my class, said she got taken from her mom and sent to live with her grandparents. She said it did get her away from the main problem, but the emotional abuse didn’t stop. That stuck with me because people assume “grandparents = safe,” but that’s not always true. Kids can still suffer in quieter ways that don’t leave bruises.

I’ve also seen this in my own family. My uncle and his girlfriend were on drugs and had a baby. The hospital found drugs in the baby’s system, so DCFS got involved. My step-aunt was a certified foster parent, so they placed the baby with her. But she was close to my uncle and his girlfriend and lived less than two miles away. That means there wasn’t much distance from the problem. Later, because of her health issues, she couldn’t keep caring for him. Then he went to my grandmother, who literally lived upstairs from my uncle. Eventually my parents took him in. In the end, my uncle and his girlfriend gave up guardianship because they couldn’t get better.

Watching this happen made me feel like the system tries, but the policies don’t always match real life. Kids get moved around again and again. Family members might love the child but still be connected to the same unhealthy environment. Just placing a child with “any” relative doesn’t guarantee safety or stability.

I believe in DCFS. I even want to work there one day because I want to help kids. I know they have a hard job, and they see the worst situations. But believing in something also means wanting it to improve. A policy that could help is making sure kinship placements (placing kids with relatives) have stronger check-ins and emotional wellbeing evaluations, not just a quick background check. Maybe there should be required counseling for the child and parenting support for the relatives. Maybe there should also be more distance from the original harmful environment when possible.

I’m not saying don’t place kids with family. Family can be the best option. I’m just saying it shouldn’t be automatic without deeper investigation. Kids deserve not just a familiar home, but a healthy one. If the goal is protecting children, then emotional safety should matter as much as physical safety.

Sometimes I think people forget that kids remember everything. They remember the yelling, the instability, the feeling of not knowing where they’ll live next. Policies aren’t just rules on paper they shape real childhoods. And childhood is something you can’t redo.

If I ever work in DCFS, I want to be the kind of worker who looks beyond “good enough” and asks, “Is this truly safe for this child to grow up in?” Because every kid deserves more than just surviving. They deserve peace.

Employment and Disability

In a recent course session I was in, the classroom discussion delved into the topic of disability benefits and work eligibility. A student in class shared their own experiences, highlighting their frustrations, uncertainty, and the financial stress they were facing. Unfortunately, disability programs and policy in the US are not a mainstream topic of discussion within our society, which is structured around the able-bodied experience. However, it is still a key matter, especially with the recent actions and proposed plans by the Trump administration, which center on reducing support for welfare policies.

There is no doubt that, in comparison to the past, progress has been made in disability programs. But there is still work to be done. In the US, disability policy is set counterintuitively; it aims to support those who can’t work consistently, but can simultaneously discourage and disincentivize individuals who try to work, forcing them into a dilemma of facing economic risk. Despite work incentives within disability policies, concerns lie with how frameworks continue to perceive employment and experiencing disability as mutually exclusive, as seen with the complex application processes, complicated reporting requirements, strict income thresholds, and punitive benefit cliffs. Much of our policy seems to encourage staticity, and such rigidity reduces autonomy and control, creates constant concern, and fosters a sense of financial limitations. People with disabilities may reduce/turn down hours or decline certain jobs, as going over certain thresholds may terminate the necessary benefits they are receiving. It's a system that enforces stagnation and essentially punishes the desire to attain economic and social autonomy as a person with disabilities. 

For example, SSDI has a Trial Work Period that allows for nine months of high earnings, but after that, earnings above “substantial gainful activity” may lead to losing benefits. This can cause many individuals to limit themselves to lower-paying jobs or irregular work to avoid completely losing necessary benefits. Similarly, for SSI, every added dollar above the income exclusion threshold reduces benefits by $1 for every $2 earned. Within this, a major stressor for people is maintaining vital medical coverage (such as Medicaid or Medicare). Healthcare is vital for many individuals with disabilities, as it gives people access to life-sustaining and essential care. Making it so healthcare eligibility is rigid, with strict income thresholds, puts people with disabilities in a difficult situation, as they must restrict themselves to continue getting such access to healthcare, cautious of any triggers that would lead to losing such medical support.

Benefits don’t just represent monetary support- they represent access to healthcare, housing stability, and maintaining a good quality of life. The anxieties and fear of losing such support can make the path toward employment seem more like a gamble, not a path toward further independence. On top of all of this, the Trump administration has taken steps and is looking toward eliminating support for vital policies. In 2025, they cut off federal support for the intervention training within the SOAR program, which teaches caseworkers to be adept at navigating the complicated disability application process, and also supplies other important support and resources to their target population of individuals facing homelessness, particularly those experiencing severe mental health illnesses. 

Disability is not a monolithic reality- it can be unpredictable, fluctuate for some people (some days may be better than others), and can be impacted by the environment and factors surrounding the individual. In moving toward a system that truly values independence and supports individuals with disabilities, efforts should focus on reflecting how employment and disability can coexist. As a society, we can move towards universal healthcare, not tied to income/employment or benefits eligibility. There can be steps toward pushing for more gradual benefit tapering and bolstering employment supports, such as with part-time, episodic, or accommodated work. Within all of this, it is vital to make navigating the system of disability programs and policies clearer, simpler, and better communicated. Policy and discussion should revolve around the basis that individuals with disabilities want meaningful activity, autonomy, and stability, grounded in values such as dignity, inclusion, equity, and person-centered support. We can not walk away or allow administration decisions veer away from vital welfare policies and support. The current system can perpetuate a sense of ‘movement as dangerous,’ forcing people to ‘stay still.’ We must reshape this, as support should be a foundation people can safely build upon, where mobility is genuinely supported.

Adoptive Grandparents Need Support

 One issue that has been on my mind for a long time was the lack of supportive care my grandparents had to adopt my four siblings and me. As a kid, I was in and out of foster care from the ages of six to twelve because of being abused and neglected by both my parents and their never-ending stream of partners. Both my mother and father at the time would rather buy drugs and alcohol instead of food for us children. Because of this, we starved. I was malnourished when I was first placed into DCFS. Often, my brothers, sisters and I were only allowed one meal per day and were punished if we got into any food related items in the kitchen. Some meals that I remember eating as a kid consisted of only these items: sugar cubes, canned tuna because we had to feed our cats, fruit loops given to us dry, in the box, in the morning and told to make it last, and most memorable a maggot ham that we had to cut around to eat. Reasons like this were why I often went hungry. I remember being so grateful when school time rolled around because it meant that I got three meals a day. My older brother got caught several times stealing honey buns and pop tarts from the nearby gas station. He got into so much trouble trying to keep us safe and fed. He worried so much about what we were eating next because he understood more than us younger kids what was going on. 

I know I keep rambling on about food, but it is most important to the story because it wasn't the fact that we were malnourished, abused, and smelled like pee and cigarettes every day that caught the school administration’s or DCFS’s attention. The specific situation that got us permanently taken away from our parents happened one morning when my sister woke up yet again, hungry. My mother, being high on drugs, was asleep on the couch. When she was like this it was nearly impossible to wake her up, and when she did wake up, it was crucial to get out of her sight for at least three hours unless we wanted her wrath. My sister tried to wake my mom up for something to eat and she wouldn't budge. So, my sister went back upstairs, only to come back about an hour later to try again but with the same luck only this time she went into the kitchen. She pulled a chair over to the counter to get into the cabinet to see what she could find to eat. She found a sleeve of ritz crackers and began eating them. I guess my mom had heard my sister come downstairs because my mom walked into the kitchen to find my sister eating. She beat my sister for this, probably because she wasn't high anymore and needed to get high. My sister had a phone at the time and ended up calling the police. I don't remember this day at all except for being put into a car in my pajamas and going to the DCFS office. 

After going to several different homes for a few months of my life, I was placed into the care of my paternal grandparents. While I can say that my physical needs were met with my grandparents, I think that the emotional support lacked significantly. See, at my grandparents’ home, we were emotionally abused, called pigs, told to use our brains, called dumb, basically worthless, and most memorable, my grandpa telling my sister to go kill herself and that he would help her do it. I've heard from my family that from the period of my dad and his brothers being children to my siblings and I being children, my grandpa has calmed down a lot. Generational trauma is most certainly present in my family. This makes me terrified to hear the stories of what happened to them as they have never come to light, but also a little confused. My mother and father however, after all the abuse and neglect they gave during their addiction, had to go through a significant list of requirements such as parenting classes, NA meetings, AA meetings, randomized drug tests, randomized house visits, visitations with their children, and so much more I cannot think of. What's most heartbreaking however was that after my mother cleaned up her act and completed all the mandated requirements, more requirements were added. It only continued like this until she was fed up and surrendered her rights as a parent in the state of Illinois. The system was working against her. She lost her children, relapsed, went to prison, and only now is turning herself and her life around. 

What I would like to point out however, is that my grandparents didn't have to take any parenting classes. No required meetings, random drug tests, and most importantly no follow up care for either the parental guardians or the children involved, only the fact that they were our grandparents held up. According to americanbar.org, “kinship caregivers often receive fewer supports than non-relative foster parents”. My grandparents didn't understand what it was like to raise children in today's world, let alone children that have severe trauma from abuse and neglect. They don't believe in mental illness, and they laugh at counseling and say “just pray about it” to almost everything and because of this, I think my siblings and I’s mental illnesses exacerbated more than it should have. I think it is safe to say that as children, we were all angry and mostly towards each other. We took the abuse and it turned into anger. It wasn't until we got placed together with our grandparents that we trauma bonded, leaned on each other, and became each other's best friends. I think the emotional abuse we took from my grandparents had more of an impact on us because we had just come from such a bad situation, thinking it would be better just to find out it's the opposite. We all suffer from depression, but this didn't show up until we all were in the care of my grandparents. What could have prevented it is education. 

I think that DCFS should mandate all guardianships to take a course at least every two years on mental illness. These courses would be created by social workers, either online or in person, to educate guardianships of mental illness, trauma, abuse, neglect, and other related issues children face. I think that a lot of the arguments and disagreements we had growing up with our grandparents involved them not understanding where we were coming from. They didn't understand our food insecurity, our mental states, or the care we needed to become active members of society, so they couldn't help us out at all. These courses could have offered my grandparents some insight into our thinking and ways of doing things. However, it almost seemed like because it was kinship care, DCFS didn't investigate any further into our situation with our grandparents, when they should have especially after our adoption. As stated by sagepub.com, “the majority of previous research has primarily focused on maltreatment that kinship children suffer, often overlooking the complex trauma, including household dysfunctions, that kinship children experience (Winokur et al., 2014). Therefore, expanding the lens from child maltreatment to include the full spectrum of adverse childhood experiences (ACEs) is needed to better understand children in kinship care’s behavioral problems”. I think there should be DCFS after care for up to 5 years with just 6-month checkups. During said checkups, I think they should privately interview every family member involved to get a greater picture and take any further action that is needed. 

Another useful requirement that could be implemented to help more children is speaking with them individually. A little bit after being placed into the care of my grandparents, I struggled with food insecurity. Hiding, hoarding, and bingeing food was very common, and I was caught one time, the only time I ever got caught because I never did it again. My grandpa caught me eating my cousin's valentine’s day candy that was hidden on top of the fridge, which at the time I didn't know. I was screamed at, grabbed by the back of the neck and thrown into a love seat that we had. What was most scary, however, was not getting grabbed, but being yelled at. Anyways, DCFS doesn't like when children are grabbed and thrown, so word got around and next thing I know I was sitting next to my grandparents with a social worker in front of me asking me, “do you feel safe here” and my response was “yes” even though I disagreed. I would have told them otherwise had I not been sitting next to my grandparent. It just makes me wonder how many maltreatments slip between the cracks like this because a child is scared to sit in the presence of their abuser and admit that what they did had an impact. I'm not sure if it has changed since then, but I think that, not every visit, but maybe once a month, individual meetings should be necessary. Another requirement that I think all guardianships should have mandated to them is counseling. I think that, especially in situations like mine, generational trauma was present and affected us beyond the protection of DCFS. Just like in social work, you can't help people if you don't help yourself first. That applies to guardianship care as well. 

 

 

References

https://journals.sagepub.com/doi/full/10.1177/10634266221076475

https://www.americanbar.org/groups/public_interest/child_law/resources/child_law_practiceonline/child_law_practice/vol30/september_2011/kinship_caregiversreceivefewersupportsthanfosterparents/

Decatur is too car-centric

 Today, Monday, February 2nd, I went to a city council meeting here in Decatur, where I live. I had prepared a two-and-a-half to three-minute speech where I would ask the city council to consider more infrastructure development, as they allow citizens to speak for about three minutes at a time at these meetings. Since moving to Decatur, I have been concerned that, unlike in Chicago, Decatur has no bike lanes and no easy way for pedestrians to get around, especially in certain areas that connect parts of the city to one another. In Chicago, there are so many ways to get around. I didn’t own a car until I was 40, when the pandemic hit. I left shortly thereafter. Decatur seems very car-oriented, and no one seems to question this state of affairs.

When I arrived at the city council meeting, there was a line of people ready to speak to the city council on a controversial project in the city, which I was unaware of until today. There were people standing in the meeting hall. I couldn’t get past because there was no room. The meeting was being broadcast on a live feed, and a lot of people who were outside, like me, had the live feed of the meeting on their phones. I listened to and watched it on my phone too. I heard person after person speak for or against this project. Some people were concerned about the possible negative effects that this newly proposed cogeneration plant at the ADM plant would have on the residents of this city, on the water supply (Lake Decatur), and on the environment. They were concerned that the positive economic impact wasn’t enough to offset the negative effects of the new facility. There were also business and economic interests there who spoke and propped up the economic benefits of the new proposed plant. They mentioned jobs and tax revenue.

I was there to speak about my concerns regarding how car-oriented this city is and how we need to consider people who are not able to own a vehicle and try to make the city more accessible in general. I felt a little like my topic wouldn’t be relevant.

A little while ago, my nephew, who lives with me and does not own a car or have a driver’s license, had a job at Kroger, which is walking distance from where we live in the South Shores neighborhood of Decatur. It was very convenient for him to work there. He told me about his experiences walking to and from work. On snowy days, because the city doesn’t clean up main sidewalks, he said he had to “play frogger,” walking on the roads and then jumping back on the snow-covered sidewalks to avoid getting hit by cars. He also told me that he had a colleague at Kroger who would regularly walk across a main bridge (on Business Route 51) where there is no pedestrian walkway and where it is very unsafe to cross, just to get to and from work. On nights when the weather was too bad, he would call off work just because it would be even more dangerous to cross that bridge on those days. My nephew told me this colleague had to brave walking across that bridge to get home at night because buses in the city only run until 8 p.m.

Recently, the city implemented a new rideshare program called Decatur Moves. It is a very affordable rideshare system that only costs $2 per ride. That has been a saving grace for a lot of people in the city. Decatur Moves functions all over Macon County and is wheelchair accessible. However, Decatur Moves is a service that stops at 8 p.m., leaving shift workers, like my nephew’s colleague, to fend for themselves.

A few years ago, when I did Uber and Lyft for supplemental income, I recall picking people up from work in the Mount Zion business area of Decatur. They lived in the more low-income center of the city, but they got off late at night from their jobs at the fast food restaurants in that area with no pedestrian access and had no other way to get home than to pay anywhere from $12–$18 (or more!) for a ride. A fast food employee doesn’t make more than about $15 an hour, if that, so for someone to devote an entire hour to an hour and a half of their six- to eight-hour shift to getting home is a huge expense.

All of these experiences, as well as my own personal preference for bike riding and walking (the way I used to do in Chicago), made me very eager to go speak to the city council about these concerns. I am someone with privilege. I have a job that allows me to own a car and get around relatively easily, even during weather that would make it difficult to get around on foot or by bike. If I had an emergency, I could get an Uber or a Lyft. I have also ridden the bus on a few occasions here in Decatur. However, because there were so many people at the city council meeting today who were upset about the new proposal that the city council was supposed to vote on, I decided not to speak.

As I walked out, I thought to myself, “Maybe you could have added a little bit more somewhere in your speech about how the city needs to put terms on these projects and demand investment in infrastructure for these proposals to even be considered.” But it was just an esprit de l’escalier, a little too late. The city council had already moved on to talk about their agenda items as I walked out of the building.

This experience sparked something in me, though. One of our assignments in this class is to write a policy brief, and I have already started working on mine. It will be about this issue of helping people move through the city of Decatur with dignity, regardless of their ability to own a car or pay for expensive rideshare services later in the evening and at night. I intend to email it directly to the city council members. I also intend to come back to the next city council meeting to speak. Next time, I will be more prepared.

Deceptive Narratives of History

      First Free-Writing Reflection Essay in response to deceptive narratives of history

As I reflect about current issues related to policies, social work or services, writing about the concept of history told in a deceptive one-sided narrative is weighing heavily on my heart and for that very reason I will begin to unpack just why this is so. To do this I am going to begin to explore what I have learned about the process of hero making by sourcing the book “White Rage” by Carol Anderson and the text, “Lies my teacher told me; Everything American History textbook got wrong,” “by Loewen James. 

Firstly, the text, “Lies my teacher told me; Everything American History textbook got wrong,” highlights how the process of hero making often highlights a more simplistic approach, which is often questionable and leads to misinformation. Because it illustrates heroes in American History in a way that does not present the whole context of that person or unit of analysis. But instead depicts half narrative or whitewashed version.  (James). An example of this was seen in the text, but I will choose my own example from the text, White Rage about former U.S President, Abraham Lincoln outlined below.

The American history made out Abraham Lincoln as a hero, because he freed the slaves. But what they failed to do was tell the whole story about how he felt about slaves, or even his objectives or intentions behind freeing the enslaved. (Anderson). This Creates a narrative that is one sided, thus leading to misinformation, which is seen as the full context of Abraham Lincoln, a supposedly hero was not told and lead to the misinformation that the injustice of African American ended when the 13 Amendment was passed.

Overall, the specific instances of history told in a deceptive one-sided narrative bothers me not only because of the misinformation it gives as I have illustrated. But also, because it alters effective change for it prevents people from learning from passed mistakes, finding effective solutions and clearing up misconceptions of prejudice, racism, stereotypes and other biases that are still inherently amongst us today. Therefore, current laws or debates about things such as banning books that speak on issues race, weighs heavily on my heart because it furthers the agenda of deceptive narrative, which is disruptive.

Truth is important, isn't it?  But truth is complex.  Every moment has so many aspects and dimensions.  In any event, or in any person’s life, we can only perceive or consier a tiny fraction of the full range of facts.  Narratives about history or another person are always highly selective.  The question we must answer is what motivates our selection of the facts?  Are we trying to give an honest and fair and accurate account of an event or person?  Are we trying to inspire people?  Are we trying to provide a cautionary warning?  I we sharing a narrative to help readers form a shared cultural identity with us?  Are we using facts selectively to present a particular viewpoint of the world and reality?  How can we judge which approach is best in creating “good” narratives or “false” narratives.

A core problem facing those of us alive today is the way some people are undermining the idea of truth or facts.  We have people engaged in a sort of post-truth political entrepreneurship.  These are people who will not even bother to create a narrative that is false or misleading—they just spew so many words that are untrue, and do so constantly, that they create confusion and disengagement.  They create an impression that no one can know what is really going on, so it’s better to let the experts figure things out, or to place our trust in people who have the vibes that we like. 

It seems to me that traditions of teaching history in the USA were shaped by the ideas that a purpose of education is to inspire people and make them patriotic and loyal to the USA, and also the belief that teaching people about the heroism or admirable qualities of historical figures would enhance patriotism and civic engagement and idealism.  No doubt there would have been many motives.  Ours is a nation of great diversity, and we want to hold together as a nation dedicated to a few basic principles, so perhaps people who created historical narratives were trying to help people get a common ideology or set of values so that we could enjoy national social cohesion and a values-based national unity.  Or, perhaps some of the textbook writers and leaders of education had more sinister motives, such as getting working classes and common people to accept a system that did not always treat people fairly.

In the case of Abraham Lincoln, consider the way our National Park System examines Lincoln and his relationship with Frederick Douglass.  Sometimes official history is capable of nuance and a recognition that people are complex, with noble qualities and admirable aspects mixed in with character flaws and personal limitations.  Sometimes people put down Lincoln by finding some passage from some speech or letter or debate, and then claiming “this is what he believed”.  This can be extremely misleading, because Lincoln grew during his life, and his views and opinions generally improved. In his last public address he mentioned that Blacks (at least ones who had served in the Union army, at a minimum) would probably need to receive a right to vote.  The conspirators (or at least John Wilkes Booth) were in the audience, and decided upon hearing this that instead of kidnapping the President and Vice President and cabinet members, they would just murder them.  An examination of Lincoln’s personal behavior and his relationship with African-Americans also shows that he had an exceptionally warm and respectful attitude, especially in the last several years of his life. 

I would prefer to have history taught in terms of themes.  The themes I’d emphasize would include: 1) progress toward recognizing the equal dignity and rights and value of all persons; 2) progress away from governments based on tyranny and aristocratic rule and toward democratic principles; 3) progress toward enhancing and increasing human freedom; 4) progress toward ensuring that basic needs are met, especially through technology in agriculture, clothing manufacturing, and energy production; 5) progress in using technology and science to improve the quality of life (e.g., water purification, mass transit, vaccinations, germ theory, antibiotics, etc.); 6) Development of peace consciousness and diminishing emphasis on warfare, imperialism, conquest, and militarism; and 7) milestones in political practice, political theory, legal developments, and basic facts about American or international law and events related to how we govern ourselves.

I would teach history and organize history textbooks in terms of these seven dimensions of history, and emphasize ways that we moved away from the ideals, and the ways we advanced those aspects.  I think history should raise awareness in the general public about the goals we have sought in our society, and how we have progressed toward those goals, and how we have regressed away from those goals. 

It is so difficult to get benefits.

Lately, I have been thinking a lot about how hard it is to get help even when you really need it. I personally almost got rejected from getting Medicaid, even though I am a full-time student and only working two days a week. They told me I was not working enough hours, even though school is basically a full-time job on its own. This was really stressful because I have a lot of health issues. One of my prescriptions cost about 260 dollars, and I had to pay out of pocket before they finally approved my Medicaid. That money was not easy to come by, and it made me feel scared about what would happen if I got sick again before coverage kicked in.

Trying to get help like Medicaid or EBT takes so much time and energy. There are long phone calls, confusing letters, online portals that barely work, and rules that feel impossible to understand. You are always worried about saying the wrong thing or missing one form and losing everything. It really feels like the system expects people to mess up. I kept thinking about how many people do not have the time, internet access, or support to deal with all of this. If I felt overwhelmed, I cannot imagine how someone feels who is working multiple jobs or dealing with a serious illness.

Let’s take the I, Daniel Blake movie we watched in class as an example. Watching him go through endless waiting, being sent from place to place, and being treated like he was lying was hard to watch. The system never really listened to him. It felt very real because that is how these systems work sometimes. You can be clearly struggling, but the rules matter more than the person. The movie made it clear how harmful these long processes can be, especially when people are already at their lowest.

What scares me is that this is not just a movie. In the real world right now, new policies are making things harder for people who rely on EBT and Medicaid. Many states are adding or bringing back work requirements for SNAP, which means people have to prove they are working a certain number of hours just to get food. This affects students, people with disabilities, and people with unstable jobs the most. There is also talk about adding more limits and rules to Medicaid again, which could cause people to lose health coverage even if they still need it.

Right now, about 40 million people in the United States use SNAP to help pay for food, and over 70 million people rely on Medicaid for health care. These numbers show that these programs are not rare or extra help. They are basic supports for millions of families, kids, students, disabled people, and older adults. When rules change or benefits get cut, it does not just affect a few people. It affects entire communities and puts more stress on people who are already struggling.

All of this makes me think about how social welfare systems are supposed to help people survive, not push them deeper into stress. When food and health care are treated like rewards instead of basic needs, people suffer. It makes me even more certain about going into social work, because these systems need people who understand how hard they really are and who are willing to speak up for the people stuck inside them.

When it comes to social welfare there are two conflicting priorities in reducing error.  On one hand, we may prioritize denying benefits to those persons who do not deserve them or do not qualify for them.  We want to reduce the error of giving undeserving and “cheating” people benefits they don’t deserve. If this is our higher priority, we will make more errors of the other sort: of denying benefits to persons who deserve or qualify for them.  But, if we instead want to be sure that everyone who deserves benefits receives them, we’ll need to make it easier to qualify and easier to apply for benefits, and that means we will be allowing more people who are cheating the system or trying to get benefits that they don’t deserve. 

It seems to me that the values we have when we make a decision between which type of error to prioritize will need to be set by our conception of human nature and private property.  If we highly value private property, and we have a pessimissitic view of human nature, will want to be more vigilent and selective about who receives help. We will assume that many people will try to cheat the system and take what they do not deserve, so we will want strong systems of guarding against people taking benefits that aren’t intended for them.  And if we highly value private property, we will be extremely concerned about how public resources are distributed, because we will be very aware that gathering those resources to re-allocate them through a social safety net required taxing people, and taxes are a way of taking away time and wealth from people, removing their control over some of their private property. 

On the other hand, if we think private property is conditionally granted to us as a sort of trusteeship, or is only permited to exist because of a collective society that protects our property, we may be more willing open to seeing that our income and wealth partly belongs to us and partly is owed to society as a collective, both to secure a social welfare safety net and also to generally protect our property and our person.  

A second divide beyond the one between pesimissitic private property devotees and optimistic persons with a less fundamentalists commitement to the value of private property can be seen in the divide between people’s views of social welfare safety nets.  On one hand there are those who see the social safety net that provides housing, basic incomes, food, medical care, and various other benefits as a temporary bit of assistance that should be minimal and limited.  This is a view of social welfare safety nets as tools to help people briefly maintain their standard of living as they transition from one form of income-generating economic life to another.  The assumption is that people will take some work, and people should not be too selective about the type of work they take. The safety net should be minimal and stingy, so that people will have a reasonable incentive to recover from addictions, regain health, find employment, and take whatever job they can quickly find.  In this point-of-view, the safety net is a humanitarian gesture, but people’s fundamental duty to society is to be self-supporting and self-sufficienty.

Contrasting with this view is one where the social welfare safety net is a tool to enhance freedom or ensure that people’s human rights are being respected. With this point-of-view, welfare benefits should ensure that everyone has “an adequate standard of living, including food supplying adequate nutrition, basic health care, and shelter. In this perspective, if someone shows some degree of hunger, or lacks housing, or needs access to health care, a social welfare system is a means to supplying what they lack.  Questions of who deserves the help are not as important as making sure that everyone has enough, with “enough” being defined by some standards informed by conceptions of human rights.  The role of welfare in enhancing freedom and the power of employees would imply that benfits ought to be generous and available for long durations without threat of termination.  The perspective here is that the welfare system ought to provide a high enough standard of living that employers will need to induce workers to work for them with high salaries and attractive benefits. This approach assumes that workers need the power to refuse to take employed work, so that they can have more freedom, and that includes the freedom to leave employment where an employer is unfair or unreasonable or abusive, and the freedom to stay out of the paid labor force as long as necessary to find an attractive way to earn money. 

You and many other social work students are horrified at how unreasonable the social welfare system is, making it so difficult for people to qualify to receive benefits.  Generally, social work students have presumptions about human nature that are optimistic, assuming people want to work and be productive. You may also prefer a social welfare system that maximizes the freedom of people who are working class, easily giving them generous benefits for a long time so that employers will be pressured to improve compensation and working conditions to attract workers. You also prioritize the values found in the 25th article of the Universal Declaration of Human Rights.

1. Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
2. Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

High costs of health care in the USA

 One of the biggest problems the United States healthcare system struggles with is high cost. This issue contributes to reduced access to care which lead to negative consequences such as increased health debt and poorer patient outcomes. 

Rising healthcare costs creates a burden on patients by making necessary care unaffordable. This leads to delayed treatment, skipped appointments, medical debt, and patients not getting necessary prescriptions due to the cost. If patients are not able to afford healthcare this can lead to worsened chronic conditions and overall poorer health outcomes. Unaffordable healthcare can also force patients to accumulate debt through credit cards, personal loans, or high deductible plans to pay for medical care.

Woo, a young man, who used to live in a run-down apartment in Milwaukee stepped on a nail and refused to get medical help because he couldn’t afford it, according to Matthew Desmond (2024, p. 15). After a few weeks, Woo eventually had to visit the hospital. His foot and leg had a severe infection causing him to get his leg amputated (Desmond, 2024, p. 30). This story is an example of how people may put off treatment due to the cost of care, which can result in chronic conditions and overall poorer health outcomes. 

I believe that in order to improve people’s financial stability, healthcare cost should be reduced. By doing this, people will be able to reduce medical debt and allow individuals and families to afford other necessities. This will also improve public health outcomes by encouraging preventive care and early interventions, resulting in better health for the population.

Reference

Desmond, M. (2024). Poverty, by America. Penguin Random House LLC.

Americans spend about $5 trillion on healthcare.  Or, maybe that figure is up to $5.5 or $6 trillion by now.  That's about 18% of our Gross Domestic Product. 
Presumably, a national health care plan, whether covered by a single payer or whether using multiple different payers (see the German or Swiss systems for examples) would cover something slightly under 100% of costs: possibly 95% of healthcare costs.  And, presumably, there would be increased efficiencies in health care, and that would reduce costs even more, so the cost of a national health care program that covered everyone would presumably be about $5 trillion if we are currently spending nearly $6 trillion on healthcare. With 340 million Americans, that works out to about $14,700 in payments that would be needed for each person in the United States.  So, for a family of four, if the costs of all health care was spread evenly, that family would need to pay $58,800 in taxes to cover their share of health care costs.  That is the average amount each four-person household would need to contribute to a public program that covers nearly all health care for everyone. 

But of course, a health care scheme like this would not distribute costs evenly.  We already cover about 43% of health care spending through Medicare, Medicaid, and the Veteran's Administration. We would only need to raise about another 47% of total healthcare spending if we wanted a universal health care system.  So, taxes would have to gather another $2.9 trillion from the population. 

The 57% of us who receive health insurance through our employers would get a huge windfall (or our employers would), because employers would no longer have to pay for private insurance for their employees, allowing them to pass on what they now pay to cover health care benefits on to their employees as income.  The increased income from health insurance policies our employers are purchasing on our behalf would, for most of us, closely match the required increase in taxes to get federal revenue up by $2.9 trillion. The average health care benefit per employee is about $8,000, and about $19,000 for family plans.  So, with a universal public health care scheme, incomes for the 57% of us now enjoying plans paid for by our employers would increase to mostly offset the increases we would need to pay in taxes. Currently, wealthy Americans (those in the top quintile) pay about 24% to 27% of their earnings in federal and withholding (Social Security and Medicare) taxes.  If those went up to 33% to 40%, this would go far toward raising the $2.9 trillion.  Middle class households are paying about 19% to 24% of their incomes in federal and withholding taxes.  For them, if those tax rates went up to 28% to 33%, this would be enough to cover the universal health care program.  The increases in income from employers passing on as salary the money that had been used to purchase their healthcare would probably cover most or all of the cost of their increased taxes, so that their after-tax consumption levels would be essentially unchanged.