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Condescension and infantilization

Interesting story out of Oregon on their state health insurance scheme. Much to the relief of Oregon taxpayers, no doubt, some 40,000 people have dropped out of the Oregon Health Plan program, which provides state-subsidized health insurance.

The reason they dropped out? I don’t know, really, but it is interesting that the newspaper casts the story entirely in terms of the poor folk being dropped from the program. I say the participants dropped out because they apparently chose not to pay the premiums, which are as low as $6.00 per month. The response of “advocates” for the poor is just priceless.

Advocates for the poor say the premiums are too expensive for some people and the government may have overestimated the ability of people to mail a check.

“It’s an enormous barrier,” said Ellen Pinney, director of the Oregon Health Action Committee. “Let alone the $6, there is the whole issue of writing a check or getting a money order, putting it in an envelope with a stamp and putting it in the mail to this place in Portland that must receive it by the due date.”

$6.00 a month too expensive? Give me a break. This sounds to me like a classic example of “I can’t afford it” as code for “I have other things I would rather spend the money on.” If you forego a single trip per month to McDonald’s, you will save enough to pay a $6.00 monthly premium.

Really, though, the notion that poor people are incapable of mailing a check has got to be the last word in condescension and infantilization. Believe me, anyone who can fill out the paperwork to qualify for Medicaid or other state-paid health insurance (or find someone to do it for them) is capable of writing a check or getting a money order and putting it in the mail.

I’m not sure what larger point this story illustrates, to tell you the truth. Perhaps the corrosive effect of the welfare state on its recipients. Perhaps that, if you support the welfare state, sooner or later you will start to sound like a total ninny.

Thanks to OpinionJournal for the link.

18 comments to Condescension and infantilization

  • Alfred E. Neuman

    I would add that there is almost surely some leftist paternalistic racism in there too. Most advocates for the poor mean “black” when they say “poor”.

  • A quote from the rest of the article:

    State statistics show that most enrollees are about 40 percent below the poverty level and tend to be jobless and often homeless and have a high prevalence of mental illness and drug or alcohol abuse.

    I hate to say it, but some people are so disabled by mental illness that mailing a letter really is a huge hurdle for them. (I’ve done some voluntary work in the past) Others are stoned out of their gourds 99 percent of the time on Ethanol, Crack or Heroin. Personally I don’t see why I should have to pay for their irresponsibility and amusement, but looking at it from a pragmatic Public Health viewpoint, it may be cheaper to provide them with medical care than see an increase in Hepatitis, AIDs etc that may hit me or someone I care about.

  • I spent one year in Oregon– a year that not only crushed my confidence in ever being able to find a decent job, but a year that burdened me with debt I’m still paying off. I couldn’t get more than part-time minimum wage, and I was actually told that my college degree kept employers from considering me, because “college graduates want too much money.” (At this point I was desperate and applying retail because I wanted WORK.)

    The thing that bothered me the most? We were both working, and together our wages didn’t hit the poverty level (I found out later we could have qualified for food stamps!) and we *still* had to pay a lot for state income tax (the first year I made a grand total of $1000 and had to scrape up $50 for state taxes at a time when there was nothing but ramen in the cupboard.) Something’s a wee bit wrong with that scenario.

    Oregon’s a lovely state; pity it’s impossible to live there.

  • John J. Coupal

    The idea that “health care” is a natural right is absurd. It is a personal responsibility for which each and every one of us is responsible.

    To B. Durbin: I had thought that Oregon was part of the Left Coast in which “progressive taxation” was a given. I now give credit to the people who came up with the idea that you pay $50 on an income of $1000. Why do you think that freedom is free?

  • R C Dean

    I hate to say it, but some people are so disabled by mental illness that mailing a letter really is a huge hurdle for them.

    If they managed to get into the program in the first place, they have navigated far more difficult paperwork. Probably with help, of course, but where were the do-gooders when it came time to follow-up?

    (I’ve done some voluntary work in the past) Others are stoned out of their gourds 99 percent of the time on Ethanol, Crack or Heroin. Personally I don’t see why I should have to pay for their irresponsibility and amusement,

    Me neither. End of discussion.

    but looking at it from a pragmatic Public Health viewpoint, it may be cheaper to provide them with medical care than see an increase in Hepatitis, AIDs etc that may hit me or someone I care about.

    Of course, you tend to get more of what you reward, so subsidizing these lifestyles that appear to be a menace to “Public Health” may not be the best way to protect public health.

    Tolerating and dealing with the risks of other people’s bad decisions is one of the prices of living in a free society. Now, you get to deal with these risks AND subsidize the people putting you at risk. Its a two-fer!

  • Steve

    “Of course, you tend to get more of what you reward, so subsidizing these lifestyles that appear to be a menace to “Public Health” may not be the best way to protect public health.”

    Yeah! Otherwise what incentive do these people have not to contract HIV?

  • toolkien

    Of course, you tend to get more of what you reward, so subsidizing these lifestyles that appear to be a menace to “Public Health” may not be the best way to protect public health.

    Yeah! Otherwise what incentive do these people have not to contract HIV?

    Assuming you were being sarcastic, I think the larger meaning to the statement is that this sort of program is in fact the worst possible course of action. People will engage in whatever activity they like, sometimes to their own detriment, and further, in some cases the maladies are communicable. Providing for a transfer through the force of the State (i.e. to provide health care) only increases the population of those afflicted and communicating, increasing the health risks for those who are paying the toll in the first place. Generally speaking the liberal dominated culture we live in allows just enough freedom of action for many to make poor decisions (and the resulting consequences) but then instill enough collectivism to preserve the afflicted population. I guess the good news is the Statism is now eroding freedoms in the first place to prevent social maladies from occuring (cough cough – the fat police, the smoking police etc etc). The logical course of action of course is to subject the decision maker to the consequences (mitigated by those who voluntarily choose to give resources) and ultimately removed from the social register if that is the consequence of their actions. Using the Force of the state to confiscate one’s property to maintain a dependent and virulent population is the least logical.

  • Kevin L. Connors

    Providing public health care will do little to stop the spread of hepatitis and AIDS. Although earlier detection and treatment could reduce the suffering of those aflicted.

    What will do a great deal to stop the spread of these, and other, comunicable diseases is to decriminalize the posession of hypodermic syringes, which a diabetic can purchase by the 100s from any pharmacy for about .05/ea, but currently costs the junkie on the street $2-5/ea.

  • steve

    Providing for a transfer through the force of the State (i.e. to provide health care) only increases the population of those afflicted…

    You mean by keeping people alive?

    …and communicating, increasing the health risks for those who are paying the toll in the first place.

    You seem to think that the availability of free treatment means that people, lacking the economic disincentive not to contract some illness, will therefore behave in a riskier fashion. I think people realise that becoming ill is a bad thing in itself and require no economic discouragement from doing so. Witness the low rates of, say HIV in Europe where social healthcare does provide free treatment to anyone who needs it. If your hypothesis were correct would we not be witnessing an explosion of the diease here? Indeed, there is much to be said for providing treatment. A person who knows treatment is available is far more likely to undergo testing, and someone who has been diagnosed is far less of a threat to others than those who remain ignorant of their condition. If, as you suggest, treatment were not available you would simply see a larger pool of people behaving in ways that put the general population at more risk, not less. You’re also making the mistake of thinking that it’s always in a person’s power to avoid exposure.

    You can argue that whether or not such treatment should be funded by the state or by some charity or NGO, but I think you’re basically mistaken in thinking that the best way to minimise the spread and impact of some epidemic is to simply leave those too poor to afford treatment to die.

    What will do a great deal to stop the spread of these, and other, comunicable diseases is to decriminalize the posession of hypodermic syringes

    It’s an offence to posses them in the US? That’s insane. In the UK (and much of Euope I think) syringe exchanges make syringes freely available, and these programs have been credited with greatly reducing the spread of HIV, Hepatitis and other conditions amongst IV drug abusers.

  • fnyser

    THERE MAY BE SOME ERRORS HERE
    Oregon actually has a flat income tax rate of 9.8% with a $3000 personal exemption (1500 per for married couples). Measures raised that to $5000 and made federal taxes deductible up to $5000 from $3000 – but that has been wiped out by the legislature.

    Multnomah county now has an income tax of 1.25% of of gross earnings beyond $2500 – voters passed this but believed it when it was sold as a surcharge i.e. (0.0125)*(taxes owed) not 0.0125*(taxable earnings). Oh well. They were pretty pissed off when they figured out there would be a brand new county income tax form and and a brand new administrative/collection agency that would cost scads of money. Dolts.

    Tax advocates in Oregon spew the fact that Oregon is 42nd among the states in taxation, but this is, of course a lie. We are 7th or 8th in government spending per capita. We are not a very rich state and very low in federal spending so the pecentage of state GDP spent on government ranks even higher. Many of our taxes have been renamed “fees,” “user fees,” “system development charges,” etc… so they are not TECHICALLY TAXES dontcha know.

    The Oregon Health Plan now allows people earning 185% of the federal poverty threshold to enroll (200% for families with children under 18). It keeps expanding but cutting actual services – I guess the great idea is to get everyone in Oregon on it but not provide doctors, kinda like the NHS?

    It was never supposed to take more than 3% of state spending but has grown to over 10% during a period when government spending has more than doubled (around +70% after population growth and inflation).

    while the rest of the country has ca. 6% unemployment, we’re at 8.3% and business is fleeing at an alarming rate. We are just kind of a California light. Time to move to Colorado.

  • Too bad. Oregon is such a beautiful state that it’s a pity to see how statism can screw it up so badly.

    Even worse is that the liberals are concentrated in a few centers — mainly around the universities [duh] and in the cities. Go out east of the coastal belt and metro areas, and you’ll find only conservatives.

    California Lite indeed.

  • toolkien

    Providing for a transfer through the force of the State (i.e. to provide health care) only increases the population of those afflicted…

    You mean by keeping people alive?

    Yes. A person becomes infected by exposure to another person with the illness. Confiscating my property to maintain another person’s life creates a situation where I pay for the privilege of at least maintaining a population of infected people who are dependent upon me for extending their lives, and may or may not infect others but the risk is still present. If they die, further risk of exposure ends.

    As far as low levels of HIV in Europe there may be other cultural forces at work other than the availability of free health care as to why it is low as compared to the US. There is certain evidence that the resources allocated to AIDS and HIV (disproportionate to all illnesses by the way) has led to an increase in the promiscuity in the Gay community. All the education programs, insurance regulation, and research dollars has simply led to a riskier level of behavior of individuals. If they are using private resources (savings, private insurance contracts) to mitigate the consequences of their behavior, fine, but to further bleed me of my property beyond that already allocated in years past based on their knowingly risky behavior is wrong. So how this reality jibes with that of Europe I don’t know, but must be some differing cultural paradigm. In any event, behavior (at least here in the US) are tied to the understanding that the consequences of one’s behavior will be mitigated by the State has individuals making questionable decisions, ones that they may not have made if they were fully responsible to do so themselves.

    You can argue that whether or not such treatment should be funded by the state or by some charity or NGO, but I think you’re basically mistaken in thinking that the best way to minimise the spread and impact of some epidemic is to simply leave those too poor to afford treatment to die.

    I think your ultimate concern is the cold heartedness on my part, as it always is for those who would like to transfer one persons property to another.

    The containment of an epidemic in the sense of a quick spreading disease (one that is most likely to involve me directly, and is most likely to circumvent an individual’s capacity to prevent contraction by using their intellect and their value judgement) will certainly be dealt with outside of the transfer system and will use the executive force of the government to remove the threat. Slow activating illnesses (such as AIDS) is not likely to effect me as I do not engage in any of the behaviors associated with its contraction, and the likelihood I’d contract it one of the other ways is as likely as some other illnesses that aren’t fully controllable either. So ultimately am mostly a disinterested party except when sums of money are removed from my wallet. A person living or dying is of no interest to me unless I have made a value judgement to the contrary, and oblige myself to assist someone accordingly. But, again, through transfer by force, I do become interested because someone is now extending their lives with my resources and may infect a third party whereas they would not have occured otherwise. Of course the third party bears some responsibility for their actions as well. Suffice it to say that the population that is most dependent is likely to be the population most cavalier in their behaviors, and, everything else being equal, and it is my resources that are required to keep the person alive, and I have no capacity to make a value judgement about this other person, I would rather they die.

  • fnyser

    Kim du Toit;

    Well, we’ve got shall issue CCW – for now.

  • Alfred E. Neuman

    I think your ultimate concern is the cold heartedness on my part, as it always is for those who would like to transfer one persons property to another.

    Exactly. Toolkien nails it on the head.

  • Steve

    I think your ultimate concern is the cold heartedness on my part, as it always is for those who would like to transfer one persons property to another.

    In libertarian utopia aren’t I allowed to hope that you might transfer some of your property to a scheme such as this? I’m not going to hold a gun to your head. Feel free to refuse. Personally I think that the epdemiological arguments in favour of universal availability of treatment are strong. If I believe that the availability of treatment is likely to lead to fewer infections then the disease is less likely to have an impact on me. I can look after myself, but would hate to see someone I care about affected, and can see that if a disease like Aids were to become more widespread then that would be more likely. Even if I could be sure nobody I knew would be affected then there are economic consequences, look how growth in African nations is being hampered by shockingly high levels of Aids. No man is an island. I also recognise that not everyone is able to avoid becoming infected as not everyone has it in their power to act according to their will, children for instance. If you were to be infected through no fault of your own, and were unable to pay for your own treatment (and why should you have planned for that?) would you not hope others to show some compassion, and to help you?

    I am not arguing in favour of coercion to fund treatment programs. But if availability of treatment slows the spread of a disease, and I think the European experience suggests this may be so, then, for all the reasons above, I consider it wise that treatment be made available. State interference or coercion is not a part of my argument. And while I may consider you cold hearted, that’s none of my business. I don’t, however, think I’m violating your rights by pointing out what the effects of your proposal might be.

  • R. C. Dean

    In libertarian utopia aren’t I allowed to hope that you might transfer some of your property to a scheme such as this?

    Sure. Voluntarily, of course. And the difference between voluntary and coerced is what makes all the difference.

    The major factor in slowing the spread of disease is not treatment, but sanitation and hygiene. That goes double for STDs, by the way, where the concept of “hygiene” encompasses your choice of partners.

  • “To B. Durbin: I had thought that Oregon was part of the Left Coast in which “progressive taxation” was a given. I now give credit to the people who came up with the idea that you pay $50 on an income of $1000. Why do you think that freedom is free?

    Posted by John J. Coupal”

    It was mostly the shock on paying taxes on an amount so small, when a typical grocery run at the time was literally a scrimp and save endeavor. And yes, they do have the progressive tax setup, especially for property taxes; if I paid $50 on $1000, imagine what the upper incomes were paying.

    I’m unsure what you were driving at with the comment “Why do you think freedom is free?” I think I’m missing the context. :)

  • 1Human1Vote

    You ignorant little “conservatives” here posting your ignorant little “conservative” posts are truly ignorant indeed, not to mention uncivilized and pathetic. I love the guy here who asserts that “health care” is not a “natural right” for instance. There’s a guy who’s gonna win the hearts and minds of the world for America through championing human rights! Or the way that “universities” and their supposedly “left-wing” professors are all demonized by you undereducated cretins. Why don’t you “folks” join the human race and get civilized, instead of trying to remain perpetual adolescent boys. Or let’s just say instead, may you go bust in the lame Bush economy! And, don’t get sick now…remember “health care” is “not a natural right”! Have a nice “conservative” day!