The issue is consistency. For services to be uniformally and consistently available, they must be federal government programs. Otherwise, you have one town with good citizens helping the less fortunate and twenty other communities in the same county with no services at all.
We have those situations with states now. Since most government service programs require state contributions, the poorest states, where the citizens need the most help, opt out or cannot contribute enough to provide the necessary services.
Or, even worse, if services are provided by private groups, such as churches, they can choose who deserves help based on their beliefs and agendas. LGBTQ people, single mothers, most people of color and all immigrants would be denied services by many, if not most, white churches and groups in the South and many other places.
There is something inherently wrong with Americans in, say Connecticut or Massachusetts, getting top-notch services while those unlucky enough to be born in, say Mississippi, die at alarming rates from treatable conditions.
I work with a woman whose son has 5 diagnosed mental illnesses. You would be shocked at what she’s gone through to get him the most basic of services. Not good services, mind you, very basic ones. She had to cobble together a variety of federal, state, county, and private aid. Fortunately, she had the intelligence and computer skills to be his advocate, and her employer allowed her a great deal of paid time off to run hither and thither. Most people can’t do that.
ACA, as originally conceived, would have been more than adequate and affordable. It’s been gutted since the ink dried on the proposal. What passed Congress was not the plan Obama and his healthcare advisors wrote, and it’s been hacked many times since. Not to mention all the states, mine included, that refused to participate in the Medicaid part of it, gutting it even more.
Our country sucks at taking care of its own. Hell, if nothing else, look at veterans! Why are they suffering from PTSD, homeless and begging on street corners? Why are financially strapped communities forced to provide services for these veterans? Of all citizens, aren’t they, the ones our government sent to war, the most deserving of federal assistance?
We, as a nation, are greatly lacking in compassion and empathy. The old pull yourself up by your bootstraps mentality is not one for evolved people.
And, now I will step down from my soapbox!