tRump Country is Medicaid Country

[pstokely]

http://www.stltoday.com/business/local/republican-medicaid-cuts-hit-rural-america-hardest-report-finds/article_21cd232b-1988-5900-91b0-1ecc001040e6.html

"According to the center’s new report, Medicaid covered 45 percent of children and 16 percent of adults in small towns and rural areas in 2015. Those figures are lower in metropolitan areas — 38 percent of children and 15 percent of adults.

Rural areas have larger Medicaid populations because more people with disabilities live there, household incomes tend to be lower, unemployment rates higher and jobs with employer-paid insurance less common, the Georgetown report said.

In Missouri, which had nearly 484,000 children on Medicaid in 2014-2015, many rural counties had a higher percentage of children on Medicaid than urban counties (see table below). And in terms of actual numbers, some regions have more Medicaid beneficiaries: For example, there were more children receiving Medicaid in the Missouri Bootheel (the counties of Bollinger, Butler, Cape Girardeau, Dunklin, Mississippi, New Madrid, Pemiscot, Ripley, Scott, Stoddard and Wayne) than in the city of St. Louis in 2014-2015, according the study.

In states that expanded Medicaid under Obamacare, the rate of uninsured people in small towns and rural areas fell by 11 percentage points between 2008-09 and 2014-15 — from 22 percent to 11 percent, the report said. That was slightly larger than the decrease in metro areas of expansion states.

If the House-passed bill became law, Medicaid would be cut by more than $800 billion over 10 years. Alker said that would lead to higher uninsured rates and reduce Americans’ access to health care."

[PoindexterOglethorpe]

1. Why would more people with disabilities live in rural areas?

Or is there a real possibility that people in rural areas are gaming the system? That those rural people commonly disparage those on welfare, even though so many are themselves on welfare, strikes me as classic hypocrisy.

[phylny]

2. I work with families getting every government program imaginable in my rural area. Vote Republican.

Some are on disability. A few are possibly gaming the system. There are no jobs anyway. One family I saw yesterday has the father and mother on disability, family gets SNAP, WIC, Medicaid for the child, who may or may not be on disability - she's under 3, but does have a medical condition.

Dad was out working, though, chopping wood. He's paid under the table. I asked mom if he will try to find work. Nope. He's on disability. Plus, if he got a job, he'd have to pay child support for the other two or three kids that he has with different women. Can't have that.

BIG Trump sticker on one of the three non-running vehicles in his front yard.

And I'm the liberal snowflake who should "get a job."

[PoindexterOglethorpe]

4. And of course relocating someplace

where there are jobs is unthinkable.

People like that really are gaming the system. Not supporting their children, enrolling in every possible program out there, but never working legally to pay some taxes to help pay for any of that stuff. And of course demonizing anyone not lily-white who gets any kind of assistance. And voting for Trump.

[MiddleClass]

5. Demonizing anyone not lily white, who gets any kind of assistance

Why the discriminator?

Is your problem with only lily white Republicans, what about lily white Democrats?

What about lily white Democrats on disability?

Why alienate lily white liberals?

Do they have compassion?

More important, don't they vote?

Why can't we just demonize Republicans as a whole and not alienate fellow Democrats?

Just asking

[PoindexterOglethorpe]

9. I didn't make myself clear.

I was intending to say that people like those described are the ones demonizing those not lily white. And if lily white Democrats on disability are demonizing those others, then they need to be called out on that.

As for those who voted for Trump and now are suddenly facing a cut-off of their benefits, they get no sympathy from me. No matter why they voted for him. No matter where they live.

[MiddleClass]

14. Thanks, I just don't want to alienate people on this side

While that very attitude you speak of is quite prevalent on that side,

I would avoid alienating those who probably agree with me 100 percent. Just in case.

I hear you on the idiots that voted against their interest, but I'm having a real battle crucifying them for it.

Even though obviously they deserve it

[PoindexterOglethorpe]

15. I'm glad you gave me the chance to clarify my intention.

Hang in there. I see you're relatively new here, so get used to people either not clearly stating what they intend, sometimes saying something deliberately provocative, or the passionate disagreements that spring up.

[MiddleClass]

17. Newbie here

Yes, now more than ever, we got to pull in the same direction. With the Big tent, to mix my metaphors

[haele]

6. Well, it's not a black and white situation.

The people in rural areas tend to have primarily physically strenuous jobs available for the majority of inhabitants.
When they get injured, or worse, develop chronic and debilitating pain in their late 40's to mid 50's that keeps them from putting in a 5/40 week for a living wage job (not just a minimum wage job), there's nothing else they're capable of doing, even should they re-train.
Look, even if you have no injuries, a wait staff job at Waffle House or a line worker at a small manufacturing job are killers on the legs and back, and working full time becomes more difficult the older one gets. It's not like working on your house or your car over the weekend; it's the full time 8 - 10 hours straight on your feet and repetitious motion that wears out the joints and makes it increasingly more difficult to get out of bed or in and out of one's vehicle every day.

And in rural areas, competition for the few management or higher skilled/less physical jobs - even "work at home" or online means that only a handful of those who have the learning skills and/or resources (i.e., reliable computer and internet) will be able to continue working after their bodies wear out. As for relocation - that's a difficult choice. My father chased jobs when I was growing up; it was stressful and a lot of times we ended up worse off for a year or two after relocation than we would have if we stayed.
That year when it was we was living in a slum-lord special, eating one meal a day and my parents wouldn't eat on some days while Mom was still taking care of my under 1 year old at the time brother and Dad was struggling to maintain some form of income working as a substitute teacher and still keep a part-time job as a shift gas station mechanic until he was brought on as a full time teacher was really quite rough. While there are the GM Gypsies and other such workers who follow a plant opening when their plant closes, a lot of families either don't have the resources or the inclination to leave a supporting community to just pick up and go halfway across the country for a job that doesn't pay much more than the one they lost.

In effect, these people are unable to sustain full-time work where they live. So by definition, they are disabled - unable to work. As this is one of the reasons we have SSDI, it makes sense to them that if they paid in for 20/30 years of hard work, they should be able to be supported once they can't work full time for a living income anymore.
Y'know, if we dropped the Social Security age to 55, it would mean a lot less people getting SSDI.

Haele

[phylny]

8. There is a real need for SSDI.

The family I'm talking about are in their 20s. He's out chopping wood

[haele]

12. Maybe it's competence?

Honestly, there are some 5% of "normal" people who appear to be perfectly healthy and competent who cannot be trusted to make a cup of coffee without burning down the house. People who can't hold down a job, and can't seem to "grow out" of mid-teenage. I know of several - I had an uncle like that, as well as it seems half my Son in Law's family is like that - and I'm sure you know of a few.

Normally, they're living above the family garage, or working the family business while living with Mom and Dad (or in a house Mom and Dad bought them). Or in the old days, if they could make it out of the family home, they were working as a farm or ranch hand, or a part-time janitor/security guard/housekeeper in a small out-building or cheap hotel room for basically room, board, and a small allowance for the occasional "Saturday Night Fun" for most of their lives.

If they got married, it was to a spouse who could both take care of the house and work to make enough income to support them, or to a spouse who was just as immature and self-destructive as they were.

In the old days, there was a frontier to send them off to either live or die with no cost to the rest of society. Or they'd end up the town lay-about and/or drunk, living off charity and not much was expected of them. Now - they're expected to hold down a job and take care of themselves like the average person.
And they fail miserably. If they make any money - it's gone. Investment in time or effort to get to a better position in life - why should they?
No one with a successful business or who wants a reliable workforce will hire these people for anything more than an occasional one/two day job. And they'd be seriously concerned about the completion of that job if it lasted more than the day.

Nothing really wrong with them. They just aren't emotionally competent enough to get past the "living off an allowance" level of maturity, and are not going to admit there's anything wrong with that - ever.
What do we do with these people? For some, the only options are a life of remittances (if they're lucky enough to have parents who own family "business" to support them), SSDI, MLM "work at home" scams, chronic poverty, or eventually a life in and out of incarceration because they took the wrong financial short-cut for a moment of comfort.

Just think - if Donald Trump were born to Fred Smith, a shoe salesman in upstate New York, instead of Fred Drumpf/Trump, where would he be now?

Either hustling, or in jail, or on SSDI.

Haele

[PoindexterOglethorpe]

16. Excellent analysis.

Every so often I think about the fact that we no longer have a frontier that can absorb our misfits. Or that our economic system isn't good at accommodating those who can, for whatever reason, only work intermittently.

And given the nature of Donald's personality, I'm sure he'd be hustling in some way. Although he might have hustled something that got him jailed.

[PoindexterOglethorpe]

11. I know what it's like to stand for eight or more hours in high heels

and lifting various heavy objects. I was an airline ticket agent for ten years, so that's what I did all day. I have a back injury from that job, although not at all to the point of being disabled.

And yes, I do agree that there is a genuine need for SSDI.

And if the age to start collecting SS were dropped to 55, the amount a person could collect at that point would probably be about 40% of the full retirement age amount, so there's that to consider. A disability benefit, looking at some old statements from Social Security, is much closer to what you'd receive at full retirement age. So someone going on disability at a relatively young age would be better off financially compared to collecting regular SS at an early age. Of course, you have to have worked enough quarters and paid into the system to be eligible, and I keep on being quite taken aback that at stories like the one above, about the family in their 20s apparently collecting all sorts of benefits and completely unwilling to work.

I used to work for an attorney who handled appeals for people who'd been turned down the first time for disability, and it was incredibly instructive. I did live in a fairly large metropolitan area, so many jobs were potentially available, unlike in rural areas. But sometimes it seems as if too many of those in the rural areas have zero willingness to get work, refuse to remotely consider relocating, and want just to receive a regular check. If that's not gaming the system, I don't know what is.

[MiddleClass]

13. Exactly, that was my point

You're right about the rural areas.

I have a unique perspective on the issue,
I was born in New York, went to school in rural Ireland.
Spend the summers saving hay, the winters feeding cattle and horses.
My parents did not work the kids to the bone, like all my neighbors did, it's what has to be done.
I used to help my friends milk the cows, spread the manure, washout the dairy, pigpen, chicken coop, and worse still, the geese coop. And all that was they are chores after school.

Opportunity is hugely different when it comes to city living.
Your 55, worn-out, and prime lay off material, in this city, you can get something else, you can move in with a friend, you could pay the bills. In a rural area you can't go doing odd jobs, because that's what twentysomething is doing for a living.

When you are living so close to the edge. There are no choices on healthy living, you eat and survive and 30 years of macaroni, cheese and hotdogs takes its toll. 30 years of physical labor takes its toll. When you are 20 of 100 workforce, you are one fifth of the workforce. In this city, we speak of that 20 would be one percent of the workforce. Big difference.

My comment was more geared towards erecting racial barriers when there is none. On this particular side.

I think it's a great idea to drop Social Security to 55, millions of people get laid off because of concerns of healthcare's expenses escalating with age.

You spend the first 50 years of your life building your family and security

for some, they spend the next 15 years trying to just make Social Security, Medicare.

And in the process lose everything they worked their life for. That should stop

[pstokely]

18. lower cost of living?

nt

[TheOther95Percent]

3. Doesn't Surprise Me

I have rural family members who receive every kind of government benefit for low-income people. Section 8 housing assistance, food stamps, WIC, Medicaid. They voted for Trump too.

My family will periodically call me asking for money to "help out." I have not felt moved to contribute since the last election cycle when one relative told me that I was a bleeding heart liberal and a few other perjoratives that didn't bear repeating.

[pstokely]

19. so they're just fine with "hand outs" from family members?

Last edited Thu Jun 8, 2017, 10:33 PM - Edit history (2)

?

[TheOther95Percent]

20. Yes, they are

I have one younger relative who I have helped by paying for an SAT prep course and her book expenses through 4 years of college. I can afford it and feel it's something my mom would have done. Mom was always big on education. This relative did not vote for Trump although her drug addict dad and alcoholic mother (both on disability) did.

[MiddleClass]

7. Last time I researched it, Southern Red states have the highest per capa on Medicaid

Mississippi, Arkansas, Alabama, Louisiana

, cut Medicaid, cut food stamps they shout the loudest, despite being on both programs.

Hypocrisy is built-in to the grand old party

[Thrill]

10. Yet they're out there cheering and defending him