HEALTH CARE/Joan Retsinas

Immiseration: Karl Marx Meets Donald Trump

Karl Marx lobbed “immiseration” into the political lexicon. He believed the avaricious drive of capitalism would, inevitably, plunge the proletariat down to bare subsistence – immiserating them. Of course, he didn’t foresee the totalitarian horror of the Soviet Union, with its gulags, bread lines and the true immiseration of people in that socialist nirvana. Nor did he foresee the rise of strong state movements to protect citizen-workers: Social Security, national health insurance, public dollars spent on infrastructure, parks, schools. Throughout the 20th century the standard of living for workers throughout the West rose.
Donald Trump wants to reverse that rise – in effect, “immiserating” America’s poor.
The poor-among-us do not live comfortable lives, in spite of the right-wing rhetoric. Many live in substandard housing, queue on long waiting lists for housing subsidies, eke out extra dollars from part-time minimum wage jobs, send their children to crowded, often dangerous schools, and know that a broken car will cost them their job, an illness will cost them their rent.
The question for this Administration: how can we make the lives of the poor more miserable? How many dollars can we save?
This president has the answer.

Food Stamps

Right now Uncle Sam gives poor people “food stamps” (a.k.a. “electronic benefit transfers”), redeemable at supermarkets. Instead of putting a credit card in the machine, a customer inserts an EBT card. The payment is subsidized, but the subsidy is not obvious. The recipient retains the dignity of purchasing food, just like non-subsidized customers.
Why not return to those old days of giving people food directly. Let’s unload the surplus food that farmers are eager to sell, that can be warehoused, that will prove, maybe, cheaper than EBTs. (The Administration didn’t detail the administrative costs of distributing these food bags.) Imagine blocks of processed cheese, boxes of dried milk, vats of peanut butter. The poor can eat those, maybe lining up weekly to collect their rationed packages.
Why not let the poor be hungry, a little?

Heat

The heating subsidies, according to the President, invite fraud. Let’s cut them. Let the poor people in the Northeast, Midwest, and Northwest shiver a little. They can wear sweaters, even snowsuits.

Housing

Honestly, how much of a subsidy should we throw at housing? In the good old days, people crammed together, in cold-water (we are returning to the cold) flats. Let’s return to those days. The Administration wants to cut housing subsidies by 14%. Too many people are drinking from the public trough.

Work-for-Medicine

We want “the poor” to work for welfare; that was the Clinton-era innovation. This Administration, cheered on by governors, wants the poor to work for healthcare even though some of the would-be patients are sick. Do we want to refuse insulin for an unemployed man with diabetes? To bar a woman with asthma from a pulmonary visit if she isn’t going to school the requisite number of hours? We provide health care to inmates in prison; yet we want to take it from the “undeserving” poor. Donald Trump, meet Ebeneezer Scrooge. Dickens would marvel.

Libraries

Almost every Horatio Alger success story, especially an immigrant one, praises the local library. People still go there to read, to log onto computers to look for jobs, to apply for benefits. In the winter, people go for warmth; in the summer, for air conditioning. The federal government gives a sliver of money to libraries; President Trump wants to ax that sliver.

Veterans

Without a draft, we recruit young men and women who see the military as a ticket to an income, education and/or job training. Unfortunately, some of those recruits don’t go to school, but to war, in countries they barely studied in high school. In years past, we gave returning veterans subsidies for housing (low-interest mortgages), unemployment compensation, and education (the GI Bill). No more. On any given night, almost 40,000 veterans are homeless. With healthcare, the president promised to fix an underfunded poorly performing system. VA Chief David Shulkin not only hasn’t fixed it, but took himself and his wife on a taxpayer-funded 10-day trip to Europe. He said that, while in Europe, he was working to improve care at a New Hampshire hospital.

Rationale behind the draconian cuts

This President promises jobs, “wonderful” high-paying jobs, even in the dying coal fields. But these cuts are delivering a tax bonanza for the wealthy.
Marx predicted that an immiserated populace would rise up. America’s poor live in a democracy; they have the weapon of the ballot box. They should vote — as should every American appalled at this president’s callous denigration of a swathe of the population not blessed to be part of the top 1% — to oust not just him, but his cohort of craven lapdogs, in Washington and in state capitals.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, April 1, 2018


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