Student with experience as a human services caseworker reflects on services to help get people out of poverty

 Social service programs, welfare, public aid, food stamps, SNAP, and Medicaid; these are programs that are mostly used by working people. Not the stereotype of the single mother sitting at her housing project apartment relying on the government to take care of her and her five children that she does not know where any of their daddies are. Stereotypes always have some truth in them but they are not the truth. The truth is your average working person is on some kind of assistance, has been on it in the last year or will be on it within the year.

I have worked as a human services caseworker in the local office also known as the public aid office. Some of the saddest cases are not cases of the average person; they are, for example, cases like the single parent who wants better, but must face a great struggle with barriers for employment; or cases like the aged individual who is on a fixed income and cannot work any longer, but also is not quite poor enough to receive full benefits—they can receive $25, while a young able-bodied adult (with or without children) can receive over $200 a month. Yes you read that right. And no, you cannot make that make sense. Due to the great inflation of the past few years there have been some increase; however, some of the policies and working directives have not been changed or updated since their implementation. The policies need to be reviewed and updated.

Working as a caseworker in the TANF unit allowed me to get to know some of the clients and help them create plans of self sufficiency. During the Clinton administration, welfare to work programs began with the intention of getting people from welfare income to working income. These were additional benefits to their welfare benefits. That is, in addition to the cash benefits, we offered supports to help recipients identify and overcome barriers to getting and keeping employment—and the supports included education. Such supports are very important to making a plan to get off of welfare and become self sufficient. These programs were good because they helped welfare recipients with things like transportation to and from work, child care, budgeting classes, resume classes and help, job skills training and help, and career training for entry level jobs in sectors like hospitality and office work. Those who received TANF were helped with job searches. Sometimes these supports and services were offered by the caseworkers in the local office, and at other times these services were offered by a third party contracted with the state of Illinois to provide the service. Some of these things may appear to be hand holding or extra giving of free things to recipients. However they were designed to be supports for the family. This is especially important when the government also began limiting the number of months a person can receive welfare benefits over their lifetime. Here in Illinois that amount of time is 60 months, or five years.

To help with transitions from welfare to working the SNAP program has an automatic extension of benefits for 6 months when a head of household finds a job and their income increases. In times past, recipients have reported jobs and then been cut from receiving their benefits, and since the offices are working a month in advance it was easy for a recipient to report getting a new job and have no benefits in the next month—often before a full paycheck had even been received. So transitional benefits—especially SNAP or food stamps or EBT—are good for the person who has received a new job. They have now been given and opportunity to get accustomed to budgeting and using funds from the new job without the undue stress of the gap of waiting for the first paycheck after the last benefit has been received. Medical benefits are for an extended period of time. There are programs to assist with transportation costs, including car repairs, up to a limit. There are funds and things available. Sometimes it is a matter of both the client and the caseworker knowing they exist and how to implement them.

This description of some of the services and how they are used offers classmates insights into how policies are supposed to help people transition from a bad economic moment to a more prosperous future. However, as you have pointed out, some of the people getting services are elderly and “cannot work any longer” or they are single parents facing a “great struggle with barriers for employment”.  A significant barrier to employment might exist when employers aren’t hiring new workers, and after applying for scores of jobs, a person hasn’t even received any invitations to interviews. A frequent suggested from the left we have been hearing for decades is that the government ought to offer employment when the free market does not. 

One objection to this suggestion is that as an employer of last resort, whatever work the government was accomplishing with employees who were hired after they failed to find a private sector job would be done badly (because the employees would be inferior, having been rejected by private employers).  Another objection is that this would require the employment (and salaries and benefits) for about 1.5 million to 2 million more government sector workers, which would be more costly than simply providing EITC, TANF, SNAP, Unemployment Benefits, and Medicaid to underemployed and unemployed persons.  Another objection is that most of the persons who are poor are either going through a phase, and without government employment options they will eventually find employment and get out of poverty, or else they are afflicted with some sort of chronic health problem, mental health issue, personality disorder, or addiction, and they will be unfit to work for government just as they are unfit to work for private sector jobs. The first group doesn't need the government employment, but the second group would not be able to take advantage of public employment.

On the other hand, arguments in favor of universal employment through new public sector employment suggest that we could use more public employees to fill gaps in services that the private sector is failing to provide, such as creation of affordable housing, provision of affordable long-term care, environmental science projects such as species surveys, and public infrastructure construction and maintenance. Also, with full employment, wages and benefit levels at the low-end of the income distribution would generally increase, since the private sector would need to at least approximately match the wages and benefits offered in the public sector employment. Involuntary part-time employment would also be replaced by full-time employment as federal full-time jobs became an option and private employers decided to match such options. Guaranteed public sector employment might be more politically feasible and less revolutionary compared to basic minimum income stipends, and the guaranteed public sector jobs might also help to essentially eliminate poverty and homelessness, if the public sector jobs paid well enough to take all employees out of poverty while at the same time boosting the supply of low-cost housing.

Some student reflections on SNAP

  SNAP has always been something that’s controversial, in my mind.  Growing up I would hear and see people talking about others being poor in the grocery line, not knowing the context or implications that those words may have.  To the people it was directed it, they would get uncomfortable—which of course I understood at the time—but the real world implications of this happening everywhere is quite telling. 

Now the government provides EBT cards that look like credit or debit cards to help with some of the social stigma surrounding SNAP, allowing users to buy groceries without the judgment that they used to experience.  It’s not just the fact that these judgments happened, it’s the fact that people can look down on others for being poor or experiencing temporary hardships, which we all have in life.  I don’t understand why we need to constantly judge others for their situations; instead we should be kind and offer help where needed.

No, this doesn’t mean going up to every SNAP family and asking if they need help.  That would be silly and add to some of the social stigma; instead, gaining real world experience by volunteering at shelters or local programs that help the poor.  Understanding where these people are coming from, and recognizing that not everyone is the same.  Not everyone is abusing the system and driving Mercedes home.  There are people out there trying to get by and to be judged for that is immoral, in my mind.

Hopefully this paper isn’t controversial for those currently in Social Work or going through school to become one.  I don’t want to confuse anyone reading this, however—people can judge others for anything, but to vocalize it and put others down is wrong.  Therapists can judge clients, but they should never vocalize those judgments in a negative way.  

Emotions aside and judgment aside, I want to move towards the benefits and downfalls of SNAP in general.  The program is wonderful, but it has shortcomings as do most things that are government ran (some would argue all things).  One of those things is not accounting for specific circumstances per family.  What I mean by that is certain areas have higher costs of living than others.  So if a family lives in Washington DC, it’s probably going to be more expensive than a family that lives in Memphis, TN.  The government should focus more on cost of living areas rather than a static number based on how big a family is.

One of the great things about SNAP is how it allows families food security while letting them spend money that would have otherwise gone towards food to go to other important things, like rent or utility payments.  Having food security makes a world of difference when you’ve experience insecurity yourself.  It helps with depression; health outcomes; academic outcomes; life expectancy.  All of these things because of one single government program.

I have a friend that uses the program and she benefits tremendously because of it in her life.  She would say all the time that she wishes she didn’t have to always eat ramen noodles because she’s worried about the long term health effects of doing so.  When you get older, thinks like nutrition start to  matter a whole lot more than to a 19 year old collect student in a dorm room forced to eat the same thing for a couple of semesters.

Nutrition is very important.  Unfortunately, SNAP doesn’t necessarily accommodate the highest efficacy in nutritional returns, but some would say its good enough.  I’m in a similar mindset—as long as some nutritional goals are being met and ramen noodles aren’t being served for breakfast, lunch and dinner everyday, then clearly it’s a net benefit to be in the program.

An academic journal talking about poverty in America and how SNAP helps alleviate it had this to say: “We found an average decline of 4.4 percent in the prevalence of poverty due to SNAP benefits, while the average decline in the depth and severity of poverty was 10.3 and 13.2 percent, respectively. SNAP benefits had a particularly strong effect on child poverty, reducing its depth by an average of 15.5 percent and its severity by an average of 21.3 percent from 2000 to 2009.”

References:

Smith, J. A., & Doe, R. B. (2017). Alleviating poverty in the United States: The critical role of SNAP benefits. Economic Research Service, U.S. Department of Agriculture. https://ageconsearch.umn.edu/record/262233/files/17742_err132_1_.pdf 

You mentioned that Not everyone is abusing the system and driving Mercedes home.  That is an important observation, as it seems to me that many people quickly raise the issue of cheaters who use SNAP benefits because they falsely report low incomes, or who have low incomes, but have hidden wealth or support. I think anyone who deals with the general public soon realizes that a small fraction of people (probably fewer than 5%) are sort of dishonest, slimy, predatory, or psychopathic.  In any system involving lots of people, there are going to be a fraction of people who cheat, steal, lie, and justify this behavior to themselves. However, the sort of cheating where people with hidden wealth or unreported incomes use SNAP must be extremely low (estimates from 2018 suggested a 0.14% fraud rate where recipients were investigated and found guilty of fraud.  If that is 20% of all recipient fraud, the actual level of fraud might be as high as 0.7%.  Fraud committed by retailers trafficking SNAP benefits is estimated at about 1%). 

Your citation from the 2017 article is also encouraging, as it suggests that SNAP makes a significant reduction in experienced (post-tax / post-benefit) poverty. 
I wonder sometimes whether it might be better to just give poor people cash rather than SNAP.  SNAP benefits can only be used to purchase uncooked food (although there are grocery stores that will cook some raw foods for you as a service, for no fee), and so while SNAP benefits help make malnourishment and starvation exceedingly rare in our society, the problems of housing insecurity or other problems of poverty cannot be addressed so much with SNAP, aside from the point you make that every dollar in SNAP is a dollar less the family needs to spend on food, giving the household more money to use for other necessities.

I'm a bit concerned about refusing to allow households to spend SNAP benefits on sweetened drinks, candy, or other morally suspect foods.  A goal of a welfare safety net is to give freedom and autonomy to persons who are suffering a period of low income, either because of an economic hardship they are temporarily passing through, or some more permanent problem, often related to physical or mental health conditions or disabilities. Restricting what people purchase with SNAP benefits will be justified by health concerns, which is why a person is not allowed to purchase cigarettes or alcohol with SNAP benefits, but at some point the restrictions on SNAP use cross from nutrition and science to moral or religious reasons, and I’m wary of that.  For example, I suspect that consuming most meat or animal-derived food products available in supermarkets is immoral, since much of that meat is generated through industrial livestock systems or industrialized marine harvesting, and so if we are going to forbid the consumption of alcohol or soda pop, why not also ban the purchase of animal-protein products and restrict SNAP users to vegetarian diets?  What if some persons thinks that only organic food is moral or healthy, and we start forcing SNAP to be used only for organic products?  This seems like a Reductio ad absurdum argument, but I think the assumption that we should be strict in limiting what welfare recipients do with the aid we give them is one that we must treat with caution and concern, if we highly value individual liberty and dignity.

The earlier part of your reaction where you think about how people are eager to judge others reminds me of some psychological experiments that show humans tend to be very good at detecting cheating and unfair exchanges where someone else gets an advantage.  Helping people overcome that innate tendency toward distrust, cynicism, paranoia, and judgmental prejudices is certainly a huge task we have in advancing civilization and improving society. I wish people were better at recognizing the actual levels of threat from cheating and deceit. 

As for government programs being inherently inferior.  Of course they are.  In an ideal or perfect society, people would be so honest, charitable, fair, and open-hearted that we would not need a public welfare system, nor police, courts, nor jails.  Taxes would be very low, paying mainly for infrastructural improvements and pooling risk.  Given the scope of the problems we face, given the actual material (humans and their human natures) we are dealing with, we must settle for government and coercive charity through social welfare systems, at least for the time being. I look forward to the utopian anarchy our remote descendants may someday enjoy when people are better than they are now.  

Student Reaction Essay Deplores Trump Administration's Handling of Poverty

I have several concerns with social policies—or the lack thereof—in our world today. My main thought concerns our approach to poverty. I have heard the age old phrase “the rich get richer and the poor get poorer.” I never understood this until I got older and started consuming media. The rich are rich. Rich enough, unfortunately, to buy multi million dollar corporations without the bat of an eyelash, or persuade young teens that money is all you need and you have to do whatever you can to make as much as you can. Tossing all morals out of the window for money. Disgusting. How rich exactly are the rich? Lets look, a quick google search told me the richest man in the world currently is Elon Musk, with a net worth of approximately 421.6 billion dollars. Now let us not forget his recent display of a fascist symbol that ended the lives of around six MILLION people.  But it’s okay because he’s rich. Apparently. Unfortunately. 

You seem to be raising three issues. First, you’re noticing the issue that small inequalities tend to grow into larger inequalities over time.  People with wealth tend to become wealthier. Second, you seem concerned with a materialistic view that replaces traditional values, where wealth and the pursuit of wealth is highly valued over more traditional values. Third, you are concerned with the tremendous power that goes along with extreme wealth, and the suspect ideologies of some of the wealthy persons.  You might be interested in connections between the American Liberty League, the Du Pont family, Robert A. Taft, the National Association of Manufacturers, Ayn Rand,  Robert W. Welch Jr., the John Birch  Society, Charles Koch, Robert G. Grant, Tim Dunn, Farris Wilks, Murray Rothbard, William F. Buckley Jr.,  The America First Policy Institute, Paul Dans, the Heritage Foundation, and so forth. The fabric of American conservative political thinking includes a fair share of upper-class and wealthy enthusiasts.

Now understandably the one reason people gave me for voting for Trump this term was his promise on cheaper groceries. With his tariffs to be able to make his pockets warm, this is far from happening. They say he is a “businessman” and although this may be true, he is a businessman for himself not for you. See businessmen are the worst people to leave in charge of your country. They always say when you're buying a car that the businessmen are only focused on selling to you to ensure they leave with thick pockets, that’s all they care about. When you put a “businessman” in charge of your country alongside a fascist as his right hand man, you may as well set fire to your assets yourself. 

There are many different sorts of business leaders. My own understanding of family-owned businesses is that they take on a different character compared to firms that are publicly traded where stockholders can demand ever-increasing profits and sales growth. No doubt idiots can be cruel dictators in family-owned firms, but some families seem to be more concerned with long-term sustainability, creating loyal and well-compensated workforces, and benevolently running their firms for idealistic aims in terms of serving their customers and employees while maintaining their own wealth. There are brilliant and well-rounded business executives or investors who are probably highly capable in running government agencies, and of course there are investors and business executives who are terrible and incompetent when it comes to government service or public administration. I personally like life-career civil servants who are promoted to the top because of their competence and good leadership skills, or clever academics with some practical experience, and prefer these types to business types, but I know that people with business, military, legal, artistic, and scientific careers might be good, depending upon their character and competence. 

You may think well surely they are doing something to help lower the poverty rate right? The sentiment is adorable but it’s quite the opposite. Trump’s idea to cut federal funding includes but certainly isn’t limited to affordable section eight housing, LINK and EBT cards, homeless shelters, etc. Trying to use the defense that it will force people to better themselves and their lives rather than leech off the government. He only says that with a green cast and dollar signs in his sights. Less federal funding is more money staying in the government, more money in the government is more money to use to his advantage. He doesn’t care about you, he doesn't care about me, he doesn’t care about the nation's children. HE. DOESN’T. CARE. 

Yes, the budget proposed by President Trump was astonishing in its sadistic torments for low-income Americans.  I think Trump’s cognitive decline has brought him to a point that he is almost entirely out-of-touch with what is going on, and his budget is probably the product of some lackey or henchman such as Stephen Miller or Paul Dans.  

Have I seen cases where people continue to willingly live on the government so they don’t have to go back to work? Actually no, I haven't.  As a child I had friends that were on different forms of welfare. Mom was kept at home because of an injury or having to care for young children due to not being able to afford childcare, and Dad was either getting settled with a new family or missing and strung out. People don’t willingly fall on hard times. People don’t want to stay in hard times, taking tennis shoes from the street so their children can have a pair for school, selling their deceased mother’s jewelry to afford even one gift for Christmas, giving their food to their children because they’re “so full and need help finishing it all.” We need to be there for each other, damnit, we can do as much as we want from the bottom but if the top turns their back on us we ALL need to stay together. These are frightening and exhausting times to be living in. This is not how I imagined to spend my 20s. Never forget what they say, but be sure to watch what they do. 

I like how you wrote this as a sort of stream-of-consciousness reaction to events.  Your writing is full of emotion and it is a deeply personal reaction to current events.  I use the reaction essay assignments to give students a chance to write in this style, and sometimes I'm a little saddened when students write more traditional academic essays for their reaction essays. 

The Struggles Veterans Face in Getting Mental Health Care: A VA Perspective

 As an Advanced Medical Support Specialist with Health Administration Services (HAS) at the Department of Veterans Affairs, I see every day how hard it can be for veterans to get the mental health care they need. My team and I are often the first people they talk to when they’re upset or frustrated. We’re also the ones who have to break the bad news, whether it’s about delays or services they don’t qualify for. These experiences have shown me how many challenges veterans face when they’re just trying to get help.

The VA system can feel like an endless maze. Veterans dealing with PTSD, depression, or anxiety already have enough on their plate, but they also face piles of paperwork, confusing policies, and long wait times for appointments. Many get so frustrated that they just give up. A phrase I hear all the time is, “hurry up and wait.” It really describes how veterans feel, like they’re stuck in a system that moves too slowly. In some areas, veterans wait up to 40 days just to get a mental health appointment, according to a 2022 VA report. For someone in crisis, waiting that long can feel unbearable.

Stigma makes things even worse. Many veterans feel like they have to “tough it out” because asking for help might seem like weakness. I’ve talked to veterans who were clearly struggling but said things like, “I should be able to handle this on my own.” It’s heartbreaking because no one should have to face these battles alone. A study in 2021 showed that 61% of veterans with PTSD didn’t get help, and stigma was a big reason why.

Another big challenge is that there aren’t enough mental health providers. New counselors or therapists join the VA with the best intentions, but they quickly get overwhelmed by the number of veterans they need to see. Many leave for other jobs in the VA that are less stressful, which only makes the problem worse. Some areas have staffing shortages as high as 30%, according to the VA Office of Inspector General. This means even longer waits for care, leaving veterans struggling even more.

Even though veterans can seek mental health services whether their condition is service-related or not, there are still rules and steps they have to meet. This can confuse or discourage them, especially if their struggles are from things like childhood trauma or civilian life challenges that don’t fit the VA’s criteria. It’s hard to watch veterans get turned away when they clearly need help.

Thankfully, there are programs that make a real difference, like the Moral Injury and PTSD Initiative and the Veterans Crisis Line. The Moral Injury Initiative helps veterans work through feelings of guilt or shame about their service, while the Crisis Line is there for anyone in immediate crisis. These resources are great, but they can’t fix the bigger problems with the system.

The numbers don’t lie. Around 20% of veterans from Iraq and Afghanistan have PTSD, according to the VA National Center for PTSD. But almost half of veterans with mental health issues don’t seek care, often because they feel ashamed or believe they should deal with it on their own. It’s a heartbreaking reality I see every day.

Working at the VA has taught me how important it is to listen to veterans and push for change. They’ve given so much for this country, and they deserve a system that works for them, not against them. We need more resources, more providers, and a simpler, more compassionate approach. Veterans have already sacrificed so much the least we can do is make sure they get the care they need to heal and move forward.

References 

Department of Veterans Affairs. Mental Health: Access and Availability of Services. 2022, https://www.va.gov.

National Center for PTSD. Prevalence of PTSD in Veterans and Military Personnel. 2021, https://www.ptsd.va.gov.

Veterans Affairs Office of Inspector General. Review of Mental Health Staffing at Veterans Affairs Medical Centers. 2020, https://www.va.gov/oig.

Policies on Marijuana

 The use of marijuana has been a controversial topic for quite some time now. Some argue that it is a damaging gateway drug while others protest that it has health benefits for many different physical and mental issues and should be used medically. Some states have banned it while others have legalized it. As of 2020, Illinois has legalized the recreational use of cannabis with some limitations, including: it must be from a licensed dispensary, you must be 21 or older, and there are limits of how many grams you are able to possess at one time. In some states you are required to carry a medical card prescribed from a doctor to purchase from a dispensary. The doctor must be given a specific health condition to prescribe you a medical card. 

Some issues known to be treated by marijuana include chronic pain, nausea associated with chemotherapy, epilepsy, Tourette’s syndrome, loss of appetite or weight loss, and psychological disorders such as anxiety and depression. The consumption of marijuana has been associated with many positive and negative outcomes. Positives include improved sleep, mental health, and appetite. However, the disadvantages include the possibilities of addiction, lung and brain damage, impaired perception of memory and reality, irritability, and more. 

Cannabis is often a controversial topic and there are many different policies over the world around its consumption. From its legalization in some states we have found some positive outcomes. The sales directly impacts our economy as we can see throughout the years with it  becoming less stigmatized that more and more people are purchasing the drug. Legalizing the drug can provide many benefits alongside that fact. With individuals purchasing directly from dispensaries it has become a safer way for people to purchase the drug with no risk of dangerous and life altering effects that are possible when purchasing from untrustworthy sellers. With it being legalized crimes of greater magnitude would be brought into clearer focus. This also means incarceration rates would change, ensuring less prisoners from charges of possession. 

My personal opinion is that it should be legalized as people should be expected to utilize their free will and make the decisions they believe are in their best interest with no harm to others. It seems to provide many benefits for our society both economically and structurally. It is known for its medical benefits as well as its cons and with proper information I believe individuals should be able to identify their own risk versus reward and how they wish to proceed.

Controversies around marijuana use go back to the mid-19th century, and there were attempts to restrict marijuana sales to medicinal uses in several state legislatures in the 1880s and 1890s. Federal laws restricting marijuana were enacted in the 1930s, and in 1970 the federal government decided to define marijuana as an illegal substance.  I suspect that the motivating theory to make marijuana illegal had more to do with political oppression of government critics than concerns about the health and well-being of citizens, but the rhetoric that was used was all about controlling dangerous drugs and so forth.  I remember when MDMA was made illegal (when I was a high school student) and there was a similar cry about how dangerous ecstasy could be, possibly causing deaths from overdoses or the onset of Parkinson’s Disease, or deaths from allergic reactions. These claims were based on flimsy evidence, and MDMA was useful in therapeutic settings when used under the direction of a professional, but that didn’t seem to count for anything. 

The arguments that seem especially persuasive to me involve the deprivation of income to unsavory drug cartels that might have grown and trafficked marijuana before it was legalized, and the benefits to our justice system and reductions in costs for incarcerating people involved in the trade or use of marijuana. These arguments are pragmatic (let legitimate farmers and businesses conduct the trade in the open where they can be regulated and taxed rather than encouraging illicit businesses) and ethical (the government should not create victimless crimes and deprive people of liberty or freedom unless there is a compelling benefit to the public by doing so).  So long as the benefits and harms seem to balance out, these other two points seem to make marijuana legalization the wiser choice.

The harms tend to get downplayed. Marijuana can be very bad for persons with bipolar disorder.  Heavy marijuana use is associated with some antisocial behavior. But, there are several benefits for some people, which you have accurately listed. Alcohol seems like a substance that is no safer than marijuana, and it seems to me that our experiment with banning alcohol consumption in the 1920s was a disaster we won’t repeat. However, voters in states such as North Dakota, South Dakota, and Arkansas rejected legalizing recreational marijuana use, and marijuana is completely illegal in Texas, Indiana, Wisconsin, Iowa, Kentucky, and Georgia, even for medical use. Federal legalization of marijuana would be popular, but despite advocacy for a change in federal laws, Republican and Democratic presidents and congresses have not moved bill to legalize marijuana.  

Student outraged and inequality and unfairness in American Economy

 After my first few weeks in this class, I have grown very frustrated with the system we are in. I have always doubted that the American government had the people’s best interests in mind, but now I know that they completely do not. I had never really understood economics and how our economy works. All I knew was that we were in a partially controlled, partially free market economy. Reading the graphic novel Economix helped me understand more of how our system works, and how it has also wronged the American people in the past and present. I was very frustrated learning about Reagan and his economic policies, as I felt like they were completely backward and just did not make any sense. I will never understand why we have such low tax rates for the wealthiest people in the country. The idea of trickle-down economics just does not make any sense and does not work. Why do we have such high tax rates for the poorest people in the country and low tax rates for the rich? If we taxed the rich a fair amount, our country would be so much better off, as we could provide more services in the public sector to those who need them. However, in this country, we prioritize the top 1% and not the rest of the country.

You may remember my lecture on taxes based on IRS reports.  I point out that the wealthiest Americans pay about 26% to 30.5% of their income in federal income taxes, Social Security taxes, and Medicare taxes, whereas persons earning $75,000 to $100,000 pay about 24% in income and payroll taxes (I include the employer portion as well as the employee portion of the payroll taxes). Persons earning $30,000 to $50,000 tend to pay 19% to 20.5% in combined federal income and payroll taxes (if we include the employer portion of payroll taxes).  In Illinois, the wealthiest pay about 7.3% in state and local (sales/income/property) taxes, so their total would be 33.3% to 37.8%.  People in the middle pay about 12.1% (so, the total they pay in all taxes federal/state/local/payroll would be about 36.1%).  People near the lower end pay about 14.8% (so, their total might be 33%).  Of course, people near the bottom income distribution would get a significant of their federal and state taxes back in Illinois through Earned Income Tax credits, Child Tax Credits, and benefits such as SNAP and the monetary value of Medicaid, but if we just look at the raw taxes paid before benefits and deductions, we see poor paying about a third of their income, people in the middle of the income distribution paying about 36%, and the wealthiest paying 33% to 38%.   Perhaps you think we would have a fairer tax burden if the total of all taxes on the low income households was closer to 10%, and persons in the middle of the income distribution were paying about 35% to 40%, and people at the wealthiest end of income distributions were paying 40% to 50%.   

The people in Congress who have been writing the tax code over the past decades certainly do prioritize the well-being of the wealthiest persons with the highest incomes. There has been a long tendency through generations of governing elites to think that the country “belongs” to the people who own the most.  You can see this sentiment expressed at the Putney debates (1647) in opposition to the positions of the Levellers. It was also an opinion expressed by some delegates at the Philadelphia Constitutional Convention in the 1780s. I think there would be broad support for a simplified reform of the tax code to reduce its complexity and make it fairer.  That should not be a partisan issue.

 I have been a strong believer in Universal Healthcare and providing more social welfare systems to the American people. I thought that maybe the government was not supplying this because it costs too much money, but again this is not the case. The United States government spends outrageous amounts on things such as our defense budget. We can supply the American people with quality Universal Healthcare, and we simply choose not to, as this would completely kill the private healthcare industry and the private insurance companies. The concept of insurance already upsets me, as I feel like it is doing the American people completely wrong. Insurance companies kill people by denying their claims for life-saving procedures, medications, etc. Yesterday I went to the doctor and got a medication prescribed to me, but I could not afford to pick it up. My medication was not covered by insurance and would have been $70 if I wanted to pay for it out of pocket. I simply do not have the funds to pay for this. Luckily, I can go without the medication, but this is the reality for so many people where they NEED medication and cannot afford it. I do not know what I would do if I needed the medication and could not pay for it. Would I bite the bullet and pay for it or go without and risk my health declining? 

Private insurance still exists in the UK and Germany and other places with universal health care insurance.  In places with universal health care, standard contribution rates tend to be about 16% of income.  That is, if we had universal health care in the USA, it might be paid for by an earmarked tax of 16% paid by everyone on their incomes. We could pay an old-age pension tax of 13% and a health insurance tax of 16%, with the federal income tax averaging about 8% on top of that, and state and local taxes averaging about 11%, so that average people were paying about 48% of their income in all taxes to local/state/federal systems.  But, in that situation, private out-of-pocket spending on health care would drop from about 5% of household budgets to less than 1%, and spending on health insurance paid through employers or bought directly by households would also drop significantly.  Although taxes would have increased from about 33% to nearly 50%, reductions in other costs would leave spending budgets in most households fairly similar to what they are now.

Reading the novel Poverty, by America made me so angry. Hearing about the Walmart employees who are on SNAP and Medicaid because they do not earn enough is so frustrating. Walmart promoting the EITC to its employees and even lobbying for it to get expanded is just pure corporate greed. These people only qualify for these programs because the corporation they work for does not pay them enough. People could work a full-time job here in America and still not be able to afford necessities. It is not like these corporations can’t afford to raise wages for their employees. They make plenty of profit, and they raise the wages for the executives, so why can’t they raise wages for their employees? The only answer is that it is not in the best interest of the company. When Walmart raised its minimum wage around the recession, the company saw its largest single-day loss of profits in the stock market on record. People were dumping their stocks because they raised wages. This resulted in the company losing millions of dollars. 

The government wants to create an economic climate in which there is very little unemployment, and investment in creating more jobs is an attractive way for rich people and banks to invest savings. This could be achieved by regulation and a generous welfare system that forced employers to pay good wages to their workers, so that poverty was reduced, and the resulting wealthy population would stimulate demand and create an economic boom.  Or, it can be done by allowing business to pay low wages and have the general public step in to supplement the purchasing power for households in the bottom third of the income distribution, allowing business to collect higher profits, but forcing the rest of us (the top two-thirds of the income distribution) to pay taxes to support the low-paid workers and prop up the profits of those companies with low-wage employees. It's not just an economic question, since designing a system that inflicts poverty and scarcity on a third of the population is creating crime, despair, anxiety, stress, health problems, and misery on a large minority of our country.  

The American people have to pay the lost wages for these people because their corporations won’t, and this should never happen. These corporations and CEO’s keep getting richer and richer and the American people are paying for it. The wealth gap keeps expanding every day and nothing is being done about it. There needs to be some serious reform within the systems, and I think the first step is to finally tax the rich a fair amount. We need to stop letting these billionaires and their greedy corporations swipe us by barely paying taxes. 

I think there is a good case to be made for a system in which spending and taxation reflects the situation in the 1960s and early 1970s, when productivity gains were shared more equitably among the working population, and capitalists and the higher income earners gathered wealth that was not so wildly different from what everyone else was doing.  It's this class of about 100,000 American households with extreme wealth that seem to be perverting our society and democracy, and I'd rather that these households were merely somewhat wealthy, with tens of millions of dollars, rather than obscenely wealthy, with hundreds of millions or billions of dollars.

Insurance & Substance Abuse

When this assignment was first introduced, I began to overthink it. What would I choose to write about that I could just talk about for an hour without having to overthink what I am writing about and making sure I spend the proper time limit on it? The more I got to thinking, the more what I do every day came to my mind. 

I work at Gateway Foundation Drug and Alcohol Treatment Center here in Springfield, IL, and the way that insurance companies control everything that clients can do really grinds my gears. Clients come to us for help, and sometimes we must turn them away because of insurance. There are times when clients come in and they are ready to turn their life around and do better for themselves, and there are other times when clients come in because they are being forced to by legal or DCFS. There are sometimes times when they come in and we have to say “no” because their insurance won’t cover Gateway and as we are out-of-network they can’t afford to pay the out-of-network costs. 

An example that I can use about insurance dictating what clients can do that I don’t agree with happened a few months ago. Even though weed is legal in Illinois now, in some counties it is still illegal, or in some counties probation departments don’t allow it to be in the person’s system. There have been a few clients who come in and the only substance that they struggle with and want treatment for is weed. Insurance companies will approve treatment for it in the outpatient setting, but they will not approve it for the inpatient or residential treatment setting. If someone is only coming to outpatient, they leave and go back everyday to the same environment every day that could maybe be contributing to them using. They also could be going and hanging out with the same people who are encouraging them to smoke. There were a few certain people who wanted to go to residential treatment to get away from these factors. Residential has many factors that can be beneficial to the client to help them. Being away from weed for 28 days or however many days insurance will approve the stay, could be life changing for a client, but insurance companies, especially state funded Medicaid plans, don’t see weed as being a substance that treatment is needed for. Some private insurance companies will pay for it, but it is tricky to get it done. 

We also have the instances where after so many weeks and hours of being in treatment at a certain level of care, they have to be transitioned to a lower level of care, or they have to be completed from the program if they are already at the lowest level of care. Clients know themselves and they know their boundaries, and when we must tell them that by this day of the month they have to go to a lower level of care, or this day of the month they have to complete the program. When you tell clients this and they aren’t ready to be at a lower level of care or complete, you can almost see the light drain from their eyes. A lot of the time, clients use their drug of choice to be rotated to a higher level of care or be able to stay in the program longer to get around insurance and what they dictate.

I don’t believe any of this is right and I hate how much insurance dictates everything in our lives and how expensive it is. I hope one day we have a world where insurance doesn’t have such a significant impact on everything, and if the day comes I hope I am here to see it. 

Thank you for sharing these insights into some of the barriers that diminish the quality of care available to persons who are trying to recover from substance use disorders. Insurance is supposed to play a useful role in a couple ways.  First, it offers pooled risk.  If 90% of us will never need treatment for a problem, but 10% of us will need treatment, and we can figure what the average cost of that treatment would be, we can spread out the risk by having 100% of us paying a fraction of the average cost of treatment so that if we ever need the help, the money will be there for us.  That's pooled risk, and it can be done by private insurance or by taxing people and having a public program to provide services.  Also, insurance companies (or administrators of public programs) should be reviewing treatment plans and interventions, and keeping an eye on providers, to guard against providers charging too much, or charging for providing ineffective treatments.  But, this needs to be done at an aggregate level.  There are always outliers, extreme cases, and exceptions, and so long as the rate of these sorts of cases isn't much higher or lower at a provider, the insuring (and paying) entity ought to just defer to the wishes of professionals and clients.  Only if a particular provider seems to be frequently having exceptionally costly or long-term treatments should the insurer come in and start examining each case and determine what is going on.  

I wish we also had a way to help relocate people to healthier environments, since so much about substance use disorders is conditioned by the social environment in which a person lives.  

Insurance companies are widely loathed, and there are many egregious examples of insurers denying treatments to their subscribers or payments to the providers. The 2010 Affordable Care Act put some restraints on how private insurers provide coverage, but abuses and outrages continue, as you illustrate in your reaction essay.

A Note on Executive Order: Unleashing America's Energy

Under Trump the United States has withdrawn from the Paris Climate Accords. This aligns with his aims to “unleash America’s energy”. Trump’s energy policy seeks to free us “from burdensome and ideologically motivated regulations”, which translates to any environmental policy or practice that acknowledges the perils of climate change and the negative impact human “progress” has on the environment. 

This executive order abolished the American Climate Corps, which was a program implemented under Biden to support clean energy development and fight climate change. This executive order also calls for the weakening of the National Environmental Policy Act of 1970, which in essence holds entities accountable for their environmental impact. This order also disbanded The Interagency Working Group on the Social Cost of Greenhouse Gases.

This executive order and the policies lying therein have the potential to do great harm to the animals, wildlife, natural spaces, and humans of the United States. This plan is shortsighted and greedy. Excess use of natural resources is not sustainable. I hate the term “natural resources”. It makes nature sound like a commodity. Nature is not a commodity and humans are not separate from nature. We are nature. What happens to the planet, happens to us as well. 

Trump doesn’t care if the national parks are destroyed or if factories dump toxic waste into our waters. He’s going to be safely tucked away at Mar-a-Lago where none of the fallout of environmental disaster will touch him or anyone he knows. Bottom line - I greatly fear that this executive order indicates a dangerous disregard for the environment on the part of President Trump. I worry that there will be long lasting and probably irreversible consequences to policies implemented under this order. 

I wonder whether President Trump has ever visited national parks, gone camping, or gone for long hikes in nature.  He does seem to love the outdoors, as he is an avid golfer. At least two of his sons seem to enjoy hunting, and sometimes hunters are very interested in wildlife and nature conservation. 

My problem with the current President relates to his lack of curiosity or self-awareness.  A person with wisdom, who is intellectually curious and has some degree of insight into internal motivations and biases, is likely to seek out an accurate understanding of reality.  I’ve been acutely interested in climate change ever since I happened upon the “hockey stick” article while browsing through Geophysical Research Letters in a university library back in 1997. I’ve followed critiques of “alarmism” and the works of persons who doubted the severity and swiftness of global warming, and the work of the scientists who warn that things are very bad and threaten humanity’s future.  I can remember the climate forecasts that were being made in the late 1990s and early 2000s, and I can look at recent climate news from the past decade, and the models of 25 years ago have been fairly accurate. The critiques of the climate warming models have also been mostly answered.  There really isn’t much room for doubt now, and we can be highly confident that human release of greenhouse gasses (and feedback effects related to methane release from natural sources in response to melting permafrost and warming lakes) are rapidly raising global temperatures, and raising sea levels.   

The prognosis for humanity isn’t good.   Long stretches of extremely high temperatures coupled with high humidity will make some parts of the planet practically uninhabitable for months of each year, except for persons who can shelter in air-conditioned spaces. Increases in number and severity of storms with rain and wind are likely, but in other areas droughts may become more severe and longer. Look at Table 1 on pages 10-12 of the UK Climate Change Risk Assessment of 2022, or the Fifth National Climate Assessment for the USA from 2023.  And the USA and the UK are fairly protected from many of the worst changes. Global assessments of risk show that the Central Sahel, and low-lying lands near coasts in areas regularly hit by tropical storms (places like Bangladesh, islands of the Caribbean or Western Pacific, Thailand, Vietnam, Florida and the American Gulf Coast) are especially vulnerable. 

It seems a damning indictment of our species that political leaders across the world can just shrug their shoulder and go on encouraging economic activity that increases our output of greenhouse gasses. Russia encourages the use of fossil fuels, and China builds many new coal-fired power plants. As you’ve pointed out, the USA has withdrawn from efforts to reduce greenhouse gasses.