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“Pay for Itself”? UHIP Is Designed to Increase Costs.

Ted Nesi and Susan Campbell report on the costly future of the Unified Health Infrastructure Project (UHIP):

Two years after insisting Rhode Island’s new $445-million benefits system would pay for itself by next June, state officials now admit they have no idea if the problem-plagued computer system will ever save enough to cover its cost.

Folks still aren’t getting the bigger picture when it comes to costs.  UHIP is designed to maximize the use of government services.  Not only will it never cover its “costs,” but it will continue to increase public expenditures.

At some point in the future, some gubernatorial administration may announce that the system has stopped enough proverbial “waste, fraud, and abuse” to cover the expense of implementing the program, but we can be sure such a calculation will brush aside actual increases in spending on the programs.

Rather than simply update our operating systems for welfare programs, Rhode Island government officials chose to make the state an experiment in interweaving all programs for “one stop shopping.”  We’re already paying the price, and it’s a bill that will continue to grow.

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The Coincidence of Medicaid Expansion with Opioid Abuse

The Wall Street Journal recently put a spotlight on a matter that deserves more consideration:

A recent study by Express Scripts Holding found that about a quarter of Medicaid patients were prescribed an opioid in 2015. Wisconsin Sen. Ron Johnson presents intriguing evidence that the Medicaid expansion under ObamaCare may be contributing to the rise in opioid abuse. According to a federal Health and Human Services analysis requested by the Senator, overdose deaths per million residents rose twice as fast in the 29 Medicaid expansion states—those that increased eligibility to 138% from 100% of the poverty line—than in the 21 non-expansion states between 2013 and 2015.

There were also marked disparities between neighboring states based on whether they opted into ObamaCare’s Medicaid expansion. Deaths increased twice as much in New Hampshire (108%) and Maryland (44%)—expansion states—than in Maine (55%) and Virginia (22%). Drug fatalities shot up by 41% in Ohio while climbing 3% in non-expansion Wisconsin.

A quick look around the Internet didn’t produce Senator Johnson’s evidence, so I’m not able to say how Rhode Island fits into the picture.  Still, data from the Family Prosperity Index (FPI) shows that Rhode Island’s illicit drug use (other than marijuana) as a percentage of population matches that of New Hampshire, with Maine well below.  Recall that Rhode Island’s government jumped right into the Medicaid expansion with scarcely any discussion.

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When Government Pays Us to Be Parents

Zach Maher, in a Wall Street Journal op-ed, explains how the government-paid-parental-leave-in-Sweden-is-great scales fell from his eyes:

When the girl’s parents refused to subject her to this unnecessary procedure, the hidden machinery of the Swedish welfare state sprang into motion. My brother-in-law and his wife were required to attend multiple interviews with social workers and to submit friends and neighbors in their small town for questioning. Social workers even inspected their home. Suddenly, decisions as benign as what milk to buy seemed potential evidence of parental deficiency. My in-laws feared their two children might be taken from them.

In Sweden, the state reserves for itself ultimate responsibility for children’s well-being. As a parent my job is to give my kids the trygghet necessary to become productive, tax-paying members of Swedish society. This is why I receive financial support and medical benefits. The state is paying me to be a parent. I am, in effect, an employee—and if I do a poor job, my responsibility as a parent might be taken away from me.

 

When we give government responsibility for things — even good things, like the well-being of children — we also give it authority over those who provide those things, like parents.  Suddenly, government isn’t just filling in gaps, but seeking out gaps by putting parents under the microscope.

The United States is not immune to such thinking, obviously.  Some 20 years ago, on Matt Allen’s Mental Floss radio show with the more-liberal Jennifer Brien, the latter argued that schools have to teach sex education (liberally tinted, naturally) because parents simply aren’t doing the job adequately.  I called in to ask what gives her or the government the right to make that determination, but she wouldn’t be shaken from the assertion of need.  (And then I was cut off.)

Suggesting that he and his wife “insist… on having their own ideas about raising children,” Maher asks, “Does this mean we can’t accept parental support from the state?”  My guess is that he doesn’t really have a choice — that the government doesn’t actually see it as an exchange or contract.

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Universal Basic Income and Our Aspirations

Once upon a time, folks actually hoped that a universal basic education plus a prosperity-driven increase in free time would draw people toward intellectual pursuits and self improvement.  I’m sure there’s data on such things, but for my purposes, here, let’s just speculate that most folks’ general sense would be that it hasn’t quite worked that way.

In a recent Wall Street Journal op-ed, Dan Nidess asks why we would expect a universal basic income to have a different effect.  Indeed, he suggests that the policy “addresses the material needs of citizens while undermining their aspirations”:

At the heart of a functioning democratic society is a social contract built on the independence and equality of individuals. Casually accepting the mass unemployment of a large part of the country and viewing those people as burdens would undermine this social contract, as millions of Americans become dependent on the government and the taxpaying elite. It would also create a structural division of society that would destroy any pretense of equality.

UBI supporters would counter that their system would free people to pursue self-improvement and to take risks. America’s experience over the past couple of decades suggests that the opposite is more likely. Labor Department data show that at the end of June the U.S. had 6.2 million vacant jobs. Millions of skilled manufacturing and cybersecurity jobs will go unfilled in the coming years.

Notably, Nidess uses the term “productive class,” which I’ve been using for years in attempting to describe what populations have been leaving Rhode Island.  Basically, the Ocean State has been attracting the poor and (largely) holding on to the wealthy while driving out those who are looking for some way to transform their smarts, brawn, and effort into wealth.

Put in those terms, it’s clear that Nidess fears the UBI would bring about a national version of what I’ve called the “government plantation” or “company state,” whereby the government draws in dependents in order to provide services billed to somebody else.  Whatever arguments and motivations may underly such policies, they certainly don’t have the feel of being healthy for our society.

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Indirect Moral Corruption Driving Catholics Out of the North

Part of the cynical wisdom, up here in the Northeast, is that the Catholic Church has to support pro-immigration policy because it needs immigrants to keep its parishes going.  To the extent that this demographic pressure has any effect on what the Church actually does, a Catholic News Agency article about the Church’s growth in the South should suggest other policy positions that the Northern Church could promote:

The growth in part reflects the number of Catholics moving south from northern dioceses. Though this results in the closures of churches and schools in former Catholic strongholds, it is driving new expansion in the U.S. South.

I’ve half-joked that I’ve remained in Rhode Island out of missionary motivation, and only the jest part is political.  A region that is driving families apart and separating people from their homes presents real moral challenges.  In that regard, the Catholic Church — all churches — should acknowledge what the government plantation policies of Rhode Island are doing and impress upon believers their moral obligation to stay and to change things.

Working against poverty and injustice can’t be limited to standing up for those who are clearly oppressed, or else good works risk falling into vanity.  Vanishingly few people in contemporary America question the righteousness of helping those who immediately need help, but if we’re serious about helping those whom we can’t so easily see, whether because their problems are not so obvious or because their problems haven’t yet manifested, we have to take a broader view.

That means a society that draws people toward fulfilling lives of familial stability and self-motivated work.  And while the constituencies who see a Democrat vote as part of their cultural inheritance won’t like it, the policies on which we’re currently focused are clearly not serving that end.  The moral corruption of the government plantation is that ignoring the structural justice that brings stability and prosperity, but that requires a resilient and sometimes unpopular maturity, produces ample opportunities to display visible righteousness on behalf of those whom our ignorance has harmed.

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Going from Crime to Illness Means Big Growth for the Government Plantation

Marc Munroe Dion picks up on what I’ve been calling “the government plantation” in his latest “Livin’ and Dion” column about the budget consequence of recasting drug use from a crime to an illness.  Noting that a person who comes across a homeless beggar could feed him or her with a $10 sandwich, but:

If you ran a non-profit agency, you’d need an outreach worker to find the homeless guy, an intake worker to make sure the homeless guy was really hungry, a case manager to find out what kind of sandwich he likes, a nutritional expert to make to make sure he got a healthy sandwich, a coordinator to introduce the outreach worker to the case manager, a facilitator to go into the store and buy the sandwich, and a five-member board of directors to approve the $10 sandwich, which would be referred to in all documents as a “nutritional expenditure for indigent substance abuse-affected client.”

At all times, the homeless guy eating the sandwich would be referred to as a “client.” Total cost of the sandwich? $65,000, not including benefits, and pensions.

Rhode Island’s state government is deliberately working to transform our economy into one built on this very model.  Declare some benefit to be a right, find a way to collect money from the rest of the economy and other states (via the federal government), and fill out a massive bureaucracy with government-satellite non-profit agencies with plenty of well-paying jobs whose holders will tend to support the system politically and to fund the necessary political action through their labor union dues.

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Budget Season: Opportunity for Articulating a Vision for Rhode Island

Every year, this time of year, the budget for the State of Rhode Island comes out and, accompanied with surrounding legislation (much of it premised, one can infer, on quid pro quo for budget votes) shows the vision of the insiders who run our state.  Every year, life in Rhode Island becomes more restrictive, business becomes harder, government budgets go up.

Earlier in this legislative season, the RI Center for Freedom & Prosperity put out a pair of “Hey, Dude!” radio ads illustrating the point from the perspective of somebody who wants more freebies and somebody who sees the opportunities inherent in a society out from under government’s thumb.

For a little fun, here’s a pair that I’ve put together.

Open post for audio.

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Government That Primarily Seeks To Grow Itself

We know that that the high levels of taxation and over-regulation imposed for the sake of the state budget are the primary culprit in causing the Ocean State’s stagnant performance. Put another way, overspending by a government that primarily seeks to perpetuate and grow itself, actually works against the best-interests of the very people it is supposed to be serving. Instead of seeking to grow prosperity, government seeks to grow itself.

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A Market Rhode Island Government Has Left as a Last Resort

I’ve tried to get some follow-up information from Felicia Delgado, of the Parent Support Network of Rhode Island, regarding her testimony before the Rhode Island House Oversight Committee about the harm that a non-functional Unified Health Infrastructure Project (UHIP), otherwise known as RI Bridges, has done to Rhode Islanders’ lives:

Others have lost their jobs because of these lost benefits and UHIP-delayed payments from the state to long-term health-care facilities.

At least 20 people — she emphasized they didn’t prostitute previously and don’t have substance-abuse problems — have turned to prostitution to pay for rent, childcare and food and fend off homelessness. Delgado declined to identify the people.

Mostly, I’m interested to know if she’s seen any progress, but I also wanted to ask if she had information about how this happens as a functional matter.  Did the people just know what street corners to hang out on?  Did they use Craig’s List?  Did they slip into an existing network, involving pimps?  Or do they start with people whom they already know?

What’s striking is that prostitution would be a fall-back occupation for people who hadn’t done it before.  Granted, it probably pays better than most other transactions for which people will pay unskilled entrants, but it comes with a high degree of risk and an appropriate social squeamishness.

UHIP is a problem and a blight all on its own, but a thriving economy without such a pervasive regime of regulations and licensing requirements would not only keep people from needing the services in the first place, but also give them other options when government messes up.  Instead, Rhode Islanders suffer through this process of government micromanagement of our economy’s creating a lack of opportunity, which government attempts to fix with welfare programs.  And when that doesn’t work… prostitution.

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Journalists and RI Politicians to Blame for “Mounting Anxiety” over Medicaid Reform

Earlier today, I noted how willing Rhode Island politicians are to sacrifice the well-being of Rhode Islanders and then attempt to scare us into political activism against their opposition.  In wishing the news media would play a role in bringing them back toward more-reasonable rhetoric, I probably underplayed the degree to which journalists are complicit.  Consider Lynn Arditi’s Providence Journal article whipping up the panic about federal health care reform:

Now, Porreca and others like him could lose their coverage under a Republican plan to roll back that Medicaid expansion and limit future federal financing for the safety-net program. Able-bodied adults also could be required to work in order to qualify for Medicaid.

The first sentence is false, and the second is misleading.  The paragraph is partisan fear-mongering propaganda.  As I’ve already explained, the House Republicans’ AHCA legislation includes no cut to Medicaid.  Anybody claiming otherwise is wrong, and anybody claiming otherwise whose job it is to objectively inform people is either lying or committing professional malfeasance through his or her negligence.  Adding in the work requirement in that context makes frightening something that is arguably a reasonable policy and leaves out the reality that Rhode Island’s state government would have to go along.

If “anxiety” is “mounting,” as the Providence Journal headline suggests, the news media and Rhode Island politicians are to blame.  If only people would begin holding them accountable for the anxiety they cause out of their own selfish interests.

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The Direct Line to the Voting Booth

In case readers didn’t have a chance to click through the link in my post, yesterday, related to voter fraud, I’d like to highlight another key point from the Public Interest Legal Foundation (PILF) report that was the foundation for J. Christian Adams’s essay.

It’s important to break the data down so you understand what we’re talking about, here.  PILF found that, in Virginia, more than 5,500 people who had been registered to vote were removed for citizenship reasons.  Of those 5,500, 1,852 had actually voted, casting an average of four ballots each.  Many of them, according to Adams, had been registered to vote even though they checked the box saying they were non-citizens.

I emphasize this point because the House chamber of the Rhode Island General Assembly has approved legislation that would greatly expand automatic registration of people to vote:

Legislation to automatically put anyone who applies for a Rhode Island driver’s license on the state’s voter rolls, unless they opt out, cleared the state House of Representatives on Wednesday, despite GOP efforts to block the same practice at other state agencies with troubled computer histories. …

But along the way, House Minority Leader Patricia Morgan, R-West Warwick, sought to strip the bill of language allowing any state agencies — other than the Division of Motor Vehicles — to automatically place applicants for unemployment, public assistance and other state benefits on the voter rolls. Her move failed on a 62-to-10 party-line vote.

Welcome to the world of “one-stop shopping.”  When the Rhode Island insiders are done, anybody who checks in with the state government for any reason will be automatically signed up for any welfare benefits for which they might be eligible and registered to vote.  “Here’s your free stuff and a voter registration card so you can be sure to keep electing the people giving it to you.”

And in all this, we’re supposed to believe that a state government that can’t launch a computer system or accurately determine who should get Medicaid or SNAP benefits, while resisting efforts to use basic means of control, like eVerify for immigration, will keep the voter rolls clean?

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Free Tuition as a Welfare Program

Note the substantive difference between this plan and what Rhode Island’s Democrat Governor Gina Raimondo is proposing:

Gov. Charlie Baker and Mayor Martin J. Walsh have announced a tuition-free college program.

The Republican governor and the Democratic mayor on Monday launched the new college affordability program for Boston high school graduates, enabling low-income students to complete four-year degrees without paying tuition or mandatory fees.

Students first go to public community college, and then if they finish that degree in a timely manner, they can continue on to finish a four-year degree at a public four-year institution.  At least this program is more or less honest about being a public welfare program, and no doubt some students who otherwise wouldn’t have the opportunities will take advantage of the program to good effect.

That said, Governor Baker’s lamentation that the price of college sometimes “serves as a barrier” is poorly considered.  A price should server as a barrier, to ensure that potential students have consciously decided whether it’s worth the effort of surmounting it.

Our problem is that we’ve been hiding the size of the barrier while overstating the value of getting to the other side.  Taxpayer subsidies add bricks to the wall, and easy loans hide the real cost to students.  This has flooded the employment market with people who have degrees, devaluing them to the point of being little more than a cheap method for employers to screen applicants for jobs that don’t require anything like a bachelor’s degree.

We should address that problem, first, before providing related welfare programs.

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The Budget: RI Government Seeks To Grow Itself, Not the Economy

Should the hopes, dreams, and aspirations of Rhode Island families be limited by an arbitrary, politically-driven budget number at the bottom of a spreadsheet? Unfortunately, our state is now suffering the consequences of such an approach, fueled by the progressive-left’s big-spending agenda.

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The Corporate Welfare Strategy Has Failed

The massive budget shortfall is proof that the state government’s corporate welfare strategy has failed. Rhode Island’s current corporate tax-credit economic development strategy is highly inefficient as it creates relatively few jobs at an extremely high cost per job to taxpayers. This targeted ‘advanced industry’ approach does little if anything to improve the overall business climate, which is necessary if organic entrepreneurial growth is to occur on its own. A 3.0% sales tax would disproportionately help low-income families.

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We Had the Logic, Now We Have an Example, Too

Rhode Islanders, especially, should heed the admonition of The American Interest that Puerto Rico may be a final warning lesson to states within the United States:

This [bankruptcy] could have been avoided by sensible and timely cuts, by turning a deaf ear to public sector union demands for wages and salaries, by a series of small but definite steps away from the blue model, welfare state governance. But the press, certainly including the NYT which is now reporting the disaster, would have attacked any politicians taking these steps as “harsh”, or “cruel to the poor”.

Now Puerto Rico is in a deeper hole, with much more suffering than any of the moderate cuts would have imposed.

Just look at the false rhetoric permeating the debate over some overly mild reforms to the disastrous ObamaCare entitlement system for a timely illustration.  Any restraint on government programs is declared to be a “draconian cut” that will hurt or kill people, marking politicians who support reforms as evil.  This will not end well, but just like junkies, supporters of big government just want that one more fix, and let tomorrow take care of itself, somehow.

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