Tuesday, September 18, 2012

Romney and Government Handouts

     Mitt Romney is all over the news today for comments not intended for the news media but overheard and recorded surreptitiously, and published in Mother Jones.  This is what happens when a big election is just seven weeks away.
     Romney said that 47% of Americans were being carried by the government--not paying taxes, not creating jobs, and therefore likely to vote for Obama, because they would want to perpetuate the government entitlements they receive.  Romney despaired of being able to win these voters to his side because, he said, they have no desire to take charge of their own lives.  He remarked that they don't contribute to the American economy. 
     Democrats are using these comments to accuse Romney of being rich, privileged, and failing to understand the lives of "ordinary Americans."  Their retaliation is that this group of Americans does, in fact, pay sales tax.
     I have been a longstanding Democrat, a bleeding heart, a tree-hugger, an advocate for the disenfranchised, a believer in government programs to help people, when they are in a bad way, get back on their feet.
     There are abusers of every charitable enterprise.  America is a charitable country, but we are not good at distributing charity fairly.  When someone is awarded disability, it's supposed to be for a permanent condition, and it's rare to see the label reversed.  In twenty years of work as a physician I have seen only two individuals come off disability--and they were not identified or encouraged in this by the government, but insisted on getting jobs and removing themselves from the disability rolls.  They did this because they were languishing under disability and wanted their lives to expand with greater opportunity.
     Even the Democrats agree that 46% of voting-age Americans are not paying income taxes. amd instead are receiving government handouts.  So Romney's number wasn't an exaggeration. 
     Who should be getting disability, I ask myself every day?  Not a day goes by in my office when I don't wonder, "Why is this patient on disability?"  I have started asking patients, directly, why they get disability, and I hear some pretty strange answers.  Here are two from the past week.
     "I was molested when I was nine," explained one woman in her early twenties.
     "OK," I said.  "But one-third of American women were molested as children.  Did the experience cause you lifetime disability?"
     "No," she replied.  "I feel fine."
     "Why are you on disability?"
     "I guess they thought the experience upset my mental state," she said.
     "Are you unable to work?"
     "I can work.  But I can't find a job. Besides, then they'd take away my payments."
     "Can you go to school?"
     "Yeah, I'm thinking about it."
     "Why don't you get off disability, and get some training for a career?  You seem pretty smart."
     The patient laughed at the part about getting off disability. Why would she give up free money?  But she said she was looking into an online course at Santa Fe, so she could stay home with her daughter.
     "I'm thinking about having some more children," she added. " Could you refer me to a fertility specialist?"   She had one child at home, but her new boyfriend wanted her to have more children for him.  Her Medicare and Medicaid would cover the cost of bearing children.
     Another patient, age 42, has been on disability for twenty years. He's lithe and muscular, moves about with ease, and says he makes money "on the side" by doing small construction jobs.  By "on the side" I understood him to mean "under the table."  He told me he was put on disability for a back problem.
     "Your back looks fine to me," I commented, after examining him.
     "Yeah, it doesn't give me any trouble."
     "Can you lift heavy things?"
     "Oh, sure," he said.  His powerful shoulder, arm, leg and abdominal muscles were proof of this.
     "Why do you keep getting disability?" 
     "They said my back was twisted or something," he said, with a baffled look.
     "But your spine is straight," I said.
     "Well, maybe it wasn't back then," he explained.  He had had a motorcycle accident, after which he went to the Social Security office to apply for disability.  His mother and brother were "getting checks" and he thought he'd be eligible too.  He was right.   He also gets Medicaid, food stamps, and subsidized housing.
He uses cocaine ("not regular, just every few days"), smokes two packs a day, and admitted to drinking twenty-four beers a day.  For food, he eats a baloney sandwich or two.  He likes to hang out with his friends down the road, and he watches a lot of TV. 
     My work will be to get this man to think about himself and his life differently, and to stop using substances that will cost the healthcare system mightily in the next decade or two.  But Medicaid doesn't pay family doctors for substance abuse counseling, and it forbids the patient to have more than two medical visits a month.  Whereas that might be plenty of medical care for an average person, most such patients don't have average health problems.  This man's labs were extremely abnormal, his liver was enlarged, his teeth were missing or decayed, and his EKG showed signs of stress. 
     I haven't been a big fan of Mitt Romney.  But I'm not sure what was so bad about his comments.  In a country with so much to offer, where people have access to clean air, food, water, housing and education, why are 46% of adults on government assistance?  It's a good question, and I think it's one Republicans want to ask, without being accused of insensitivity.  We need to rethink how our charity and our healthcare dollars are being distributed. 


  1. It is problematic that a vast segment of the population can support increased spending without sharing the burden or consequences of that spending. For this reason, I support a flat tax. With a flat tax, even the person making middle wage has a stake in the political process and a motivation to support fiscal responsibility. It is an unfortunate truth, rich individuals and corporations create most of the jobs and are the key to an economic recovery. With regards to Romney's words, in politics the truth can be held against you.

  2. Your comments are astute. Perhaps it is unfortunate that Republicans "have it right" when it comes to stimulating the economy, adding jobs to the workforce, and rewarding employers who are skillful enough to keep businesses profitable, thereby keeping people employed. We just can't look at issues as though they're black and white, good or evil, Democrat or Republican. That's why I like Obama's plea for partnership, not partisanship--I think he means it. After all, he made a lot of concessions to get the healthcare plan approved, despite its many shortcomings. I'd like to see a requalification requirement for people on disability. If I were asked, about many of my "disabled" patients--"Are they still disabled?" I would have to answer, honestly, "No." There is no such thing as "totally and permanently disabled," but that's the label people get when they qualify for disability. It overlooks the essential resilience of the human organism, that it adapts, and corrects, and heals itself.

  3. Although Mitt Romney may have the percentage of Americans receiving financial assistance right; his comments did not reflect the truth about the poor. Romney characterized the poor as have-nots who choose to be that way. Where does Freud’s hierarchy of needs and Erickson’s stages of psychological development come into play?

    Consider those people who have been given little in life. Just tending to the basics is hard work for the poor. Coping with their circumstance consumes most of their time and all their resources. Let’s not kid ourselves; money makes life a whole lot easier on many fronts.

    Why are we paying federal taxes if not to support programs that benefit our society? I agree that we should be talking about how we can improve the programs that exist instead of besmirching those dependent upon them for survival.

    Did we solve the job deficit problem and are all jobs paying enough to make ends meet?

    When blessed with abundance Christians should be thankful and generous in sharing that bounty. If we were all given the same advantages in life, would God care about what we did with the talents given to us?

    The Parable of the talents (Matthew 25:14-30) brings forth the notion that privilege brings responsibility and that responsibility entails accountability. The parable begins, ‘for it will be like a man going on a journey, who called his servants and entrusted to them his property. To one he gave five talents, to another two, to another one, to each according to his ability. Then he went away’ (Mattthew 25: 14-15). Through this parable God lets us know that he does not give the same blessings to everyone. We also learn that God expects us to multiply whatever talent is given to us. We need to acknowledge that there are those among us who are given small talent. We can deduce that God expects much less of those who have fewer opportunities, less guidance in their upbringing, and smaller gifts.

    Most are familiar with the Christian theme concerning preparations for the day of reckoning. We are warned to be a sheep and not a goat. ‘But someone who does not know, and then does something wrong will be punished only lightly. When someone has been given much, much will be required in return; and when someone has been entrusted with much, even more will be required’ (Luke 12:48).

    I think it safe to say that the poor hate being poor more than taxpayers hate giving them a hand up.

    1. Very well said Rinker.
      I hope a million people read and heed your thoughtful comment.

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