Tag Archives: medicaid

Harlem’s Extreme Version of The Welfare State

I met “Danny” and “Keisha” in the Jackie Robinson Park at 145th and Bradhurst, in Harlem, where they were hanging out with Keisha’s four year old daughter, and their nephew, who is two, on their day off from work. Danny works in demolition, Keisha is a dental tech in a dental office in Manhattan. To my surprise, they agreed to talk with me, though both were adamant: “No names, no pictures, no videos!”.

Danny is a tall, lanky, energetic young man, dressed in typical ghetto gear; baggy pants showing boxers, baseball hat on backwards, white undershirt, tattoos, chained wallet – who spent much of the visit alternating between chasing Keisha’s daughter through the playground equipment and sitting and telling stories.

He is gregarious and sassy, in marked contrast to his girlfriend, who is quiet, polite, and sits still as stone on the park bench beside me, considering each answer with care, and seldom showing much emotion beyond a gentle smile. In their early twenties, they both graduated from local high schools and have lived in Harlem their whole lives, though Danny has done some traveling and is interested in the idea of moving elsewhere. Keisha is Harlem through and through, loves New York, has only been across the river to New Jersey a few times – other than that, she has spent her life here in Harlem, and has no interest in moving.

Asked about welfare, they give me the same response I have heard many places this summer – first they say they only get food stamps. Then, they mention that the kids get free meals at school. Then they mention that they have the free cell phones they get for qualifying for welfare. Then they say, “Oh, yeah, I have the Medicaid card”, and then finally, yes, they do live in subsidized housing as a matter of fact.

I can’t tell if it is willful lying, or just a lack of understanding that all these programs are part of a vast entitlement system that subsidizes their entire lives, from cradle to grave. I certainly find myself wondering how many people don’t really consider any of these programs welfare programs. Indeed, Danny and Keisha think they are entitled to them in the true sense of the word entitled: to “Give (someone) a legal right or a just claim to receive or do something.” When asked about each program, their reply is “Well, I need it, I can’t do it on my own, so New York needs to take care of me.” They don’t have any concept of the difference between federal and state and local programs, though they do understand that there is quite a bit of overlap, and some ‘needs’ are met by overlapping offices (housing, for example, can be provided through either HUD (federal) housing vouchers, or through programs provided by the city of New York).

Once we started talking about fraud and abuse in the system, things really got interesting, and this is when I realized that  New Yorkers really do master everything they do, whether it is money making on Wall Street or money taking in the ghetto (though some might argue that both are ‘takings’).  Whereas elsewhere in the country food stamp recipients sell their food stamps for fifty cents on the dollar, here in New York food stamp recipients go to grocery stores, find people with full grocery carts, and negotiate what the buyer will pay for the food stamps, usually seventy cents on the dollar. As Danny said “You a FOOL if you’re paying full price for groceries, lady, when you can get instant 30% off just by using someone’s food stamps! Why would you do that? You stupid?”… Why would I do that? Food for thought!

As for health care, whereas in other parts of the country people hide income and assets to get on medicaid and medicare, here in New York people just pay medicaid card holders to borrow their ID cards, and go to the doctor with other people’s cards, so one medicaid account might be covering medical care for several people. Housing? Well, here in New York people rent out their HUD subsidized housing and take the money and go live elsewhere, in nicer neighborhoods.

You almost feel a grudging respect for these New Yorkers, who have taken gaming the system to the nth degree. I mean, frankly, you have to admire their gumption, right? But  given the population of New York City (eight million people and climbing) and the number of people involved, the cost of their creativity comes at a shockingly high cost to us all.

Mom on Disability Wants to Leave a Legacy

“Julie” was my final interview in Decatur, and weeks later I remain deeply touched by her story.

What makes Julie’s story unique is that she is dying, of a rare and incurable disease, with a life expectancy of two to three years. What makes it more unique is the choices she is making with that knowledge in hand. Rather than sitting back and letting fate have its way with her, she is determined to shape her own destiny until the very end. That destiny, for Julie, means achieving what has become her life’s passion and goal: leaving her child with the memory of a mother who worked, and made her way in the world, and provided for her.

It is not going to be an easy road, because her way is blocked by the very system that should be helping her. Because she is on TANF, she is required to participate in workfare full time. But, because she is sick, she cannot work the full time schedule required of her, and there is no flexibility for women like her who want to work, but aren’t healthy enough to work full time. In her case, her physician has indicated that she should be on permanent bed rest.

Due to her illness, she will soon be put on disability (SSI). Once that happens, she will be forbidden from working at all – in fact, her doctor has already insisted that she can’t work, although she desperately wants to, and can do so, on her good days.

And so Julie has come up with by far the most creative use of disability benefits I have ever heard – and something policy-makers should hear about as they ponder the wisdom of SSI’s impediments to working. First, she is going to take business classes at the local college, so she can learn to run a small business. Then, Julie plans to take her disability payments, save as much as she can, and open her own in-home business.

That way, she can work her own hours, thereby insuring that when she isn’t well enough to work she won’t be fired. That way, her child will be able to see her mother working for their future, and hopefully be inspired to be independent herself. And that way, when she leaves the world  and her child behind, she leaves memories of a mom who worked to make their lives better, in the face of truly daunting odds.

While we can be thankful that there is a safety net out there for people like Julie we should also question its efficacy; if she wants to work, shouldn’t our goal be to help her do that, instead of relegating her to her bed?