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Poverty is Still a Dirty Word in America
By Earl Ofari Hutchinson
The figure on real poverty in America is far worse than the Census Bureau recently reported. It found that nearly 40 million Americans are living in official poverty (less than $22,000 for a family of four). This is an 11 year high.
The Bureau figure does not take into count the number of persons tossed into poverty in the past year; the worst year so far of the recession. It also undercounts real unemployment. Officially nearly 10 percent of Americans are unemployed. Economists say that if seasonal and discouraged workers are counted the real unemployment figure exceeds 16 percent. As always, blacks and Hispanics have by far the highest poverty rate. Despite the massive economic hardship, poverty is still a dirty word. Politicians, much of the media and the public have largely ignored the crisis.
There was a brief glimmer of hope during the presidential campaign that top Democratic presidential contenders Barack Obama, Hillary Clinton and John Edwards would put the fight against poverty on the front burner of their agenda. The three contenders thundered in speeches in April 2007 that America had failed the poor and especially the black poor. With the exception of Edwards, whose candidacy soon disintegrated after public revelations about his love tryst, the candidates didn’t utter another word about poverty for the rest of the campaign.
President Obama and most leading Democrats have been closed mouth on poverty for a reason. The poor don’t have an active and viable political lobby to fight for their interests. The sole exception to this was a brief moment during the 1960s when Dr. Martin Luther King, Jr. launched his Poor People Campaign.
However, King was murdered and his dream of uniting the poor quickly fell apart amidst organizational and personal squables and disorganization. A small band of anti-poverty groups and organizers did shout, cajole, and actively lobby for a major expansion of anti-poverty programs, funding, and initiatives to reduce poverty in the nation. They attained some success in getting funds and a few new programs, but it didn’t last. The anti-poverty crusade quickly fell victim to Lyndon Johnson’s Vietnam war ramp up, increased shrill attacks from conservatives that the war on poverty was a scam to reward deadbeats and loafers, and sharp budget cutbacks.
By the close of the 1960s, poverty had not only disppeared from the nation’s table, it again became a dirty word. The poor became a political embarassment. Their existence flew in the face of the embedded laissez faire notion that the poor in America aren’t poor because of any failing of the system, but because of their personal failings. Conservatives vehemently oppose spending endless dollars on job, skills training, education, health and expanded child care programs to assure jobs for all. The widespread view that government should play a minimal role in assisting the poor has crept through in President Obama’s speeches and talks in which he touts personal responsibility as the key to uplift.
Obama’s economic stimulus plan didn’t earmark any dollars specifically for anti-poverty programs or projects. There is no indication that Obama or Congress will propose any new initiatives or increased funding specifically targeting chronic minority unemployment or for low income family support programs.
There’s yet another reason Democrats have made poverty a dirty word. In two failed presidential jousts with Bush, Democratic presidential candidates Al Gore and John Kerry figured that the only way they could win was to out Bush Bush. That meant talking and acting tough on national security, the war on terrorism, and greater defense spending and preparedness, adopting bland positions on health care, and social security that appeal to the white middle-class, and saying as little as possible about poverty. The Democrats trembled that such talk would only stir up white anger by reinforcing the old perception that Democrats tilt toward minorities.
Obama, Clinton, and Edwards briefly talked about the plight of the poor for a couple of reasons. Bush wasn't running again. So terrorism wasn't the big trump card issue for the Republicans in 2008. Black and Latino political activists also pounded on the Democrats after the Katrina debacle to make poverty an issue that. But that was two years ago. There’s little pressure on Obama and other Democrats now to speak out about poverty. With Obama and the Democrats locked in a hard battle over health care reform and the economy showing only weak and sputtering signs of recovery, there’s even less sense of a need let alone urgency for the White House and Congress to specifically address the problems of the chronic poor.
The poor, however, aren’t going away. Their numbers are likely to grow. Eventually that may force Obama and the Democrats to do something they haven’t done in decades, and that’s take the dire plight of the poor seriously. There’s nothing dirty about that.
Earl Ofari Hutchinson is an author and political analyst. His forthcoming book, How Obama Governed: The Year of Crisis and Challenge (Middle Passage Press) will be released in January, 2010.
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Drug Switching and Health-Care Disparities: Are You Being Put at Risk
By Gary Puckrein, PhD President and CEO, National Minority Quality Forum
Most medical authorities believe a patient’s needs should be uppermost when writing prescriptions. The patient’s physical status and the best available drugs can be matched, assuring the best treatment.
Regrettably, the growing practice of so-called ‘drug switching’ is putting patients at continuing risk. Drug switching is nothing more than a financial incentive, promoted by some pharmacy companies, encouraging physicians or pharmacists to use a different drug in the same therapeutic class.
This could mean the substitution of one brand-name prescription drug for another brand-name prescription drug, of a generic prescription drug for a brand-name drug, or of an over-the-counter (OTC) drug for a brand name or generic prescription drug.
It’s unethical. It’s unsafe, and it needs to stop.
More often than not, drug switching is a financial decision and has nothing to do with how effective a drug might be. The American Medical Association’s Council on Scientific Affairs confirmed this fear in 2004 following a lengthy investigation.
The report, issued in response to physicians concerns of the trend, stated that “drug formularies employed by pharmaceutical benefits managers (PBMs), health plans, insurance companies, and other third-party payers in ambulatory settings focus primarily on controlling costs rather than on improving the quality of care...”
It should come as no surprise that health plans implementing drug-switching programs often do not routinely monitor treatment outcomes, contributing to disparities in the quality of health care and health status among the most vulnerable.
For most of us, our ability to pay for prescription medications is a function of the options available through our health insurers. The care we receive must give us the best chance for successful treatment and must not be constrained by our ability to pay.
Do not hesitate to ask questions of your physicians or insurance companies, and insist they answer in a way you can understand. You will not embarrass anyone with questions. Indeed, you will clearly demonstrate you are an informed partner in your care. Demand to know of any cost-driven limits on your health-care that are being imposed upon your physician by your insurance company.
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