In King County, over 11,000 people are without permanent homes, almost half living on the streets or otherwise unsheltered. Some have fallen through the cracks of our mental health and drug treatment systems. Some are looking for work, but others have jobs and simply can’t make ends meet. Having worked in Seattle for a homeless services provider and an organization that helps ex-felons transition back to free society, I can think of clients who, at one time or another, have fit into all these categories.
Many people also don’t have access to the health care they need. About 2% of children and 8% of adults in King County lack health insurance, and 10% of adults have unmet health care needs because of cost.
Traditionally, our way of trying to ensure people’s basic needs are met is to develop publicly subsidized mechanisms to fill in the gaps when people’s resources are insufficient to adequately afford housing, health care and other essential needs. Hence the creation of such gap fillers as Medicaid and Section 8 rental assistance vouchers.
But they're not getting the job done. Not only are the gap fillers inadequate, they’re also unjust. They almost always come with income eligibility standards. Resources are dedicated toward those most in need, and there’s a certain logic to that. But those who earn too much and land on the wrong side of the eligibility line may end up not as well off as those who qualify for these programs. For example, recipients of Section 8 housing vouchers, which are limited to lower-income households that have endured a lengthy waiting list, pay 30% of their income in rent. That’s excellent, but 22% of Seattle area renters pay 50% or more of theirs.
Perhaps there’s a better way.
Public elementary and secondary schools are free for all children, and for good reason. We owe all kids a chance to get educated and to begin realizing their potential, regardless of their parents' means. We also recognize that uneducated children will likely become a costly burden on society. At the other end of life, Social Security and Medicare provide all seniors with an enhanced sense of economic security. And while these are benefits based in large part on recipients’ prior contributions, access to a minimum standard is available to all.
The key concept here is universality. If we agree that everyone deserves a decent shot at life, then all of us should benefit from a stronger economic foundation — at all stages of life. Right from life’s beginnings, we should be able to ensure that everyone can meet their essential needs and have a reasonable opportunity to pursue their dreams, recover from their stumbles and live out their days with dignity.
With few exceptions, this foundation should not be provided piecemeal, via a myriad of targeted, gap-filling programs, with the intention of helping the have-nots catch up with the haves. We do better when unencumbered by arbitrary eligibility rules and bureaucratic oversight. And when Americans sense “we are all in this together,” we are more inclined to support each other and maintain the initiatives that support all of us.
So in covering our basic needs, everyone should be brought under the same umbrella. It should be paid for through a progressive tax structure. Those who are financially well off will effectively be paying for their own benefits, as well as subsidizing those with low or modest incomes.
Yes, this is a call for fundamental change, a tall order for a political system designed to favor incremental adjustments. Such a shift in our approach would have significant implications. For instance, it would make the case for a carefully crafted, universal basic income program. Ideally, such a program would entail monthly, federally funded allocations and be accessible via debit card or smartphone as an entitlement for all Americans, including minors (whose funds would reside in parent or guardian accounts). This, in conjunction with a public jobs option, would enable almost all homeless families with at least one employed member to secure unsubsidized housing.
It would also make the case for a health care system, whether single payer or open to private insurers, that has a uniform basic benefit package, priced in a way that guarantees affordability for all — those at the bottom as well as top of the income scale.
Greater universality requires that we first define with clarity what all Americans should be entitled to and where personal responsibility should kick in. (Basic necessities, such as adequate food, clothing and shelter should be an entitlement, regardless of whether the person is thought to be “deserving.” But permanent housing and good quality health care — what I would define as conditional rights, not merely aspirations — should be subject to reasonable contributions from the recipients.) We need to anticipate the wide variety of circumstances households might encounter and ensure that access to critical opportunities pencils out under all what-if scenarios.
With a thoughtful and stronger universal foundation, our road to ensuring that housing, health care and other essential needs are within reach for all Americans becomes a more promising one. We live in a prosperous society and we owe this to ourselves.