Medicaid: An American Parable

By David K. Shipler

            Watching the Republican governors who still insist that they will not accept a penny of the federal government’s money to provide health insurance to their near-poor citizens brings to mind Alexis de Tocqueville, the French historian who traveled in the United States in 1831. He saw a country honeycombed with generosity taking the form of myriad associations organized to promote one worthy cause or another.

What he chronicled in his work, Democracy in America, has come down to us as evidence of our powerful impulses to charity, to philanthropy, to the common good—so much so that today, United Way chapters present annual Tocqueville awards to honor individuals who have been exceptionally generous with time or funds.

To be sure, Tocqueville was not a big-government advocate. He admired citizen-led private efforts over those that came from above. “Wherever at the head of some new undertaking you see the government in France or a man of rank in England,” he wrote, “in the United States you will be sure to find an association.”

But for a modern society, intricate with technological and economic complexity, this observation raises two questions: one practical, one moral. What mechanism is most practical in, say, the area of health care? What can be done privately, and what must be done publicly? And where does moral responsibility lie? Only at the local level of community, or on the broader plane of national concern?

These are the elements of our most acerbic debates as we struggle and disagree over where to locate the shifting line that should divide the private from the public.

Poverty: How Much Is a Family Worth?

By David K. Shipler

We’re being peppered with a lot of numbers that tell us less than we need to know about financial hardship. We have the 99 percent and the one percent. We have the 8.6-percent unemployment rate. We have the average payroll tax cut of $1,000 this year, which next year will become either $1,500 or $0, depending on how well Congress dysfunctions before Christmas. Either 46.6 million or 49 million people are poor, depending on whether you want to reduce “poverty” by using the official formula based on families’ 1950s spending patterns, or would rather reconcile yourself to living in the 21st century, whose facts of life produce the higher calculation by the Census Bureau.

It is hard to get to the human story of poverty, and none of these numbers takes us there. A more revealing statistic helps, but it doesn’t get the attention it deserves: a household’s net worth—assets minus liabilities.

The Blurry Poverty Line

By David K. Shipler

Now that the Census Bureau has offered a more realistic way of calculating poverty, the outdated method should be discarded instead of retained as the “Official Poverty Measure” used to determine eligibility for government benefits. It was designed in the 1960s, when the average family spent about one-third of its budget on food, a proportion that has fallen to one-seventh as housing and other costs have soared. So it makes no sense to take the price tag of a minimum food basket and multiply it by three. But that will continue to happen unless Congress and the administration act—a hard act to perform with federal and state governments in fiscal straits.