ignorance of available resources is bad fiscal policy

    The problem of 'where do I go for help' plagues anyone with any type of need to pay a cost of living who cannot afford it.  Local governments, whose accountability and proximity to constituents is perversely counterbalanced by lack of 'tax base' compared to state and federal levels of government, maintains an opacity that restrains growth of spending by ignorance that services are even available.  


   Maryland medical assistance (Medicaid) cut adult dental benefits out of its medicaid program in 1976 to save money (fiscal conservatism or 'limited government.')  By 2018 the Md Dept. of Health disbursed $825,000 in grants to providers of dental services to as part of an Adult Dental Pilot Program.  $4.2 million, with half federal spending, was the 2019 budgeted amount.  The program would need $26 million if all poor people eligible knew the help was available and used the maximum benefit.  

Having a dental benefit in Maryland’s Medicaid program isn’t a new concept. Maryland offered comprehensive dental coverage to adults on Medicaid until 1976, when state lawmakers decided it cost too much and cut all services except emergency care.

The Maryland Department of Health dispensed $825,000 in grants last year to hospitals and organizations to provide some dental care for low-income people. The budget for the Adult Dental Pilot Program in its first year is $4.2 million, with half coming from the federal government. If every poor person with disabilities eligible for the coverage used the maximum benefit, it would cost more than five times the money being allotted — about $26 million, according to state budget estimates.

   from this link which may not load its original content:

 https://www.washingtonpost.com/local/md-dental-program-for-poor-pays-to-remove-teeth--but-not-replace-them/2019/08/24/9fae8f30-c4f6-11e9-b72f-b31dfaa77212_story.html



Ignorance among the intended beneficiaries was all that restrained spending.   

   Little outreach is usually done except for occasional newspaper articles like at this link (which may have died since August 2019)

https://www.washingtonpost.com/local/md-dental-program-for-poor-pays-to-remove-teeth--but-not-replace-them/2019/08/24/9fae8f30-c4f6-11e9-b72f-b31dfaa77212_story.html

 and end of fiscal year 'fairs' to spend all of an agency or department budget to prevent cuts at the end, or middle, of a fiscal year.  Wait lists are left long enough so that people waiting are forced to move and become the fiscal burden on another jurisdiction.   The frustration of not receiving needed help by those in need could go a long way to explain why poor people often vote against their economic interests on the basis of social issues and prejudice/hatred/bigotry against others who 'look differently.'  Those people not helped outwardly perceive, and resent the inequities represented by, those helped to be receiving more financial aid from some 'welfare' (safety net) program.     

Dignified retirement and affordable housing It's a win-win

    Back in the day (in 2000) people under 35 were called post baby-boomers or gen x.  Now the same 18-35 year old age cohort is called millenials or gen y or z.  Your humble blogger rustedaspie was within the 18-35 year old cohort in 2000. 

  One book of public policy prescriptions released in 2000 was called "We've Got Issues" the Get Real, No B.S., Guilt-Free Guide to What Really Matters" by Meredith Bagby. 


  One policy discussion on page 112 of the paperback edition discussed the basics of defined contribution (with an employer match to attract people to accept job offers)  401k accounts, IRA accounts and Roth IRA accounts that were replacing defined benefit pensions.  


   The jury is still out on whether these new investment vehicles encourage savings.  But assuming they do, many politicians are lobbying to extend the amount an investor can contribute in order build our overall savings.  

                                                        page 112

 in this book "We've Got Issues"

   By 2016 the separate independent reporting of 2 journalists had found the same conclusion.  The defined contribution retirement plan, sometimes matched by employers, was a failure as a replacement for defined benefit pensions. 


  Hedrick Smith in 2006 "Can you afford to retire?"  and David Dayen in 2016 found that the 401k retirement revolution wasn't working.
People compensate for lack of savings growth in higher demands for resale housing (with renovations to kitchens, bathrooms, patios, basements think ‘man caves’) if people keep living in a house longer.  Housing sale and rental prices become unaffordable to people now with higher student loan debt trying to qualify for a steady job not multiple freelance consulting gigs in the sharing (renting) economy.   I wrote earlier about how the sharing economy uses excess capacity well while inequitably distributing the income growth in another post on this blog.

  Labor (workers or workforce) were paid less of new income (GDP) growth particularly since the 2008 'great recession' or crash of stock and securitized debt (home mortgage) markets. Lower top tax rates on the increasingly unequally high end of earnings leave less income tax revenue at all levels of government taxing income.  

 Scrapping the FICA cap in order to tax all income for social security will strengthen it.  A compromise is to radically raise the cap that rises annually by small amounts (one of the annual CPI inflation rates).  People will feel less pressure to replace retirement savings losses or low increases by demanding 'top dollar' when selling a primary residence.  Unbundle home equity growth from retirement savings growth.  Housing will remain more affordable without seller pressure to get a big capital gain for two needs, retirement and buying new housing to move to.