The Limits of Philanthropy

When I worked for our local legal services program here in Indiana, we often represented clients who had profound disabilities or severe illnesses but were unable to obtain the medicine and care they had been prescribed. Our state government provides very limited access to Medicaid, so these clientsâ?? applications were routinely rejected. Once, when one of my colleagues helped a client file an appeal of such a decision, he groaned when the case was assigned to a judge who was known for his outspoken contempt for â??welfare.â? After listening to a full hour of evidence about the womanâ??s chronic pain and her struggles to afford medication and therapy, the judge promptly denied her request for Medicaid coverage. The woman left the courtroom in tears. Her lawyer started packing up his files. The judge lingered for a moment, and broke from his stoic demeanor. â??It really is too bad what she is going through,â? he said to my colleague. â??Isnâ??t there some kind of program out there to help people like her?â? The judge meant a charity program, and the answer was no. The woman was in need of years of assistance with expensive health care, not to mention housing and food. Every free-clinic director or shelter staffer I have ever known would be the first to insist that his or her efforts are no substitute for a reliable social-safety net or a job with a living wage. But that judge is just one of many people who assume that there must be a â??program out there,â? a charity that will come to the rescue of whoever needs rescuing.