The Failing Public Health System

Indignation for how our system treats the lowest class within society.

The Public Health System has failed us. A system that requires an individual's dependence and compliance on existing components. Food Stamps, Social Security, Disability, Section 8, and Vocational Rehab to name a few… Each of these components are a system of reliance, not a foundation of empowerment that leads to each individual living a life on their own terms.

These components have successfully built the lowest class within our society. “The Derelicts”. The Derelicts rely on these components of the system. The Derelicts are the ones whom we avoid making eye contact with, we attempt to house them in separate communities so we don’t have to see them at the grocery store, coffee shop, or neighborhood park.

The Derelicts are the ones who are spending every second of every day trying to stay alive by finding food to fill their upset stomachs. They’re attempting to scrounge up the change to ride the public bus to the local library to retreat from the heat or cold. And multiple times a day, they’re forced to use the bathroom in secluded, yet public, locations due to businesses having toilets behind lock and key. The Derelicts have only one true responsibility in this world, and it’s to survive - to stay alive.

But we’ve done “our duty” by paying our taxes that fund public infrastructure allowing them the “opportunities” to succeed!”

The Derelicts aren’t given the same chance to make it in this society. These systems are the only chance they believe they have. The welfare system and other involved components portray the message, “We are here to help”, but at the end of the day they’re only here to provide The Derelicts with reliance on unsustainable practices.

Social Sustainability is “a process for creating sustainable, successful places that promote wellbeing, by understanding what people need from the places they live and work. Social sustainability combines design of the physical realm with design of the social world – infrastructure to support social and cultural life, social amenities, systems for citizen engagement and space for people and places to evolve (Woodcraft et al., 2012, p.16)”.

The components of welfare are unsustainable because they aren’t promoting wellbeing, rather they’re forcing individuals into fear based reliance. Relying on a system due to fear of loss, even though The Derelicts are already at the bottom of the social ladder. What do they have to lose other than their lives?

How is it that our society has led us to believe that this system of depravity is the means to an end? We can go to our 9-5 job, take care of our family, and vacation when we can. We turn our back on The Derelicts, the non-contributing members of society, by labeling it as “Giving Back” with tax write-offs and volunteering through organizations who pocket more than they give to those who actually need it. The Derelicts won’t even come close to seeing the amount of money we receive in the 9-5 world, because we have created a sealed ecosystem requiring social status as a metric of entry.

“Oh it’s okay, they can build themselves up by the bootstraps”

How many years of being reliant on this abhorrent system does it take an individual to find success? Are we defining success as a job requiring one to live paycheck to paycheck? Do The Derelicts have the ability to grow beyond “making ends meet”?

Is there any sustainable success accessible through welfare systems, or is it easier to break apart? To commit a crime to find a continuous bed and 3 meals a day? To become addicted to the quick fix of sex, drugs, and alcohol? To enter into psychosis and require psychiatric hospitalization, medication management, and regular doctors visits - only to find a meager sense of psychological and emotional stability?

And when they’ve entered into this territory, what component of the welfare system allows The Derelicts to leave this way of life? Steps such as Section 8 with a waiting list of a decade or two long aren’t true solutions to the housing crisis. A lack of beds in psychiatric facilities provides the opposite of an opportunity for stability and true understanding of mental and emotional health. Risk management programs and interventions, such as needle exchange programs seem great, but where are the systems truly supporting an individual in their long-term recovery? Not just their current problem, but offering solutions to each step toward societal success - Anything required to allow a single individual to find sustainability in their life to promote wellness and a life filled with purpose and a sense of satisfaction.

Is it the Social Worker’s responsibility to guide The Derelicts through each step of this journey? Is this the continued reliance on unsustainable practices? What happens when the Social Worker gets burnt out, quits due to low pay, or retires after years of being dedicated to the system?

The Derelicts have few they trust. They’ve chosen isolation rather than trusting others with their many crises needing to be solved. They have identified the crisis as their own life - And who can blame them, we’ve identified them as the crisis as well. The identity they claim is the same we place upon them, The Derelicts. They have nothing to resort to, other than asking for your help and receiving what it is you feel compelled to share. And if that ends up being nothing, they’re the ones who have to feel the shame, grit their teeth, and ask the next person.

Is it the peer support system and subsequent groups where The Derelicts need to place their trust? The peers are sure to not need an integration in society beyond their own like, boosting each other up, but not beyond the highest level of success the peer leader has achieved. The lack of vertical integration within this system is disguised as equity, providing a framework for individuals within recovery to achieve only a pre-determined amount of success. Once again, social sustainability is lacking for an individual’s continued success.

So when do we see this system as disparity-ridden, and find out for ourselves and the rest of society what true support looks like? Is it when the research shows the best way forward for The Derelicts? Do we need to dedicate years of research to methods before we allow The Derelicts their unalienable rights of Life, Liberty and the Pursuit of Happiness? What’s the breaking point for the system to be proved defunct? How high do the rates of substance use disorder, suicide, and violent crimes need to be for those of us in society to not only pay attention, but change our behaviors to be truly inclusive?

What will it take for each of us to see The Derelicts as humans, no more and no less than we are, but true equals? Surely they are capable of healing their hearts, minds and bodies, of being kind, and most importantly, containing the inherent ability to be contributing members of society. Do we need a Day of Justice, where we evaluate wrongdoings to ensure they don’t outweigh the goodness in their hearts? Or are we going to be the adults in the narrative and prepare our hearts to accept the wrongs we’ve done by judging them as less-than; of supporting the welfare systems that exist to maintain this classist dynamic, further perpetuating their hamster wheel of suffering?

What does it look like for us to shift our focus to a socially sustainable framework of support for The Derelicts? Do we need to invite them into our homes and allow them to share our kitchens, or sleep in a bed next to our children? Or can we become a little less extremist by devoting ourselves to becoming aware of our biases in each moment? By acknowledging the needs of our fellow humans and doing what we can, while respecting our own integrity?

“But the welfare system is so big, there’s no way we can possibly replace it!”

So let’s build systems set aside from what currently exists, that way we aren’t all pointing fingers and continuing this blame bandwagon. What does the new system look like? Does it involve those of us who are losing our sources of income to become innovative to form new, non-competitive forms of community sustainability? Can we communicate with The Derelicts, the individuals we’ve judged as less than in the past, to find out what their true needs are? Would this possibly allow us to step into a place of personal empowerment to build something that provides the same empowerment back to them?

Are these steps scary because it’s us acknowledging how the systems providing this facade of support seem to be crumbling around us? The criminal justice system, big pharma, psychiatric facilities, unhoused support structures, etc. all keep growing. Do we just need to keep funneling our attention and funding to these entities, or can we finally see that the solution is seeing one another as human rather than a problem to solve.

“That’s it, they’re a problem to solve. So why me?”

Who else is going to save them? Is someone going to come from a cloud and give The Derelicts the money, housing, food, clothing, bathrooms, job opportunities, and purpose they need to live their life away from the systems they’ve become reliant on? The system they can’t escape has a grasp, and if we think they can walk away, we are the ones being fooled. It is ultimately our responsibility to offer hope and opportunities to learn, grow, discover, and succeed.

How have we been supporting those closest to us without a reciprocal emotion such as gratitude and appreciation? Could these efforts be better served by giving to The Derelicts, the ones who never stop asking for our help? Are we able to shift our focus to seeing what positive impact we can have on others who are less fortunate, and also notice what changes within our own psyche as we engage in self-less ways?

Self-Empowerment should always be the goal. Eac

h of us has the capacity to become engaged in our own action-oriented sustainability. And if these efforts become socially sustainable for those of us who need it most, we begin to build a world in which we love for the right reasons, because we’re all human.

With love,

The Derelict

References

Woodcraft, S., Bacon, N., Caistor-Arenda, L., & Hacket, T. (2012). Design for social sustainability. London, England: Social Life.