George W. Bush Y2000?

In his "new" fight against poverty, Republican presidential candidate George W. Bush says he will issue a call to America's "armies of compassion" to end poverty, hunger, welfare and crime by donating to charity. The political goal of compassionate conservatism is to separate George W. from the now unpopular politics of Newt Gingrich. But W.'s compassionate conservatism is just a cold Contract on America warmed over.

Gingrich, for instance, preached "we must replace the welfare state" with a "strategy of dramatically increasing private charities." It was Gingrich who idolized author Gertrude Himmelfarb (The De-Moralization of Society) who advocated that the deserving poor should receive goods like socks in place of welfare aid. And it was the Contract (Personal Responsibility and Work Opportunity Act of 1996), which ended poor people's entitlement to public assistance and severed approximately 300,000 children with disabilities from Supplemental Security Income and Medicaid.

George W. has already been using the armies of compassion in his home state of Texas - a state known for having the largest percentage of uninsured and the largest incarceration rate in the country. Gov. Bush has the dubious distinction of having signed the most death warrants for public execution of prisoners than any other governor. Since Texas is a state with no income tax, social services are paid for with charity golf tournaments, telethons, and fund drives. When charities don't raise enough to cover the need, one gets to join the more than 20,000 people who are already on the waiting lists for services there.

What is less known is that Texas has more children living in nursing homes than in any other state. In an era where independent living has been a goal of the disability rights movement, this matter of institutional bias in Texas has people with disabilities (PWDs) rightly alarmed at the prospect of W. making it to the White House. The disability rights movement considers institutionalization a type of wrongful incarceration, and instead advocates that community-based, in home, self-directed personal support services, which are now optional through Medicaid, be made mandatory in every state. The most severely disabled individuals are found on these front lines. Their motto "we'd rather die than go into a nursing home."

Ironically, this movement is about being safe from the care-giving industry. Consumer Reports, for instance, conducted an investigation of nursing homes which concluded that nursing "homes" range from inadequate to scandalous. It reported that about 40 percent of all facilities certified by the Health Care Financing Administration (part of U.S. Health and Human Services) have repeatedly violated federal standards, including critical aspects of patient care standards. The Los Angeles Times reported on a California study which showed that nearly 22,000 nursing home inmates died from preventable conditions such as malnutrition, dehydration and urinary tract infections between 1986 and 1993. The California Advocates for Nursing Home Reform reported in 1995 that 29,652 residents were physically restrained, another 32,103 were administered psychotropic medications, and chemical restraint use jumped 12 percent over 1994. These documented violations directly resulted in 19 deaths and indirectly in another 45 deaths.

Even so public policy remains aligned with institutions. 1970s government adjustments to the Social Security Act mandates states to provide nursing home care as an entitlement but allows in home support services to remain optional under Medicaid. This bias in favor of institutionalization results in a patchy system where some states provide in home service programs while others do not, some grossly underfund theirs and some limit the number of people served. With no national entitlement, disabled people's freedom is at risk because in home support programs are subject to the yearly budget ax. The calculating nursing home industrial complex has steered public policies towards institutionalization and away from citizen-controlled home-based care because institutionalization is profitable for them. Gov. Bush is a benefactor of nursing home support and (surprise!) he has supported institutionalization of PWDs in for-profit nursing homes and state institutions over providing quality in-home care. Ideologically, it is in sync that George W. sides with profiteering nursing homes over in home care that would be directed by disabled persons or that he endorses charity over public entitlement to services. In both matters W. has sided with the interests of capital. Bush tops all opponents in money raised($50 million) from commercial banks, securities & investment, insurance, real estate, and health professionals for good reason.

Disablement is big business and it is a part of the political economy. Under what I call the Money Model of Disability, the disabled human being is a commodity around which social policies are created or rejected based on their market value. The corporate solution to disablement - institutionalization in a nursing home - evolved from the cold realization that PWDs could be commodified; we could be made to serve profit because federal financing (Medicaid funds 60 percent, Medicare 15 percent, private insurance 25 percent) guarantees an endless source of entrepreneurial revenue.

In the macro economy "unproductive" people with disabilities have been made of use to the capitalist order. When one individual generates $30,000 - $82,000 in annual revenues for nursing home corporations the electronic brokers on Wall Street count that person as an asset, PWDs contribute to companies' net worth. Corporate dominion over disability policy measures a person's "worth" by their dollar value to the economy and PWDs are worth more to the Gross Domestic Product when occupying a bed in one of these institutions instead of a home.

W. told the press that if elected, he will dedicate $8 billion during his first year in the White House for tax credits and grants as part of what he calls "a bold new approach" to governing ... enlisting charities and religious organizations to deliver social services. Specifically he would expand the federal charitable deduction to taxpayers who do not itemize, permit a credit against state taxes for contributions to charities addressing poverty, raise the cap on corporate charitable deductions from 10% to 15% of a company's taxable income. But what he is proposing is to further serve the financial interests of the same old bastions of elite power and privilege.

Nonprofits and charities create an illusion that they are mending the holes in our social fabric. By donating tax deductible dollars, the rich appear to be generously concerned about the plight of the poor. However behind the benevolent front there is an enormous hoarding of wealth. Left Business Observer editor Doug Henwood says "in economic terms, the larger nonprofits could be thought of as giant stock portfolios, often with marketing operations grafted on." For instance, in 1995, the nonprofits held assets $1.2 trillion, of which $414 billion (or 35%) is in bonds, and $295 billion (25%) is in stocks. Henwood concludes "the nonprofits have a significant impact on Wall Street."

Jerry Lewis understands the Wall street connection. When Evan Kemp, then head of the E.E.O.C, criticized the Muscular Dystrophy Association, Lewis told George W.'s father, then President Bush to "act to protect and preserve the invaluable American private-sector institution. . .with a categorical disavowal of Mr. Kemp's assault on MDA"; the sacrosanct MDA private charity business complete with its financial portfolios and real estate holdings.

Nonprofits are managed independently, primarily by the wealthy elite, and they do not pay income taxes. In 1997 the total revenues of Operating Public Charities in the United States was $649 billion, about 12% of the GDP, none of which was taxed. Roughly one third of every dollar donated is subsidized by the federal government. That means public revenue which could be going to the public's welfare is lost to nonprofits. For example, Gregory Colvin, an attorney specializing in tax law calculated that "the $1.5 million raised and spent through the Kennesaw State College Foundation... could translate into a Treasury loss of about $500,000 in tax savings by Gingrich's donors." By giving other tax breaks and government dollars to charity, W. will be steering money from democratic entitlements into the hands of charity portfolio managers.

In addition nonprofits often serve as suppliers of services to the middle and upper-class in echo of the old conservative mantra of tax credits for charitable donations - such a credit benefiting wealthy donors rather than nonprofits themselves. The Kennsaw State College Foundation, for example, had nothing to do with serving underprivileged populations, rather it was a forum for Gingrich to spread his politcs. Country clubs are often formed as nonprofits, but they cater mainly to the upper class's luxurious lifestyles.

In this light George W's proposal is questionable, because giving is a negligible revenue source in social service (20%), education (15%) and health care (5%) as compared to, say arts (50%). Moreover, most individual giving in the US concentrates in religion (approximately 60% of all charitable giving in the US). Yet W. plans to establish an "Office of Faith-Based Action" in the Executive Office of the President and to expand "Charitable Choice" to all federal social service programs, allowing religious organizations to be eligible for funding on the same basis as any other provider, without impairing their religious character. Further, he intends to provide federal matching funds for the establishment of state offices of faith-based action.

W's idea of subsituting grants for entitlements is not "new". Reagan had ambitions of turning the welfare system into grants to local groups dedicated to self-help for the poor. Gingrich tried to undo federal entitlements by turning Medicaid into state block grants with no strings attached as to how the money could be spent. One can guess, the amount spent in this "new" system would not be likely to equal the previous amount under a Federal entitlement.

The main disadvantage to service recipients of the nonprofit approach, sometimes referred to as "mellow weakness" (Seibel, W., 1989, The function of mellow weakness: nonprofit organizations as problem nonsolvers in Germany, in James, (ed), The Nonprofit Sector in International Perspective, Oxford) is that nonprofits are often used as a smokescreen for government agencies to discharge its public responsibilities while creating an appearance that something is being done. That is, instead of a well-funded and comprehensiove program to solve a social problem, governments often dole out money to nonprofits to merely tackle it.

Of significance to the future of in home support services, W. says he will promote alternative licensing regimes that recognize religious training as an alternative form of qualification for delivery of non-medical social services. Attendant services, which assist PWDs with cooking, dressing, transferring from bed into a wheelchair, are non medical services. The upshot of George W. getting elected in Y2000? Prepare yourselves to GO TO CHURCH TO GET AN ATTENDANT! No matter that no one is entitled to receive any service from a charity, much less service that is timely or competent. Under W.'s leadership, it is likely that more PWDs will end up in nursing homes.

Serving up charity as the answer to social ills is not singularly a GOP tact. Liberals, seemingly ignorant on economic justice, have historically embraced the charity paradigm. Neoliberal President Clinton advocated a greater role for charitable organizations during welfare reform. He urged each of the 135,000 churches, synagogues and mosques that have more than 200 members to hire one person coming off welfare. Three years later studies show that welfare reform has done nothing to reduce poverty for women and children; to the contrary, indicators are that it has increased it. Presidential candidate Al Gore joined with traditionally Republican territory in May when he said America must "dare to embrace" religious programs and called for a "new partnership" between church and state.