Welfare Reform: A Matter Of Justice Essay, Research PaperWelfare Reform: A Matter of JusticeMedicaid. It is the United States Federal Government plan to helpprovinces in supplying wellness attention to the hapless and impoverished who otherwise couldnon receive proper medical attention. In 1995 the federal authorities spent asum of $ 77.4 Billion on Medicaid.

This is up about 300 per centum from $ 20.1Billion in 1984, merely 10 old ages before. In the same 10 old ages province disbursement onMedicaid rose over 250 per centum from $ 16.5 Billion to $ 58.2 Billion. Under thecurrent Medicaid plans, Medicaid disbursement will increase at an one-year rate of10 per centum, to an estimated $ 262 Billion by the twelvemonth 2002.Medicaid disbursement has grown much faster than the general rate ofrising prices.

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For the Federal Government, Medicaid expenditures have grown frommerely 1 per centum of the national budget in 1970 to over 6 per centum in 1995, whileprovince outgos went from 8.1 per centum to 13.5 per centum in the same clip span.

This addition can be attributed to multiple factors. First, through a series ofauthorizations, the Federal Government has expanded the eligibility for Medicaid,necessitating provinces to function more people. They besides increased the criterionsrequired of nursing places.

This led to higher nursing place costs which werepassed straight back to the Medicaid plan. The current norm cost to carefor a patient in a nursing place is nine times greater than that of a individualdependent kid. The monetary value of medical attention, in general, has drasticallyincreased. Expensive new engineering and processs are a big portion of thisaddition. The demand for these dearly-won new engineerings is non expected tolessening, the cost will merely be passed on to the populace through higher monetary valuesand higher Medicaid disbursement. And eventually, an estimated 10 per centum of Medicaidpayments is wasted on fraud. This is largely fraud by wellness attention suppliers,with a small letter sum from patients with bad paperss.

From 1985 to 1993 Medicaid registration has gone up 53 per centum. In theearly 1970 & # 8217 ; s, Medicaid receivers were at 8 per centum. Today more than 13 per centumof the U.

S. is having Medicaid & # 8217 ; s aid. If there was no Medicaid,current cuts in employer sponsored medical coverage would hold increased theuninsured population from 41 million today to an estimated 50 million people.The politicians are happening themselves in a complete catch-22. If theyseek to cut Medicaid disbursement, they fear they will look cruel and insensitiveto the hapless and disadvantaged electors, and besides electors who sympathize with theirpredicament. But if they don & # 8217 ; t seek to cut disbursement, they will be criticized for nonseeking to bring around our current budget shortage. But while our elected functionaries siton the fencing, seeking non to pique anyone, they alienate everyone by non movingwhile this Leviathan digs us deeper and deeper into debt.In his Justice as Entitlement theory, Robert Nozick describes his positionof societal justness.

He states that aside from unassignable natural rightslike life, autonomy and felicity, justness is to make with retentions, and thatauthorities is to hold as little a portion in the lives of its citizens as possible.This is his thought of the Minimal State.Justice as Entitlement, as he puts it, has three major parts. First ishow people get their retentions, Justice in Acquisition. This states that ifa individual acquires their retentions by their ain labour, without go againsting therights of others, so this retention is merely. It is each individuals dutyto work to back up themselves and their households. Next is the thought behindtransacting concern, or Justice in Transfer.

This chief provinces that if aindividual gives something of their ain free will, so this retention is besides merely.These are the lone carnival, sensible, merely ways for a individual to get anything.Any other manner, and the retention will be considered unjust. Finally, there demandsto be a manner to rectify unfair retentions. If a individual can supply cogent evidence thattheir retentions have been taken unjustly, so the retention is unfair andrapprochement can be made. However these must be specific claims with specificcogent evidence of specific actions.Next, the Minimal State is Nozick & # 8217 ; s thought of what a authorities should,and should non, be.

He states that authorities has the duty to protect itscitizens from larceny, force, fraud, and besides to implement contracts. He statesthat any more extended a authorities will go against its citizens natural rights.He besides says that a authorities must non forbid activities of its citizens fortheir ain good or protection, and it can non coerce any citizen to help anothercitizen against their ain will.With these two major principals we can find, fundamentally, what hispositions on the current programs for public assistance reform. With the Minimal State principal,we can clearly see that in Nozick & # 8217 ; s position, the province has clearly overstepped itsbounds.

It is coercing U.S. citizens to pay revenue enhancements that will straight be spent onmedical attention for destitute citizens. Many are paying against their will.

& gt ; Some citizens think that the wellness attention of these people should care forthemselves or be cared for by their households. which leads to his Justice asEntitlement principal. These destitute people are having money, or retentions,from the province. They did non work for this, it was a transportation from thetaxpayers of this state. Since many feel that this is non theirduty, it is against their will that this money is spent on caring forfinancially challenged persons and households.

I believe that Robert Nozickwould see the full Welfare system to be unfair.The American philosopher John Rawls, nevertheless, has a far different thoughtof societal justness. In his theory of Justice as Fairness, Rawls states, likeRobert Nozick, that every individual has built-in rights to basic autonomies. Theseinclude life, freedom, felicity, all unassignable, and the one transferableautonomy, the right to keep belongings. But from at that place, their positions differ.One of the chief points in the Justice as Fairness theory, is thePrincipal of Difference. Rawls states that all places within a societyshould be unfastened to all.

Everyone should hold an equal opportunity of acquiring to anyplace within ground. He besides states that wealth should be distributed toeveryone based on their parts. The proprietor who puts up capital for theconcern, the director who has the cognition to do the merchandise, and the labourerwho puts in the difficult work and attempt are all entitled to their ain part ofthe wealth that has been created through their conjunct attempts. He besidesprovinces in this principal that disadvantaged people should be given compensationif their demands require it.

Many people work hard and still can & # 8217 ; Ts make ends meet.In the U.S. , the hapless are disadvantaged in more than one manner.

Thehigher instruction required by many professions are beyond the agencies of most. Notmerely can they non acquire the instruction to be competitory for occupations, they areexploited by the employers who may non be counterbalancing their difficult attempts reasonably.These jobs should be dealt with by the authorities. They should supply forthe demands that the deprived incur that they can non take attention of forthemselves, particularly something every bit basic as nice wellness attention. The currentplans are non plenty, there are many people traveling untreated, and now theyprivation to cut support, this will turn out fatal for some people.

In these tough economic times, times of retrenchment, layoffs, andcutbacks, the people who continue to be hurt most are the hapless. With supportfor instruction being cut, they have less of a opportunity of being competitory in thecurrent occupation market. They are unqualified for the higher paying occupations thathaven & # 8217 ; t lost medical benefits. Nor can they afford personal wellness insurancewith the meager wages they earn.These difficult working work forces and adult females, their dependent kids, and theirconvalescent parents besides need medical coverage. They need X raies, chemotherapy,to hold babes, tonsillectomies, infant immunisation, and nursing place attention.

If current programs for Medicaid reform are enacted, many will free even this lastopportunity to have nice medical attention.John Stuart Mill & # 8217 ; s theory of Utility provinces that an action is good if itproduces the greatest sum of felicity for the greatest figure of people.While all U.S. taxpayers would wish to shut the budget shortage within the followingsix old ages, most would non desire to see the aged, anticipant female parents, andparticularly kids, without acceptable medical attention. Under this doctrine,reform would be preferred, and greatly apprehended, but non at the cost of theseguiltless peoples wellness and lives.

Using Immanual Kant & # 8217 ; s theory of the Categorical Imperative, one can acquireanother position of whether we are making the right thing. The categoricalimperative provinces that if you take any action and universalise it, do itapplicable to any individual in the same state of affairs, and it remains acceptable, sothis action is good. If person had the agencies and was given the opportunity to helpanother individual who urgently needed it, would at that place be any fortunes inwhich it would be good non to offer your aid. No rational homo couldgarbage such an act ( if they were utilizing the categorical jussive mood to judge by ) .Medicaid is merely a centralised system of making merely that. Even though it & # 8217 ; s nonworking to its best possible consequence, could anyone decline to take portion?Peoples, in this state, need to overlook their ain greed. If they seethat the money they work difficult for is traveling towards breaking human life, evenmerely one, I believe that should be reward plenty. I don & # 8217 ; t believe that my moneyis being used to its best extent in regard to Medicaid.

There needs to bemajor reforms in the manner money is apportioned and used. There besides needs to bea lessening in the demand for Medical. Through inducements to concerns forsupplying wellness coverage to applicable employees, one think that this is ancome-at-able end. The current province of the Medicaid plan is inexorable, but whatwould be the province of our state without it.