Wednesday, August 1, 2018
A growing number of health policy scholars argue, with strong empirical support, that U.S. social policy is substantially over-medicalized. Having observed in recent decades that American society tends to criminalize that which it does not medicalize, we suspect that the measurably harsh consequences of criminalizing poverty offer cautions for its continued medicalization. The American moral and economic ideal of self-sufficiency unavoidably links poverty, criminality, and infirmity. Juxtaposing medicalization and criminalization reveals the ambiguities of “opportunity” when capacity is compromised, and the consequent tension between liberty and welfare as the core objective of policy. Indeed, past reformers made arguments for a positive role of criminal justice in the relief of poverty that are similar to those aired in the healthcare context today. Ultimately, however, we urge policymakers to disconnect the relief of poverty from medical care as much as possible -- not only to avoid further disadvantaging the poor, but also to encourage investment in unadorned benefits to poorer Americans that have greater potential, particularly at the local level, to build trust and cooperation without the economic and social mischief that has accompanied the medical model.