these aren’t things you can see on a poverty tour
July 22, 2019 8:34 AM Subscribe
The Last Days of the Appalachian Poverty Tour: When I first meet Jack, he tells me he stopped giving poverty tours years ago and has generally stopped talking to the media about them. He says that if we take this tour together, he won’t stop at anyone’s home; he doesn’t want to expose anyone like that again. He tells me he’s agreeing to do this one last tour only because of who I am: a single, disabled mother with my own lived experiences of poverty. For Topic magazine, writer Alison Stine gives a history of the Appalachian poverty tour.
Jack cites the increase in paperwork and work requirements for many types of assistance as hurdles that are much more difficult for the elderly, those with disabilities, single mothers without childcare, and people without access to the internet.
This really stood out to me because of a recent experience with Medicaid.
My son's IEP entitled him to Medicaid with no means test (i.e. no matter the family income). We have employer group health insurance and pay no monthly premiums, something for which I'm very grateful. So I agonized about the ethics of using a resource that we didn't truly need. We ultimately decided to use it.
Anyway, listen. I am a lawyer who works in the insurance industry, native english speaker, and have been increasingly involved with the management of my own health insurance since middle school (my parents were big on the teaching adult skills thing). The first thing I noticed is how dense the application was, how much flatly wrong and competing information I was given. For example a "dummy" insurance card was sent to me as a just in case, but it was never actually activated by the state. When the real card came, the primary care physical was incorrect and listed a doctor in another suburb nearly an hour away by car. Another person might for various reasons have felt they were stuck with that assigned doctor - I knew better, got reassigned to my son's existing pediatrician, got a new card. This is just one example, but I could give more.
Either by negligence/disinterest or deliberately (I suspect both!), the system seemed designed for me to fail and required constant vigilance. It was more difficult to manage in this sense than my private health plan, and we all know how bad they are. I was very cognizant of what the impacts could have been of disability, time constraints, lack of access to transportation or even to office equipment like a copier/scanner, language limitations, etc.
I am glad I used the Medicaid, we never had any health scares of the kind that worried me into accepting it but I certainly learned a lot and it has given me an opportunity to talk about how challenging the system was. It seems like there's an inverse relationship in the credibility you are assigned talking about the 'system' and your actual need for the benefits - that is, the mere fact of my financially not needing benefits seemed to make me more credible. Along with other privilege markers of course. Anyone legislating or regulating on the topic of public benefits should, in my opinion, challenge themselves to navigate the system or to live within the system's narrow and prejudicially-enforced requirements.
posted by ramble-on-prose at 9:08 AM on July 22, 2019 [64 favorites]
This really stood out to me because of a recent experience with Medicaid.
My son's IEP entitled him to Medicaid with no means test (i.e. no matter the family income). We have employer group health insurance and pay no monthly premiums, something for which I'm very grateful. So I agonized about the ethics of using a resource that we didn't truly need. We ultimately decided to use it.
Anyway, listen. I am a lawyer who works in the insurance industry, native english speaker, and have been increasingly involved with the management of my own health insurance since middle school (my parents were big on the teaching adult skills thing). The first thing I noticed is how dense the application was, how much flatly wrong and competing information I was given. For example a "dummy" insurance card was sent to me as a just in case, but it was never actually activated by the state. When the real card came, the primary care physical was incorrect and listed a doctor in another suburb nearly an hour away by car. Another person might for various reasons have felt they were stuck with that assigned doctor - I knew better, got reassigned to my son's existing pediatrician, got a new card. This is just one example, but I could give more.
Either by negligence/disinterest or deliberately (I suspect both!), the system seemed designed for me to fail and required constant vigilance. It was more difficult to manage in this sense than my private health plan, and we all know how bad they are. I was very cognizant of what the impacts could have been of disability, time constraints, lack of access to transportation or even to office equipment like a copier/scanner, language limitations, etc.
I am glad I used the Medicaid, we never had any health scares of the kind that worried me into accepting it but I certainly learned a lot and it has given me an opportunity to talk about how challenging the system was. It seems like there's an inverse relationship in the credibility you are assigned talking about the 'system' and your actual need for the benefits - that is, the mere fact of my financially not needing benefits seemed to make me more credible. Along with other privilege markers of course. Anyone legislating or regulating on the topic of public benefits should, in my opinion, challenge themselves to navigate the system or to live within the system's narrow and prejudicially-enforced requirements.
posted by ramble-on-prose at 9:08 AM on July 22, 2019 [64 favorites]
Jack cites the increase in paperwork and work requirements for many types of assistance as hurdles that are much more difficult for the elderly, those with disabilities, single mothers without childcare, and people without access to the internet.
So much of trying to financially survive in the US has turned into these awful games where you have to get the right paperwork sent to the right place by the right time and if something goes awry (even just a letter transposed on a form by the person on the other end of the line) and you're screwed out of whatever marginal benefit you might have gotten. The whole process seems only to benefit the intermediary companies who create the paperwork and other hoops to jump through.
In my own recent experience, in order to get some tax relief for money spent on childcare, our money has to leave our account to go stand in another account briefly and then get sent back to our normal account so we can pay the childcare provider. The childcare provider doesn't accept the debit card that the childcare savings account gives us so we have to make our money go on a little trip before it counts for the tax credit. It's beyond stupid, and it's taken 2 months already to try to get the correct paperwork to make it all happen...we still haven't succeeded.
I have run into similar dog and pony shows with retirement savings, health insurance and healthcare spending, energy efficient home improvements, and other things. These are all types of spending that our current political and economic system wants us to spend on and it's difficult to do. I can only imagine how difficult it must be to navigate these games for benefits that are generally deemed negative by our society/current administration but which are an absolute necessity to those who receive them (WIC, Medicaid, etc.). As with so much in modern American life, it always seems like the cruelty and the struggle is the point.
posted by msbrauer at 9:23 AM on July 22, 2019 [16 favorites]
So much of trying to financially survive in the US has turned into these awful games where you have to get the right paperwork sent to the right place by the right time and if something goes awry (even just a letter transposed on a form by the person on the other end of the line) and you're screwed out of whatever marginal benefit you might have gotten. The whole process seems only to benefit the intermediary companies who create the paperwork and other hoops to jump through.
In my own recent experience, in order to get some tax relief for money spent on childcare, our money has to leave our account to go stand in another account briefly and then get sent back to our normal account so we can pay the childcare provider. The childcare provider doesn't accept the debit card that the childcare savings account gives us so we have to make our money go on a little trip before it counts for the tax credit. It's beyond stupid, and it's taken 2 months already to try to get the correct paperwork to make it all happen...we still haven't succeeded.
I have run into similar dog and pony shows with retirement savings, health insurance and healthcare spending, energy efficient home improvements, and other things. These are all types of spending that our current political and economic system wants us to spend on and it's difficult to do. I can only imagine how difficult it must be to navigate these games for benefits that are generally deemed negative by our society/current administration but which are an absolute necessity to those who receive them (WIC, Medicaid, etc.). As with so much in modern American life, it always seems like the cruelty and the struggle is the point.
posted by msbrauer at 9:23 AM on July 22, 2019 [16 favorites]
Is compassion some sort of finite resource?
Where empathy or compassion threatens world views, the more powerful the call for individual compassion, the more violently the individual may reject it. Suggest that someone you've disregarded is human, it's easier to decide that they're actually a monster.
posted by praemunire at 9:33 AM on July 22, 2019 [1 favorite]
Where empathy or compassion threatens world views, the more powerful the call for individual compassion, the more violently the individual may reject it. Suggest that someone you've disregarded is human, it's easier to decide that they're actually a monster.
posted by praemunire at 9:33 AM on July 22, 2019 [1 favorite]
Why is it so difficult to square ideology with economic strategy? Infants can be excused for their selfish, inflexible behavior, but shouldn't college educated adults know better?
Because all of US society pushes the belief that poverty is caused by poor personal choices. Also the vast majority of the money that the federal government insists is spent in small towns (outside of various welfare for individuals) is mostly for road/highway expansion (some) repairs and most of the state money is for the public schools.
Also Chauncey looks bit older, but Athens is your standard 'suburb without a prosperous city attached' - ie these aren't really old cities but rather mostly 1960s and newer sprawl, which is my personal pet theory on what caused poverty to skyrocket even as income generally increased. They fully rely on outside money.
posted by The_Vegetables at 9:41 AM on July 22, 2019 [3 favorites]
Because all of US society pushes the belief that poverty is caused by poor personal choices. Also the vast majority of the money that the federal government insists is spent in small towns (outside of various welfare for individuals) is mostly for road/highway expansion (some) repairs and most of the state money is for the public schools.
Also Chauncey looks bit older, but Athens is your standard 'suburb without a prosperous city attached' - ie these aren't really old cities but rather mostly 1960s and newer sprawl, which is my personal pet theory on what caused poverty to skyrocket even as income generally increased. They fully rely on outside money.
posted by The_Vegetables at 9:41 AM on July 22, 2019 [3 favorites]
The whole process seems only to benefit the intermediary companies who create the paperwork and other hoops to jump through.
This is exactly what it is. What happens is that these programs get set up, with at least some complicity from politicians in terms of how they're set up, and then whole industries are developed to exploit them, so that they function more as jobs farms and sources of graft than public services. It's a capture of the state, basically. It's looting. It's like having hundreds of university administrators making huge salaries while cutting services and firing secretaries - the point is the graft, the point is to take state money and route it to the rich or use it as patronage.
I've said this before on here, but once I went with a friend to the welfare office. There were plenty of people available to "discuss your options" if you needed assistance, but there wasn't any assistance. Your "options" were "very little" and "nothing at all".
posted by Frowner at 10:32 AM on July 22, 2019 [15 favorites]
This is exactly what it is. What happens is that these programs get set up, with at least some complicity from politicians in terms of how they're set up, and then whole industries are developed to exploit them, so that they function more as jobs farms and sources of graft than public services. It's a capture of the state, basically. It's looting. It's like having hundreds of university administrators making huge salaries while cutting services and firing secretaries - the point is the graft, the point is to take state money and route it to the rich or use it as patronage.
I've said this before on here, but once I went with a friend to the welfare office. There were plenty of people available to "discuss your options" if you needed assistance, but there wasn't any assistance. Your "options" were "very little" and "nothing at all".
posted by Frowner at 10:32 AM on July 22, 2019 [15 favorites]
The first thing I noticed is how dense the application was, how much flatly wrong and competing information I was given.
It's slightly tangential to the issue of poverty but I had the same experience with visa paperwork and paying my taxes when I lived in the US. There was always a point where I was guessing and just sending it in, hoping that I got things right and wouldn't end up having to untangle a bureaucratic snafu.
posted by quaking fajita at 12:38 PM on July 22, 2019 [2 favorites]
It's slightly tangential to the issue of poverty but I had the same experience with visa paperwork and paying my taxes when I lived in the US. There was always a point where I was guessing and just sending it in, hoping that I got things right and wouldn't end up having to untangle a bureaucratic snafu.
posted by quaking fajita at 12:38 PM on July 22, 2019 [2 favorites]
The first thing I noticed is how dense the application was
I was on unemployment for about 6 months after getting laid off in 2013. The paperwork to show I was qualified, and continued to qualify, was very difficult. And I'm a native English speaker with an advanced degree, and many years' experience in bureaucratic environments. I cannot imagine how some people manage it at all.
I am forced to believe this is intentional.
posted by suelac at 3:28 PM on July 22, 2019 [14 favorites]
I was on unemployment for about 6 months after getting laid off in 2013. The paperwork to show I was qualified, and continued to qualify, was very difficult. And I'm a native English speaker with an advanced degree, and many years' experience in bureaucratic environments. I cannot imagine how some people manage it at all.
I am forced to believe this is intentional.
posted by suelac at 3:28 PM on July 22, 2019 [14 favorites]
I was on unemployment for about 6 months after getting laid off in 2013. The paperwork to show I was qualified, and continued to qualify, was very difficult.
I really wonder how much this sort of thing varies from state to state. Having filled out the same in MA, I was honestly surprised how easy it was.
I've often heard it hypothesized that part of why red states are red is that their state government make it as hard as possible to interact with the bureaucracy, thereby making people support the idea of just dismantling the functions of the state.
posted by thegears at 3:36 PM on July 22, 2019 [4 favorites]
I really wonder how much this sort of thing varies from state to state. Having filled out the same in MA, I was honestly surprised how easy it was.
I've often heard it hypothesized that part of why red states are red is that their state government make it as hard as possible to interact with the bureaucracy, thereby making people support the idea of just dismantling the functions of the state.
posted by thegears at 3:36 PM on July 22, 2019 [4 favorites]
Sadly, it couldn't sufficiently soften any hearts or expand perspectives. Is compassion some sort of finite resource?
Compassion isn't a finite resource. But doing something about it requires the use of finite resources, most of them controlled by powerful people. Expanding perspectives is important, and valuable - it just isn't the whole fight.
posted by AdamCSnider at 3:51 PM on July 22, 2019 [2 favorites]
Compassion isn't a finite resource. But doing something about it requires the use of finite resources, most of them controlled by powerful people. Expanding perspectives is important, and valuable - it just isn't the whole fight.
posted by AdamCSnider at 3:51 PM on July 22, 2019 [2 favorites]
The industry I work in, and many others, regularly execute AB tests and the like to see if a different approach to an interaction is better or worse than the existing one. The winner gets adopted, then you try to beat that one, until you can't make it any better...but "better" is defined by your goal.
I can certainly believe that these bureaucratic forms and processes simply don't undergo any kind of disciplined process for improvement. I can also believe that they do, but that the goal is to minimize the number of filings or minimize the amount of money that gets paid out. One is careless, the other evil, but from experience even the careless approach makes for some terrible interactions that might as well be evil.
posted by davejay at 6:33 PM on July 22, 2019
I can certainly believe that these bureaucratic forms and processes simply don't undergo any kind of disciplined process for improvement. I can also believe that they do, but that the goal is to minimize the number of filings or minimize the amount of money that gets paid out. One is careless, the other evil, but from experience even the careless approach makes for some terrible interactions that might as well be evil.
posted by davejay at 6:33 PM on July 22, 2019
This tour was mentioned here Busted: America's Poverty Myths on the podcast On the Media. Great listen if you haven't already. Glad to see this being mentioned again.
posted by Ms. Moonlight at 1:36 AM on July 25, 2019
posted by Ms. Moonlight at 1:36 AM on July 25, 2019
Either by negligence/disinterest or deliberately (I suspect both!), the system seemed designed for me to fail and required constant vigilance.
When I lived in Oklahoma, some twenty-four years ago, I briefly worked for a substance abuse treatment center, and one of the things that I did was submit statistics to the state department that gave us most of our funding. Not only was the software that we used for reporting the stats buggy and difficult to use, but whoever reviewed the reports was almost comically careless. One month, they curtly informed us that we were having our funding cut--all of it--because we'd not met our treatment hours goals. It turned out that, for some reason, they had looked only at the number of adult men that we'd treated; a great deal of our clientele were women and children in a residential unit. This, I was told, was not uncommon.
posted by Halloween Jack at 12:13 PM on July 25, 2019
When I lived in Oklahoma, some twenty-four years ago, I briefly worked for a substance abuse treatment center, and one of the things that I did was submit statistics to the state department that gave us most of our funding. Not only was the software that we used for reporting the stats buggy and difficult to use, but whoever reviewed the reports was almost comically careless. One month, they curtly informed us that we were having our funding cut--all of it--because we'd not met our treatment hours goals. It turned out that, for some reason, they had looked only at the number of adult men that we'd treated; a great deal of our clientele were women and children in a residential unit. This, I was told, was not uncommon.
posted by Halloween Jack at 12:13 PM on July 25, 2019
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