So part of this year’s election rhetoric is around “oh noes not my Medicare” which always made me a little crazy (not because I think AARP should stuff it, though I have some choice words for certain Florida voters who decided that since their kids were long out of school, they didn’t need to approve school levys ever). How did Medicaid get shoved down to food stamps and other welfare fraud bogeymen while Medicare stands next to mom and apple pie?
69: The debate about who “deserves” public assistance dates back at least 500 years to the beginnings of modern welfare in Europe. Socities have always tried to separte those who suffer through no fault of their own from those who have apparently brought their difficulties upon themselves due to substance abuse, laziness, unwillingness to work, promiscuity, or any other trait deemed undesirable at a given historical moment. The English 1531 Act for the Punishment of Sturdy Beggars, for instance, was among a number of early laws that denied charity to the able bodied. As a matter of policy, American society has generally tried to confine private charity and governmental assistance to the ‘deserving’ while insisting that the ‘undeserving poor’ improve their character as a condition for receiving relief.
73: Social Security has always been a transfer of income from working people to certain people who were not working, not a true insurance program… The program was significantly strengthened with markedly increased benefits during the 1960s. Nothing indicates its enormous success more clearly than the 1997 poverty rate for the elderly — just over 10%. That same year, the poverty rate for children, who have no such program, was twice as high. It is estimate that in the absence of Social Security payments, 50% of today’s elderly would be poor.

74: The New Deal cemented into place the ultimately untenable distinction between “social insurance” and “public assistance” that has, in the end, prevented the US from developing a more comprehensive program of economic security similar to those in Canada and the countries of Western Europe. In the US, we consider programs like Social Security, Medicare, disability pensions, and disaster relief to be social insurance. All of us pay in and, in times of trouble, any one of us can take out. Usually, there is no stigma attached to taking help from a social insurance program; we think that that’s what it’s there for and that we should take it if we need it. Yet we consider payment to families with young children, food stamps, general relief, an Medicaid to be “public assistance,” akin the charity, undeserved handouts given by a generous “us” to a handicapped or malingering “them.”
75: As a consequence, federally administered “social insurance” programs have substantially better benefits than “public assistance.” Compare the average $394 TANF payment for a family of three to the usual $515 payment for a single disabled person covered by the federal SSI program. As another example, in the 20 years before the Welfare Reform Act of 1996, AFDC benefits (adjusted for inflation) declined by 40% while Social Security benefits remained stable.
