Work, Medicaid and the Ecology of Prosperity

Ecologies are all around us – and not just the environmental kind. So many human experiences are part of ecologies that if we alter Point A, Point Z is impacted. My favorite example is the ecology of freedom. Freedom is best understood as a network of human experiences that, when in equilibrium, we can say justifiably that we are living as a free people.

Individual liberty is not freedom but individual liberty is a part of freedom’s ecology. Without it we are not free but neither are we free if that is all we have. Our freedom is comprised of various elements of our lives such as the ability to transact, the ownership of property, the common good, community and, most importantly, being our better selves.

Among the ecologies with which we are a part, the ecology of prosperity is essential to human happiness. Within this ecology exists a series of interconnected experiences that bond wealth and poverty. Everyone is familiar with the expressions “the haves” and “the have nots.” Nearly universally unfamiliar to us is how those two are inseparably interconnected – not as adversaries but in their complementarity. The ecology of prosperity includes poverty as much as it does wealth. To see these two experiences in mutually exclusive terms wildly disrupts this ecology.

There is no wealth without poverty and vice versa. Life is not that linear. And, even if born with a permanent silver spoon in your mouth, you will not recognize prosperity even if you see wealth all around you. So, yes, second lesson, prosperity is not necessarily the accumulation of wealth. Prosperity involves happiness and your happiness may or may not include where you are in terms of wealth and poverty – precisely because both wealth and poverty are elements in the ecology of prosperity.

Put another way, rich and poor are interconnected and not just by definition. Indeed, the rich and the poor are interconnected through a shared sense of human dignity and wellbeing. If prosperity is ecological, it must be a shared experience. Just the same as in the ecology of freedom, there are no free standing elements. Individual wealth and individual poverty do not stand alone or separate from prosperity. One affects the other. Prosperity is a team sport.

Why is this point important? Because an environment of prosperity must pay as close attention to poverty as it does wealth and, in paying close attention to poverty, we cannot dismiss human characteristics that create wealth. The new Medicaid work waivers are a perfect example of what I mean.

After years of being denied by the Obama Administration, the Trump Administration has begun to approve work waivers requested by states as a part of Medicaid benefits. A big objection to expanding Medicaid under Obamacare was that it did so at the expense of work. Medicaid expansion included non-elderly, non-disabled adults, even childless, with incomes up to 138 percent of the poverty limit. Prior to this expansion, there had been little reason to address any sort of work requirements in the Medicaid program. With the inclusion of able-bodied adults, work requirements now make sense.

Work is not punishment or some sort of conditional quid pro quo. Work is a part of the ecology of prosperity. If we pollute work in this environment, our ecology of prosperity is necessarily impacted for the worse. Work, when able, is a key part of the public safety net – but only understood in these terms if you see prosperity in a context of ecology.

In consideration of the elderly poor and the disabled poor, a work requirement makes little to no sense. Although, in this case, let’s not confuse the value of work with a Medicaid work requirement. Our elderly poor and disabled poor must experience the dignity of feeling needed and work, to whatever possible degree, is an universally essential element within the ecology of prosperity. Similarly, idleness among wealthy people is equally detrimental to their dignity and that, in turn, damages the ecology of prosperity.

Nobody should object to the new Medicaid work requirements when administered flexibly and rationally. Political contention exists when one party insists on rigid work requirements out of some misplaced or perverted sense of reciprocation. That strident tone only activates the anti-bodies of an equally misplaced or perverted sense of entitlement. Seeing work as an essential element in the ecology of prosperity, wherein wealth and poverty are interconnected, puts political contentions to rest, respects human dignity and maintains the proper equilibrium on the path of prosperity.

I’m Paul Mero. Thanks for listening.

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