My wife is an RN who works with the developmentally disabled. While, with her agency, they are able to support their clients decently (excessively when it comes to medical, but that’s a story all its own) the resources such as SSI are scandalously low.
One of my daughters is an NP who provides medical care (largely psych, but also general practice) to a clientele that is mostly very poor. While the federal and state resources are not great, one thing might actually be instructive. Her agency requires that the clients see her for referral before going to an ER for treatment of anything other than catastrophic conditions. And the state pays her agency well for doing that. Why? Because ER care is so terribly costly to the state through Medicaid, that even very generous payment to her agency for her care is a bargain.
And it does work. Almost always, the clients get better care than they would in the ER, because the qualifications of ER physicians varies tremendously, they know almost nothing about psych, and the likelihood of consistent followup is almost nil. What, if anything, does that tell us? Well, it tells us that medical care for the poor can be a lot cheaper than it is, but the delivery system is flawed.
Trump is now in his second year of administration. There is no certainty that he will not decently address the issues of the poor. But experience has shown that the Dems sure didn’t…not even when they had an overwhelming congressional majority and the white house. They did nothing for the poor. Nothing. Oh, well, they did pass “cash for clunkers” to subsidize people who could afford new cars. But they also destroyed the “clunkers” the poor rely on for transportation.
It’s like Trump said to black voters. What do you have to lose?