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August 8, 2012

Bringing the Dependency Portal into Focus

Justin Katz

The RI Center for Freedom & Prosperity has posted a hub page to explain and trace the development of Rhode Island's health benefits exchange into a full fledged "dependency portal," drawing people into government programs. As much as I strove to explain the concept on that page, two of the five points that one advocacy organization lists under "modernized eligibility procedures" express the disconcerting motivations behind the effort better than I was able:



  • “No wrong door” policies through which, when an application is submitted to one agency, data from the application is forwarded to other agencies to see whether consumers qualify for additional assistance—in effect, using an application for one program as an “on ramp” to other programs ...

  • Default enrollment strategies that provide eligible consumers with assistance unless they affirmatively “opt out.”


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Comments

Self-reliance is a noble thing, but how can we become so when the necessities of life are beyond the reach of most people? Can you concede that, unless we get employer sponsored healthcare, the cost of it is almost prohibitive? In this age of falling wages, income equality, and neofeudalism, how are people supposed to afford healthcare?

When you write about self-reliance, you are letting corporate greed and Wall Street excesses off the hook for the stranglehold they have over our self-determination. We don't live in an agrarian society of farmers and shopkeepers. People depend on wages, and corporations are squeezing the productivity out of their workers and paying little for it. The American worker is competing against slave wages in China. Emerson didn't have this world in mind when he advocated self-reliance, neither did the founding fathers, or the 18thc Enlightenment thinkers like John Locke.

The problem is that we need taxpayer funded universal healthcare, not health exchanges and other halfway measures, otherwise we are at the mercy of the ever increasing healthcare industry. Government's job is to protect its citizens and their property. Couldn't the greed of the faceless corporations and Wall Steet also be seen as a threat to the average American, as real as terrorism?

The Citizens United ruling has put our democracy in peril. If corporation are "people too," how is our democracy to survive? Who but the public sector can offer a counterweight? Remember, the military is the public sector too, do you want us to be self-reliant in the face of terrorism? Should we have citizen militias to deal with it? What about citizen CIA or FBI?

Healthcare is a public issue, a public concern. The nation's physical well-being against disease and ill-health is as much governments domain as its physical protection from a common aggressor. Self-reliance has nothing to do with it.

Posted by: Snow at August 8, 2012 9:39 AM

Your objection relates very closely with something that I've been researching and pondering quite a bit over the past few weeks, and I'll include your comment when I manage to write about my conclusions.

For the time being, though, I'd suggest that you overtly let government "off the hook" in your analysis of who is killing working people. You don't have to agree with me that government is the central and most culpable villain in the scenario... but not to mention it at all?

Doing so brings into doubt the entire project of fully government-run, taxpayer-funded, healthcare.

Economically, the answer to the hegemony of big interests (corporations, Wall Street, the government bureaucracies, and all the other Bigs) is more individual freedom, not less. The same is true of healthcare.

Posted by: Justin Katz at August 8, 2012 9:50 AM

Excellent commentary, Snow.

Posted by: michael at August 8, 2012 12:06 PM

I actually think using the exchange as a portal to reduced paperwork and unified safety-net services is a GREAT idea.

I don't mind having a strong safety net, but it boggles the mind how complex and labor-intensive we make navigating it. Consider that a lot of the people who are dependent are really running at such a low capacity that they can't fill out the forms or understand what services apply to them.

Hey, if this moves us closer to 'you want stuff? Sign up here, enter the info, and we'll tell you what applies to you' instead of sending people to five discrete government offices, I'm all for it.

I just worry that this will be executed incorrectly, the five discrete offices will still be fully-staffed AND there will be a sixth to run the exchange.

Posted by: mangeek at August 9, 2012 3:06 PM

We need to simplify and streamline business requirements in this state, Mangeek, not access to social programs.

Posted by: Monique at August 9, 2012 6:56 PM