Welfare Reform A Matter Of Justice Essay

Welfare Reform: A Matter Of Justice Essay, Research Paper

Welfare Reform: A Matter of Justice

Medicaid. It is the United States Federal Government program to aid

states in providing health care to the poor and impoverished who otherwise could

not receive proper medical care. In 1995 the federal government spent a

total of $77.4 Billion on Medicaid. This is up almost 300 percent from $20.1

Billion in 1984, only 10 years earlier. In the same 10 years state spending on

Medicaid rose over 250 percent from $16.5 Billion to $58.2 Billion. Under the

current Medicaid programs, Medicaid spending will increase at an annual rate of

10 percent, to an estimated $262 Billion by the year 2002.

Medicaid spending has grown much faster than the general rate of

inflation. For the Federal Government, Medicaid expenditures have grown from

only 1 percent of the national budget in 1970 to over 6 percent in 1995, while

state expenditures went from 8.1 percent to 13.5 percent in the same time span.

This increase can be attributed to multiple factors. First, through a series of

mandates, the Federal Government has expanded the eligibility for Medicaid,

requiring states to serve more people. They also increased the standards

required of nursing homes. This led to higher nursing home costs which were

passed directly back to the Medicaid program. The current average cost to care

for a patient in a nursing home is nine times greater than that of a single

dependent child. The price of medical care, in general, has drastically

increased. Expensive new technology and procedures are a large part of this

increase. The need for these costly new technologies is not expected to

decrease, the cost will just be passed on to the public through higher prices

and higher Medicaid spending. And finally, an estimated 10 percent of Medicaid

payments is wasted on fraud. This is mostly fraud by health care providers,

with a minuscule amount from patients with forged documents.

From 1985 to 1993 Medicaid enrollment has gone up 53 percent. In the

early 1970’s, Medicaid recipients were at 8 percent. Today more than 13 percent

of the U.S. is receiving Medicaid’s assistance. If there was no Medicaid,

current cuts in employer sponsored medical coverage would have increased the

uninsured population from 41 million today to an estimated 50 million people.

The politicians are finding themselves in a complete catch-22. If they

try to cut Medicaid spending, they fear they will appear cruel and insensitive

to the poor and disadvantaged voters, and also voters who sympathize with their

plight. But if they don’t try to cut spending, they will be criticized for not

trying to cure our current budget deficit. But while our elected officials sit

on the fence, trying not to offend anyone, they alienate everyone by not acting

while this Leviathan digs us deeper and deeper into debt.

In his Justice as Entitlement theory, Robert Nozick describes his view

of social justice. He states that aside from nontransferable natural rights

like life, liberty and happiness, justice is to do with holdings, and that

government is to have as small a part in the lives of its citizens as possible.

This is his idea of the Minimal State.

Justice as Entitlement, as he puts it, has three major parts. First is

how people acquire their holdings, Justice in Acquisition. This states that if

a person acquires their holdings by their own labor, without violating the

rights of others, then this holding is just. It is each persons responsibility

to work to support themselves and their families. Next is the idea behind

transacting business, or Justice in Transfer. This principal states that if a

person gives something of their own free will, then this holding is also just.

These are the only fair, reasonable, just ways for a person to acquire anything.

Any other way, and the holding will be considered unfair. Finally, there needs

to be a way to correct unjust holdings. If a person can provide proof that

their holdings have been taken unjustly, then the holding is unjust and

reconciliation can be made. However these must be specific claims with specific

proof of specific actions.

Next, the Minimal State is Nozick’s idea of what a government should,

and should not, be. He states that government has the obligation to protect its

citizens from theft, force, fraud, and also to enforce contracts. He states

that any more extensive a government will violate its citizens natural rights.

He also says that a government must not prohibit activities of its citizens for

their own good or protection, and it cannot force any citizen to aid another

citizen against their own will.

With these two major principals we can determine, basically, what his

views on the current plans for welfare reform. With the Minimal State principal,

we can clearly see that in Nozick’s view, the state has clearly overstepped its

bounds. It is forcing U.S. citizens to pay taxes that will directly be spent on

medical care for impoverished citizens. Many are paying against their will.