A family friend recently wondered why there is a social stigma attached to Medicaid that there isn't to public school. He asserts that they are both programs provided by the government, so why is one (public school) acceptable and the other (Medicaid) unacceptable? Personally, I think that there are a number of complex issues at play here. So I thought I'd share some of my thoughts — and hopefully get some of yours.
Right v. Privilege
In 1948, the U.S. agreed to the Universal Declaration of Human Rights, which stated that primary education was a right. (It is worth noting that, according to the Constitution, a treaty or agreement entered into and ratified by Congress is, in fact, also the law of the United States.) However, the idea of compulsory education has been around since the time of Plato, who first popularized the idea in his famous work, Republic. The Aztecs required education for their children, and the Talmud praises formal education. In Great Britain (especially Scotland), there is a long history of a requirement to attend school. Even Martin Luther advocated for the education of all. We have a long history in Western though of viewing education as a right — even for those of little monetary means.
For some reason, though, health care is considered a privilege. Health care is something that not everyone has the right to in our society. Only the rich have historically had access to good health care, and that continues today. In a way, the idea that some groups of people get health care for free — because they can't afford it — is repugnant to a society that is used to thinking that health care is a privilege, and something that you should pay for.
Who pays for what: Public school is free for everyone who wants it
It is also worth noting that everyone can have access to free education. This is what makes public school something that is not looked down upon. (Private school is considered even better, since it is something that you pay for, and therefore “extra”.) Not everyone gets access to free health care. Therefore, if you are using it, you are taking advantage of something that not everyone can use. If you choose not to take advantage of free public education, either through home school or paid private school, that is fine — everyone else still has the option of free public education for their children. However, if I want free health care, I can't have it unless I make less than a certain amount of money. I think that there is a degree of resentment amongst the middle class especially with regard to Medicaid. These folks work hard, pay their dues and have to pay out the nose for something that others get for free. I think this particular grievance goes a long way in explaining some of the social stigma attached to Medicaid.
Priorities: For some reason, health care just isn't a priority
We decided a loooong time ago, as Western civilization, that an educated citizenry was desirable. In a democracy, if you are going to let the people have a voice, you want the people to be educated to a certain degree. All arguments about the quality of public education aside, the idea is that a basic education is needed to participate in the opportunity that is America. If anyone can be president, that anyone should at least be educated. If anyone can vote and if anyone can legislate their views, you want those anyones to have a certain degree of education.
Health care, on the other hand, just doesn't get the same sort of priority. It doesn't really bear directly on how we participate in our democracy. I think it's ridiculous, and I think that a healthy citizenry should be a priority. Besides, we could dramatically reduce health care costs if some version of universal health care (like what Romney introduced in Massachusetts) were adopted. Preventive health care would be much more in vogue if people weren't concerned about getting charged an arm and a leg in insurance premiums for going in before the problem got much worse (and more costly). Since health care isn't a priority in our society, it retains the status of privilege, leading some of those who have to pay for health care to look down on those who don't.
What do you think? Do you think there is a social stigma attached to Medicaid? Why do you think it's there?