OK… let’s look at Cari’s comment on my Quick Takes:

I am so sorry that you have to shoulder this. I know how horrible it feels to not be able to feed your family on your own (we’ve been there, too). It’s something that you carry around all the time, like an actual weight you can feel.

So after reading your takes, I have to ask you this question: considering how degrading and ill-organized your experience with a government health care program is, how do you maintain faith that Obamacare will offer something better? Putting aside the questions of contraception and abortion, how can we look at something like WIC and VA hospitals, and the sorry state they’re in, and have faith that a universal, gigantic program like national healthcare will offer Americans a positive change?

I’m not trying to put anyone on the defensive, I am just honestly wondering. Between my husband and myself, we’ve had experience with a wide range of government services, from the DMV to social services offices (you know, “the welfare line”), and none of them have demonstrated even a minimum level of competence. I feel, from reading these takes of yours, that you probably share in this assessment. So how to we move from the model currently in practice, to a better one?

First thing: WIC isn’t in a sorry state. I did have that pissy nutritionist in Pomona but other than that, my experience has been largely positive. I think part of the reason it has succeeded for more than 30 years is that it is administered by the states and each county has their own setup with multiple offices around the county if it is a large or populous area like LA County or Sacramento County. If your experience has been different, please let me know so I can add your view to this conversation.

As far as your first question, Obamacare, thus far, has been mostly regulations on insurance companies to fix some of the abuses that were happening. I wish I could go back in time and scan some of the documents I had in 2002 and 2003 when we were having to buy our own insurance where my insurance rate was more than my husband’s and where there was a $400 monthly maternity rider on the policy if I wanted to get pregnant because a lot of people don’t believe me. Some of those problems (like the inequality of rates) have been fixed and a number of rules regarding women’s health like free preventative care in the form of annual exams and mammograms has been added. Inasmuch as I understand it, Obamacare would require Americans to have insurance but provide tax breaks to do so and create a national exchange in which people could purchase healthcare policies — we’re not going into something like the NHS in Great Britain. I haven’t read the entire piece of legislation (it’s on my to-do list) but that is what I understand from what I have read.

As far as how I have faith that this can offer a positive change, my answer is that it’s better than the situation we have now where people are declaring bankruptcy because of medical bills and people are having to choose between food and medication. I don’t have the gift of prophecy and all we can do is see where this road takes us. I wish I could say that things will all run perfectly and the forecasted problems won’t happen but I can’t say that with complete certainty.

One problem that I think we have in general with social programs is that they’re the first thing on the chopping block when there are money programs. We’re cutting funds to the VA and SNAP yet we’re expecting them to provide at the same level as we were before. For example, we’re coming out of two wars and we’re actually dealing with issues like PTSD that were just swept under the rug before the Vietnam War but the VA isn’t being adequately funded to deal with these issues. Because of the economic downturn, a lot of kids are dependent on school lunches in some cases as their only source of food. Yet, school lunch programs are usually one of the first things to get cut.

Another problem is that urban areas tend to have the most need for these programs and there’s only so much that can be done if they don’t have the money to hire staff. The DHHS in Sacramento, for example, basically does all the major social program stuff for the entire county of 1.4 million people. Could we maybe get a couple smaller offices in other parts of the county that could handle food stamps and Medicaid? I know we have a county services office in my small town but it doesn’t cover everything. The workers at the DHHS are overworked and overextended which is why it takes so much time to get things done. Comparing it to my tiny county in Montana, I looked up the local office of public assistance and found that there is one worker for 3 counties. This would probably be an issue… except we’re talking maybe 20,000 people total. In the large county next door, there are two offices with one on the Blackfeet reservation where there’s a huge amount of poverty.

Last problem I’ll highlight: we have an attitude in the USA that if people have problems and need assistance, they’re obviously not working hard enough and deserve it. This isn’t the case at all. I could claim it’s the Protestant work ethic but I don’t even think it comes from that either. I think it comes down to this (expressed beautifully by Stephen Colbert):

If this is going to be a Christian nation that doesn??t help the poor, either we have to pretend that Jesus was just as selfish as we are, or we??ve got to acknowledge that He commanded us to love the poor and serve the needy without condition and then admit that we just don??t want to do it.

So how do we fix this? We need to actually fund the necessary programs instead of letting Congress vote themselves in a pay increase. Taxes need to be based on income and investment income needs to be taxed at the same rate as salaries are. (Yes, that was a blatant dig at Mitt Romney.) We need to elect Congressional representatives that can work with each other and not waste our time and money with ceremonial votes. (Yes, that was a blatant dig at the 33 times Obamacare has come up for repeal.) How do we do this? We have to all agree that our focus should be the common good and that it is a tenet in every religion that we take care of each other and for those with no spiritual beliefs, it’s the moral thing to do.

This is just scratching the surface of the problem and there are a whole glut of issues that would need to be addressed before it would even be solvable. My aim is basically to try to answer Cari’s questions as best I can with the knowledge and experience I have. I know there are people who disagree with me and I’m fine with that. How would you solve things? Leave me a comment or answer it on your own blog and leave me a link to your answer in my comments.

Tomorrow or Tuesday, I want to tackle the comment left for me on Friday by Thomas of Listening for the Shepherd because it offers some insight into some problems in the system.