In the program Sick around America, the stories of gratitude and appreciation of the healthcare system followed by the disheartened and horrific examples of when the current system fails individuals is a true testament to the total dysfunctional of the United States’ healthcare system. Now with the implementation of the ACA, many of the discriminations that were occurring previously will be no longer. Underwriting and individuals being denied coverage due to “pre-existing conditions” is eliminated. I experienced this after I graduated from college and was dropped from my father’s employee insurance plan. I attempted to get insurance through the same company, but was denied because they saw in my medical file that I had an ongoing condition. I originally went to see my doctor for a minor issue and was given some medication to take to. The doctor did not require me to come and do a follow up and I was told to only come back if the symptoms did not go away. By me not doing a follow up appointment (as I was instructed), it left an “untreated” condition in my medical file. Similar to this and the individual in the video who could not obtain health insurance due to his heart condition, the implementation of the ACA would prevent this from occurring.

The ACA emphasis on preventative care will be beneficial for the program in the long run. Preventative medicines such as contraceptives or screenings to help detect high blood pressure or diabetes will help individuals maintain a healthier lifestyle. Overtime, insurance companies will see a decline in the more expensive procedures that are associated with advance stages of conditions that could have been treated at a lower cost if detected earlier on.

I was reading an article this week on The New York Post that discussed some of the implications that the ACA was having on many cancer patients in the country. Thousands of cancer patients are losing their coverage due to insurance companies having to cut down the number of doctors in their networks. Many of the quality cancer doctors, hospitals and centers are no longer being covered in insurance plans, leaving numerous cancer patients having to either foot the bill for themselves, or settle for lower levels of care at higher costs. So it seems, through the many stories that are being shown in the media, that the ACA is having negative consequences for many Americans.  Working with senior citizens, I am currently dealing with many of my clients seeing a dramatic change in what their Medicaid will cover and costs for co-payments and medicines increasing. Many of them argue that it is because Obamacare is “messing up everything for them”. However, many of the changes that are occurring has more to do with Georgia opting out of the Medicaid Expansion package under the ACA. The AJC highlighted the Georgia legislation efforts in passing HB 990 and HB 943 that would essentially kill any notion of Medicaid expansion for Georgia, which is throwing away thousands of dollars that current recipients of Medicaid as well as many uninsured Georgian could benefit from.

In sick around the world, Switzerland’s view of healthcare is one of the reasons why their reformed system works relatively well. Viewing healthcare as a basic human right, rather than a privilege for some, I believe is what sets Switzerland’s healthcare system apart from other countries. If the United States viewed access to affordable and quality healthcare as it does for education, than much more would be getting done in the policy stream. How can effective reform occur when the country is divided on who is worthy to have access to it? My belief is that the Affordable Health Care Act will eventually begin to work more effectively for the country, but only if all of the players get on the same board. Business, doctors and hospitals, and even insurance companies said that they wanted “reform”, but it seems that no one is will to sacrifice or at least compromise in order to make reform happen effectively.

The intersection of race, gender and class:   How did reading DeParle change your perception of the ability of social policy to combat poverty?  In thinking about Stone’s definition of the goal of liberty and the problem of equality, describe how DeParle’s book discusses the liberty-welfare trade off.  Do you think DeParle believe’s there is a trade off?

The intersection of race, gender and class:   How did reading DeParle change your perception of the ability of social policy to combat poverty?

Before reading American Dream by DeParle, my thoughts of the welfare system was conflicting. At one end, I believe helping those in need is a good thing and the government should intervene with programs and initiatives to execute those efforts. However, I also feel that there comes a point where you may be hindering the progress of an individual. I’m not sure if setting time restrictions on the aid to these individuals or restrictions such as requirements to work is the answer, but the welfare program as it was depicted through the lives of the three characters did not do much to fight poverty for them. The stories depicted in American Dream helped shed light that there is more to being in poverty than limited income coming into the household. Also, the parallels that were made between the main characters family history of sharecropping and their current efforts in maneuvering within the welfare system causes me to question my view of the welfare system and the motivation behind it.  Though I want to feel that the overall effort of welfare is to help individuals succeed, DeParle shows how the system of sharecropping is so similar to the structure of the welfare system today.  Beliefs surrounding the sharecropping system of the past and how individuals were viewed was that “the Negro is congenitally lazy and must be kept in debt in order to be made to work” (DeParle, p.29). The popular belief today is that welfare recipients are too lazy to go and get a job on their own and to provide for themselves and families.

In thinking about Stone’s definition of the goal of liberty and the problem of equality, describe how DeParle’s book discusses the liberty-welfare trade off.  Do you think DeParle believe’s there is a trade off?

In American Dream, DeParle quotes anthropologist Carol Stack who studied improvised single mothers by saying “survival demands the sacrifice of upward mobility” (DeParle, p.79). The character Angie attempted to become independent and get a job (though she denied being dependent on the welfare system), however she found that it was not worth it; She would be getting more if she continued to receive the welfare check, as opposed to working full time and not being able to afford her rent and bills. Similarly, Jewell attempted to become a part of the JOBS program and receive education, however the dysfunction of the overall program discouraged her.  I think in both of these two cases, survival for them did demand that they sacrifice the opportunity to move up into better circumstances. DeParle would blame this on the overall bureaucracy and faulty set-up of the system which continued to fail them.

DeParle believes that government assistance such as welfare programs are needed in order to help all individuals achieve equality. Similar to Stone’s discussion on positive liberty, making basic resources available such as education, income, health and security is a part of having liberty. DeParle feels that there is more to inequality and poverty than just being poor. Issues such as single-parent households (lack of fathers in the home), sex and drug abuse cannot be solved by issuing out a check.  If these issues are not addressed while providing the assistance (which is legitimately needed), then the cycle will continue and the culture of poverty will continue as well.

Thinking about the three characters in the book, I don’t recall them expressing any of their dreams or aspirations. Positive liberty involves being able to conceive goals and to realize you potential, however how can you have goals when your basic needs are not being met? I believe DeParle was attempting to highlight this point.  For these three women, the “American Dream” was not part of their reality nor did they have any familiarity with it from other family members. Their liberty was already lessened at a young age due to family structure and history, so to say that these three individuals were sacrificing their liberties to become dependent on welfare is somewhat problematic. What are the reasons why these individuals are seeking welfare and assistance? What obstacles are in their background and environment? I would say that DeParle’s overall feelings of liberty and welfare is that if the welfare is not helping to provide those essential liberties, then there is a trade-off. The system (which includes the focus, structure, rules, regulations and types of programs offered) is being ineffective in its role to help individuals gain opportunities and realize their potential.