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The Common Good: Social Welfare and the American Future
at least the poorest of the poor.
(This will be discussed in more detail in the section on welfare
later in this chapter.)
Medicaid
coverage should not be limited to those who receive cash welfare
assistance. Federal law now permits states to extend Medicaid
to people who live below the poverty level but do not receive cash
assistance; the new welfare reform law mandates a year's coverage
for those who are just off the welfare rolls. Beyond this, special
emphasis should be placed on extending Medicaid, without time
limitations, to people who are poor, categorically ineligible for
cash assistance, and not working enough hours or weeks to qualify
for the mandated coverage specified above.
Medicaid
should place more emphasis on early treatment and preventive health
care.
Redesigning Unemployment and Welfare
Programs
For people of
working age, two basic components of the income-maintenance system
are Unemployment Insurance
(ui) and Aid to
Families with Dependent Children
(afdc). Both were
initiated in the mid-1930s under conditions that were very
different from those of today. These programs should be
fundamentally reoriented to reflect present economic and
demographic circumstances.
Instead of
enhancing employment opportunities and real social protection, both
ui and
afdc have evolved
into systems that too often involve no more than income
maintenance. Neither program places enough emphasis on training and
retraining people to develop skills that are needed in today's
labor market. At the same time, both programs provide cash benefits
that have eroded in real terms and that vary widely from region to
region, so that benefits in some states are simply too low. Both
programs should be redesigned to do the following: first, provide
more adequate short-term income support for assistance between jobs
and for training people for long-term participation in the labor
market; and second, offer greater incentives for people to take a
job after this up-front investment is made.
Unemployment Services.
Although a
growing economy is a prerequisite for ensuring opportunity to the
working-age population, there will undoubtedly continue to be
periods of economic recession and substantial unemployment.
Furthermore, the continuous ebb and flow of economic activity
across the nation means that some