Where is taxpayers money going?

As the textbook mentions, America’s population is growing older. Population in prime working years is likely to fall from 62% today to 58% in 2030, meaning more people will be dependent and in need of services. The shrinking proportion is likely to compromise taxpaying wage or salary earners. How to continue to finance social security and medicare will remain a big concern. An already existing issue is whether or not the government should even be giving these kinds of handouts. However, the voting power of the elderly makes it difficult for elected officials to reduce social insurance programs for Americans who are older than 65. This means that there will continue to be a big tax burden on the workforce.

An article recently published in the New York Times says that “States reported spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries, an average of more than $30,000 a person”. However, it seems to be unclear how these Medicaid beneficiaries are being treated. This industry is handed billions of dollars yet operates under “vague standards” and “limited supervision”. In assisted living facilities, states are required to report cases of abuse, neglect, exploitation or unexplained death of these Medicaid beneficiaries. However, over half of the states did not keep track of these cases. Of the 22 states who did provide a report, there were more than 22,900 incidents of “physical, emotional or sexual abuse of residents”. People in assisted living are generally vulnerable with physical or intellectual disabilities. These people are being taken advantage of.

The Centers for Medicare and Medicaid Services homepage of its website states “We pledge to put patients first in all of our programs”, however it seems as though their patients are no longer their main priority. The lack of federal oversight is quite concerning because as taxpayers, it is unclear where exactly our money is going in regards to this funding.

As the population continues to grow older, the need for this Medicaid assistance will also grow, but how are we supposed to know that the elderly population are properly being taken care of? Or that the taxes we pay are actually going to their healthcare? As the numbers rise, the more difficult it is to keep track of this sort of information, and the easier it is for corrupt practices to be unaccounted for.

This is not an issue than can be swept under the rug, as the government and government services are not doing their job. Stories like these are what feed Americans distrust in the government that the textbook mentioned. This distrust seems somewhat backwards. Americans expect the government to provide Social Security and Medicare but “even when they support particular government programs, they worry that government is getting too big, too expensive, and too involved in running things”. However, in this recent case, the main problem seems to point to the lack of government interference in the regulation of the funds. Do American’s even know what they want anymore? Or are there too many issues circulating that it would be impossible to stay consistent with one viewpoint?

6 Responses to "Where is taxpayers money going?"

Abigail Belcher says:

February 11, 2018 at 11:16 pm

Sophia,
I think that it is difficult for the government (or even ourselves) to understand what the people want when our ideas and views of our tax dollars and where they are going differ due to our own personal situations. There has also been a lot of discussion (as well as episodes on shows like Law and Order) about the terrible way that older people are treated within senior care facilities. This, to me, seems like the most important issue that needs to be resolved. And, perhaps I should say, the easier of the two issues (the other issue being where our taxes are really going) as well as the most important in my opinion. Older people who are unable to mentally and/or physically take care of themselves should not have to worry about an employee at their facility taking advantage of them due to their inability to understand their surroundings. I believe part of a solution could be to start by intensely screening all applicants who wish to work in these senior care facilities (background checks, family/ work references, multiple years of experience working with other people, etc.). Also, the government should enforce frequent visits within these facilities, maybe even undercover visits to help put a stop to the horrific behavior some of the employees exhibit when they think no one is watching.
Virginia Myers says:

February 12, 2018 at 12:09 pm

Dear Sophia,

Thank you for your post reflecting on taxpayers money, what we expect from the government, and Americans’ distrust of the government’s spending habits. The concern you raised regarding the mistreatment and abuse of elderly people in care facilities supported by Medicaid is startling, and the statistics (22,900 incidents filed) is alarming. The rising cost of healthcare is hurting everyone, which is why we need coverage for the elderly and low-income families. The more resources people have, the more pressure care facilities will feel to provide good care or else people will leave cheap, abusive homes and demonstrate their disapproval with their wallets. Thus, it is critical that the government enforces frequent visits to these facilities to ensure these people are living in healthy and safe environments. As Abigail mentioned in her comment above, it is challenging for the government to spend in a way that addresses all of our individual issues, since every individual aims to change different areas. As we discussed in class, so many factions exist because they each have a unique, common goal they want to change or address. Thus, how is it possible for the government to make all Americans satisfied and make Americans trust them when there are so many opposing views at play? The Center on Budget and Policy Priorities lays out the major areas the government spends the money it collects. However, we are left with very little information regarding how the money is spent in each main area. Perhaps it would increase trust between citizens and the government if they first, made an effort to publicly acknowledge all different groups’ and factions’ interests and desires and second, provided more details about where federal tax dollars go.

https://www.cbpp.org/research/federal-budget/policy-basics-where-do-our-federal-tax-dollars-go
Isabella Brown says:

February 12, 2018 at 10:50 pm

Sophia,

Thank you for bringing this up this topic. I personally do not have any relatives in assisted living facilities, so this is an issue that I was not aware of. However, after reading your post and doing some research, I was astounded by how severe of a problem this is, and that it is not getting the attention that it deserves. I think that every citizen can agree that when they pay their taxes, they do not want their money to support the continued mistreatment and abuse of people being supported by Medicare, and that when they themselves grow older they do not want to be subjected to this kind of lacking care. It’s when cases like this come to light that people’s trust in the government wavers, and with good reason, as the government is failing to do its job of serving its people. I agree with Abigail in calling for reform with how these facilities are run, as well as enforcing stricter rules and on the staff, and frequent checkups to ensure that the facilities are running correctly and efficiently.

An interesting proposal came up in Florida that advocates for resident’s rights. It proposes for residents to be treated “courteously, fairly and with the fullest measure of dignity” as well as a safe environment to live in. It also guarantees residents the rights to “access courts, have speedy trials and sue without limitations for damages.” If the proposal is approved, then it would be voted on in November. I think that this proposal is a great step in the direction of improving and reforming assisted living facilities, as it guarantees protection of the residents’ rights, as well as assisting them in case something does go wrong. Assisted living facilities will also be pushed to clean up their act and provide better conditions for their residents. This is an issue that needs to be fixed, and hopefully we see more proposals like this emerge around the country.

http://www.orlandosentinel.com/news/politics/political-pulse/os-nursing-home-watch-list-proposal-88-story.html
Hannah Grow says:

February 13, 2018 at 12:31 pm

Sophia,

Thank you for this compelling articulation of the lack of federal regulation of funds with specific reference to the treatment of Medicare patients. I completely agree with your sentiments regarding the contradiction that lies in the American people wanting help from the government while also complaining about the government being too “involved.” This caught my attention because a relative of mine is currently in assisted living thanks to Medicare after a stroke that left her with a disability, and I was unaware of the poor treatment that was going on under Medicare’s supervision. The Trump administration is currently advocating to cut Medicare funds in an effort to push people to seek employment, which will arguably help promote better health physically and emotionally and would decrease the need for Medicare overall. Its incredibly easy to see the two sides of this argument especially when you know someone benefitting from Medicare, however, when the poor treatment and exploitation of patients comes to light Trump’s arguments are more logical and justified. It serves absolutely no purpose to taxpayers or beneficiaries of Medicare to continue dedicating funds to a cause that is causing more harm than good. The government needs to either dedicate more resources towards ensuring proper treatment of Medicare patients under strict surveillance or the program should be altered so that resources are not being wasted on services that are doing more harm than good.
Elizabeth Curland says:

February 13, 2018 at 1:24 pm

Sophia,
I really enjoyed your post – specifically, it’s relation to this topic of “government distrust”. As we’ve spoken about in class, American’s tend to look to the government for aid in our lives, but fear and distrust the government being too pervasive and powerful.

When writing the Constitution, the Framers never imagined our Government carrying the level of responsibility it has today. To name a few – fixing our economy, providing Medicare and Social Security, and dealing with environmental issues – are all issues that are not covered in our U.S. Constitution, yet the Government still deals with these issues. So to turn to the Government and expect them to provide such services like Medicade, but also mistrust and criticize the government for being too pervasive and powerful, is extremely hypocritical.

However, our tendency to distrust the government is one of the core beliefs that underly our American political culture – and that’s something that’s hard to change or ignore.
Santiago Rivas says:

February 14, 2018 at 10:14 pm

Sophia,
First of all, I liked the issues that you mention in your blog post and the three problems that the American society is facing when referring to this topic. Now what I see throughout the issue is that one factor feeds the other further, meaning that the American people have lost track of what they really want and need, because they feel that their taxes are being mishandled due to the mistreatment of the elderly in these programs. Maybe these issues are not three separate circumstances, but one deriving from the other and this could provide both, the government and the American people a way to solve it. If this is the case, a step by step analysis of the situation is needed, and this cannot be done unless all states are somehow forced to provide with the information only 22 states are reporting at the moment. So maybe that is the optimum place to start fixing the issue and understanding the problem, with having all the states report on these programs. However, because of the mistrust in the government, this can be difficult to enforce, causing this issue to become a vicious cycle.

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