David Brooks and the Federal Government's $14,000 Per Year Per Poor Person
Of course if New York times columnists were expected to be accurate when they talked about government programs, Brooks would have been forced to tell readers that around 40 percent of these payments are Medicaid payments that go directly to doctors and other health care providers. We pay twice as much per person for our health care as people in other wealthy countries, with little to show in the way of outcomes. We can think of these high health care costs as a generous payment to the poor, but what this actually means is that every time David Brooks' cardiologist neighbor raises his fees, David Brooks will complain about how we are being too generous to the poor.
The other point that an honest columnist would be forced to make is that the vast majority of these payments do not go to people who are below the poverty line and therefore don't count in the denominator for his "poor person" calculation. The cutoff for Medicaid is well above the poverty level in most states. The same is true for food stamps, the Earned Income Tax Credit (EITC), and most of the other programs that make up Brooks' $14,000 per person figure. In other words, he has taken the spending that goes to a much larger population and divided it by the number of people who are classified as poor.
If Brooks actually wants to tell readers what we spend on poor people, it's not hard to find the data. The average family of three on TANF gets less than $500 a month. The average food stamp benefit is $133 per person. If low income people are working, they can get around $5,000 a year from the EITC for a single person with two children at the poverty level. (They would get less at lower income levels.)
These programs account for the vast majority of federal government payments to poor people. It won't get you anywhere near David Brooks' $14,000 per person per year, but why spoil a good story with facts?
Folks seem anxious to count Medicaid spending as spending on the poor. That's fine by me. The point I was making is that we pay twice as much as people elsewhere in the world for care that is no better because doctors and other providers get paid twice as much.
That seems worth noting in an assessment of how generous we are to the poor. To take an overblown analogy, suppose terrorists took some number of poor people hostage and demanded tens of millions of dollars for their release. We can include our ransom payments as money spent on the poor and say again how generous we are.
In this case, the folks playing the role of the terrorists in making big money demands are the doctors and other health care providers. In other words, they are David Brooks' cardiologist neighbor who gets well over $400,000 a year in large part due to payments from the government. You're welcome to see this as generosity to the poor, I see it as generosity to David Brooks' cardiologist neighbor.
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