Welfare Reform: A Matter Of Justice Essay, Research Paper
Welfare Reform: A Matter of Justice
Medicaid. It is the United States Federal Government plan to help
provinces in supplying wellness attention to the hapless and impoverished who otherwise could
non receive proper medical attention. In 1995 the federal authorities spent a
sum of $ 77.4 Billion on Medicaid. This is up about 300 per centum from $ 20.1
Billion in 1984, merely 10 old ages before. In the same 10 old ages province disbursement on
Medicaid rose over 250 per centum from $ 16.5 Billion to $ 58.2 Billion. Under the
current Medicaid plans, Medicaid disbursement will increase at an one-year rate of
10 per centum, to an estimated $ 262 Billion by the twelvemonth 2002.
Medicaid disbursement has grown much faster than the general rate of
rising prices. For the Federal Government, Medicaid expenditures have grown from
merely 1 per centum of the national budget in 1970 to over 6 per centum in 1995, while
province 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 of
authorizations, the Federal Government has expanded the eligibility for Medicaid,
necessitating provinces to function more people. They besides increased the criterions
required of nursing places. This led to higher nursing place costs which were
passed straight back to the Medicaid plan. The current norm cost to care
for a patient in a nursing place is nine times greater than that of a individual
dependent kid. The monetary value of medical attention, in general, has drastically
increased. Expensive new engineering and processs are a big portion of this
addition. The demand for these dearly-won new engineerings is non expected to
lessening, the cost will merely be passed on to the populace through higher monetary values
and higher Medicaid disbursement. And eventually, an estimated 10 per centum of Medicaid
payments 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 the
early 1970 & # 8217 ; s, Medicaid receivers were at 8 per centum. Today more than 13 per centum
of the U.S. is having Medicaid & # 8217 ; s aid. If there was no Medicaid,
current cuts in employer sponsored medical coverage would hold increased the
uninsured population from 41 million today to an estimated 50 million people.
The politicians are happening themselves in a complete catch-22. If they
seek to cut Medicaid disbursement, they fear they will look cruel and insensitive
to the hapless and disadvantaged electors, and besides electors who sympathize with their
predicament. But if they don & # 8217 ; t seek to cut disbursement, they will be criticized for non
seeking to bring around our current budget shortage. But while our elected functionaries sit
on the fencing, seeking non to pique anyone, they alienate everyone by non moving
while this Leviathan digs us deeper and deeper into debt.
In his Justice as Entitlement theory, Robert Nozick describes his position
of societal justness. He states that aside from unassignable natural rights
like life, autonomy and felicity, justness is to make with retentions, and that
authorities 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 is
how people get their retentions, Justice in Acquisition. This states that if
a individual acquires their retentions by their ain labour, without go againsting the
rights of others, so this retention is merely. It is each individuals duty
to work to back up themselves and their households. Next is the thought behind
transacting concern, or Justice in Transfer. This chief provinces that if a
individual 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 demands
to be a manner to rectify unfair retentions. If a individual can supply cogent evidence that
their retentions have been taken unjustly, so the retention is unfair and
rapprochement can be made. However these must be specific claims with specific
cogent 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 its
citizens from larceny, force, fraud, and besides to implement contracts. He states
that 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 for
their ain good or protection, and it can non coerce any citizen to help another
citizen against their ain will.
With these two major principals we can find, fundamentally, what his
positions 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 its
bounds. It is coercing U.S. citizens to pay revenue enhancements that will straight be spent on
medical attention for destitute citizens. Many are paying against their will.
themselves or be cared for by their households. which leads to his Justice as
Entitlement principal. These destitute people are having money, or retentions,
from the province. They did non work for this, it was a transportation from the
taxpayers of this state. Since many feel that this is non their
duty, it is against their will that this money is spent on caring for
financially challenged persons and households. I believe that Robert Nozick
would see the full Welfare system to be unfair.
The American philosopher John Rawls, nevertheless, has a far different thought
of societal justness. In his theory of Justice as Fairness, Rawls states, like
Robert Nozick, that every individual has built-in rights to basic autonomies. These
include life, freedom, felicity, all unassignable, and the one transferable
autonomy, 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 the
Principal of Difference. Rawls states that all places within a society
should be unfastened to all. Everyone should hold an equal opportunity of acquiring to any
place within ground. He besides states that wealth should be distributed to
everyone based on their parts. The proprietor who puts up capital for the
concern, the director who has the cognition to do the merchandise, and the labourer
who puts in the difficult work and attempt are all entitled to their ain part of
the wealth that has been created through their conjunct attempts. He besides
provinces in this principal that disadvantaged people should be given compensation
if 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. The
higher instruction required by many professions are beyond the agencies of most. Not
merely can they non acquire the instruction to be competitory for occupations, they are
exploited by the employers who may non be counterbalancing their difficult attempts reasonably.
These jobs should be dealt with by the authorities. They should supply for
the demands that the deprived incur that they can non take attention of for
themselves, particularly something every bit basic as nice wellness attention. The current
plans are non plenty, there are many people traveling untreated, and now they
privation to cut support, this will turn out fatal for some people.
In these tough economic times, times of retrenchment, layoffs, and
cutbacks, the people who continue to be hurt most are the hapless. With support
for instruction being cut, they have less of a opportunity of being competitory in the
current occupation market. They are unqualified for the higher paying occupations that
haven & # 8217 ; t lost medical benefits. Nor can they afford personal wellness insurance
with the meager wages they earn.
These difficult working work forces and adult females, their dependent kids, and their
convalescent 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 last
opportunity to have nice medical attention.
John Stuart Mill & # 8217 ; s theory of Utility provinces that an action is good if it
produces 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 following
six old ages, most would non desire to see the aged, anticipant female parents, and
particularly kids, without acceptable medical attention. Under this doctrine,
reform would be preferred, and greatly apprehended, but non at the cost of these
guiltless peoples wellness and lives.
Using Immanual Kant & # 8217 ; s theory of the Categorical Imperative, one can acquire
another position of whether we are making the right thing. The categorical
imperative provinces that if you take any action and universalise it, do it
applicable to any individual in the same state of affairs, and it remains acceptable, so
this action is good. If person had the agencies and was given the opportunity to help
another individual who urgently needed it, would at that place be any fortunes in
which it would be good non to offer your aid. No rational homo could
garbage 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 non
working to its best possible consequence, could anyone decline to take portion?
Peoples, in this state, need to overlook their ain greed. If they see
that the money they work difficult for is traveling towards breaking human life, even
merely one, I believe that should be reward plenty. I don & # 8217 ; t believe that my money
is being used to its best extent in regard to Medicaid. There needs to be
major reforms in the manner money is apportioned and used. There besides needs to be
a lessening in the demand for Medical. Through inducements to concerns for
supplying wellness coverage to applicable employees, one think that this is an
come-at-able end. The current province of the Medicaid plan is inexorable, but what
would be the province of our state without it.