Citizens who receive governmental aid under the Temporary Assistance for Needy Families program in Kansas will probably want to move to another state. When Kansas Gov. Sam Brownback signed House Bill 2258 into law last week, he made it illegal for TANF enrollees to spend their benefits on alcohol, professional or collegiate sporting event tickets, body piercings, movie theater tickets, lingerie, dog or horse racing facilities, psychics, and jewelry store purchases.
This list represents just a fraction of H.B. 2258’s spending restrictions, which are strangely specific. Apparently, Brownback believes the poor should be allowed to spend their money at golf courses but not theme parks. They can spend their cash assistance at ski resorts, but they are barred from using it at swimming pools.
So, since the Kansas Legislature has effectively decreed that welfare recipients are no longer allowed to have fun, it is in the best interest of TANF enrollees to get out of Kansas as quickly as possible. Unfortunately, H.B. 2258 bans them from spending cash benefits in any state other than Kansas. Even assuming that those on welfare have the financial means to travel outside of Kansas, this provision substantially reduces their ability to leave the state for even brief trips.
The law also limits cash withdrawals from ATMs to $25 per day, which places an unreasonably heavy burden on anyone who, you know, pays for things in cash.
On a most basic level, H.B. 2258 is stupid and unenforceable. But more importantly, it is an outrageous affront to anyone who receives government assistance. It assumes that TANF enrollees are wasteful spenders who do not know how to manage money responsibly. It further perpetuates the wrongful notion that welfare recipients have the luxury of choosing to spend money on cruises and casinos rather than food and rent. Finally, it suggests that the poor are somehow less deserving of pleasure and enjoyment than the wealthy.
In 2013, the U.S. Bureau of Labor Statistics published a study that compared the spending patterns of families receiving means-tested government assistance to those not receiving assistance. The results indicated that families receiving assistance spent 77 percent of their total income on food, housing and transportation. Families not receiving assistance, in contrast, spent only 65.5 percent of their income on these items. Moreover, the study revealed that the total expenditures of families not receiving assistance were, on average, double those of families on welfare.
The BLS publication thoroughly discredits the myth of the lazy, tax-wasting welfare recipient, as do other similar reports. Statistics show that families enrolled in programs like TANF do not spend the majority of their income on the goods and services listed in H.B. 2258 — but, rather, on necessities such as nutrition and health care.
If Kansas wants to limit how its welfare recipients spend money, it should impose the same restrictions on people who receive governmental aid in other forms. State legislators, for example, whose salaries are fully funded by taxpayers, should be subject to the same spending guidelines. After all, they weren’t elected to go swimming or watch movies.
Although it was passed in Kansas, H.B. 2258 seems like just the type of law that the Arizona State Legislature loves to enact. Hopefully, Gov. Doug Ducey and his puppets on Capitol Hill will demonstrate respect for those who receive government benefits by refusing to follow in Kansas’ footsteps.
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Elizabeth Hannah is biochemistry sophomore. Follow her on Twitter.
Credit: P Bibler on Flickr, under Creative Commons
BEIJING (WOMENSENEWS)– Such was the media frenzy after the death of 33-year-old Chinese pop star Yao Beina from breast cancer this winter that one team of reporters donned scrubs and snuck into a hospital morgue to photograph her body. They were roundly denounced, but state media, seizing upon the tragedy as a teachable moment, could do little more.
In its coverage of Yao’s death, the staunchly nationalist Global Times spoke with a doctor who admonished women to buy better-fitting lingerie. An oncologist interviewed by China Daily urged women to probe their own breasts for lumps regularly, though such self-administered exams have only proven effective for women who have been tutored first by a doctor. Even the World Health Organization offered advice that, while solid, seemed closer to common sense than solace: girls and women should lead a healthy lifestyle and breastfeed if possible to lower their risks.
For the vast majority of Chinese women there may in fact not be much more they can do.
While women in the U.S. and Europe are urged to consult their doctors if they discover irregularities in their breasts and to screen regularly once they reach a certain age, such advice does not easily translate.
Doctors are in short supply here and mammograms have proven less accurate at detecting cancers in Asians, whose breasts are smaller and have denser tissue than other women’s. Even with adequate detection, China’ hospitals are ill-equipped to handle the upsurge in breast cancer.
A review of research on breast cancer in China published in the Lancet last year concluded that detection, diagnosis and treatment for breast cancer “urgently need to be improved.” Misdiagnosis, long wait times, drastic surgeries, excessive chemotherapy and, perhaps most important, catastrophic expense lead many to avoid detection in the first place, often seeing it as little more than a death sentence, the review found.
Breast cancer is one of a roster of non-communicable diseases that have surged with China‘s economic development, bewildering a health care system already understaffed, overly centralized and prohibitively expensive. Efforts to raise awareness have largely failed to convey useful knowledge. And reforms to the system, while dramatic, have done little to ease access to screening and treatment; they may have made the situation worse.
New Disease Burden in China
“China is facing an epidemiological transition with non-communicable diseases replacing infectious diseases as the leading killer,” Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations told Women’s eNews in an email interview. “But the country’s development model, the governance structure and the health system are not ready to handle the changing pattern of the disease burden.”
Breast cancer is the most frequently diagnosed cancer in Chinese women, with an age standardized rate (ASR) of 22.1 cases per 100,000 people, according to GLOBOCAN estimates from 2012.The incidence is low relative to the United States, where the ASR was 92.9 cases per 100,000 people in 2012, but that is changing.
Since 1990, the number of new cases detected has been growing at twice the global rate. By 2010, China accounted for 13 percent of newly detected breast cancer cases around the world with about 208,000 new cases, according to data from China‘s National Office on Cancer Prevention and Control.
Much of that growth was in cities. Urban women are twice as likely as rural women to be diagnosed with the disease. The cancer is more commonly found in wealthy than in poor women. It’s likely that many rural cases are never recorded. Hospitals are scarce in the countryside and people tend to shun those that do exist, choosing a faraway city hospital if they go to one at all. But modern city life, where people eat more and move less and do so amid a haze of pollutants and where women tend to wait longer to have fewer children, is itself thought to accommodate the disease.
Campaigns to raise awareness about breast cancer have brought a human face and, perhaps, even a glamorous aura to the disease in this country, where the disease affects women with a median age nearly 10 years below that of women in the West (in China the mean age at diagnosis is 45 to 55 years old). But it hasn’t done much beyond that.
As an ambassador for China‘s Pink Ribbon Campaign Yao, the pop star, had posed nude after a 2012 mastectomy, described the scar on her left breast as a “badge of honor” and topped the charts with a spunky survivor’s anthem. She was slight and luminous with a girlish quality that belied a powerful voice. She sang “Let It Go” for the Chinese language version of Disney’s 2013 animated blockbuster movie “Frozen.”
One survey of women in Eastern Chinafound that while a majority of women knew of the existence of breast cancer, few understood risk factors or symptoms. For example, 70 percent did not know whether family history of the disease was a risk factor and nearly 60 percent were unaware that a lump could be a symptom of cancer, according to the study, which was published in BMC Public Health in 2014. Even fewer women knew about the risks of long term hormone replacement therapy or symptoms like discharge and sunken nipples.
In 2009 the government began to roll out broad insurance schemes for the poor and ordered companies to insure workers. At the same time it has encouraged private investment in hospitals and throughout the health care industry and eased the entrance of foreigners into the sector, in the hopes that competition will improve care and lower costs.
By 2011, health insurance coverage had climbed to 95 percent. While broad, coverage is fragmentary and shallow. State insurance for the poor provides less than $70 a year. Employer-provided coverage varies. In his annual work report earlier this month, Premier Li Keqiang promised to implement a scheme for universal coverage for major diseases, including breast cancer.
But the costs that patients will cover with that help — between 10 percent and 30 percent — are still too much.
Largely because the cost of patented drugs remains prohibitively high, less than half of patients with metastatic breast cancer receive a second round of chemotherapy and only a quarter are treated with a third set of chemotherapies, according to 2011 research published by Kantar Health, a U.S.-based firm that does market research for pharmaceutical companies. Furthermore, patients are far more likely to be treated with toxic chemotherapy than with newer drugs that target cancer cells, Linda Zhao, director of clinical and scientific assessment at Kantar told Women’s eNews in an interview.
Streamlining the approval of new drugs and capping prices could bring “landscape change,” Zhao said.
Huang, from the Council on Foreign Relations, was less optimistic. While China set about its most recent round of health care reform in 2009, a year before U.S. health care reform became law, rising prices mean that care is no more affordable than it was in the past.
Huang fears that reforms are heading toward a two-tier system: one for women who can afford treatment and another for those who cannot.
“Inequalities may continue to exist if the benefits offered by the state schemes become an inferior good only consumed by the poor and the marginalized,” Huang told Women’s eNews. “By maintaining an extremely fragmented system in health insurance coverage, with different benefit packages accorded to different segments of the population, the new health care reform to some extent reinforced the problem of inequality in accessing care.”
