Second in a two-part meditation on my job as a Health Advocate.

This is from Dead Prez’s 2004 hit “Hell Yeah (Pimp the System)”.

I know a caper
we can get some government paper
ya' know food stamps, can we really do that
hell yeah right there for the takin'
fuck welfare we say reparations
Ya' know the grind
get up early get on the line and just wait
everybody on break
that's part of the game and when they call your name
Miss caseworker lemme state my claim
I'm homeless, jobless, time is hard
about hopeless, but I gotta eat regardless
no family to run to I'm 22
now tell me what the fuck am I supposed to do
my sad story made her feel close to me
I made her feel like it was in emergency
and when I came to the crib niggas couldn't believe
I came back with a big bag of groceries

The song suggests that people struggling to feed their families in this country are better off committing petty crime (against retail stores, credit card companies, and the government, never against other poor people) than they are playing along with the System. This song follows in a long line of Hip Hop songs that will blow you away illustrating the social and economic origins of crime. The line “now tell me what the fuck am I supposed to do” is lifted directly from one of the first such songs, “Loves Gonna Get’cha” by KRS-One

[More in the extended]

Listening to this song the other night caused me to realize what the whole project of nonprofit advocacy is up against. With social inequality at such an extreme in the United States, what can a non profit advocate ever hope to achieve, absent some major structural change? As ggmartinez commented on my last post, an NGO can help a few hundred or few thousand people, but real social and political (policy) changes will have to occur before our society will realize its responsibility to provide healthcare access to everyone.

But there is a deeper and more discouraging problem than simply a lack of the right political conditions that would lead to a just healthcare system. It’s a problem of two separate realities. There is a fundamental disconnect between the reality of well-meaning NGO advocates sitting in a carpeted convention center and the reality of “Hell Yeah (Pimp the System). This second reality is the dark underbelly of the welfare state.

I might even add a third reality of the government policymakers who are much more removed from the desperation of poverty than the NGO people. This disconnect therefore presents a fundamental challenge not only to the NGO project, but also the project of social welfare in general. Can the policymakers every really comprehend the experience of poverty, of criminality? Can the welfare state imagine poverty? Will the voices of the truly destitute (undocumented immigrants, the residents of the slums in New Haven) ever really have a voice (a vote?) in the decisions about who will get program benefits and how much. Do Govenor Rell and President Bush know what its like to have to put back some of their groceries when they discover that they don’t have enough food stamps to buy milk?

I am conflating a number of different problems. There is one problem that does have a fairly simple answer. Much of the failing of America’s social welfare today is that it has suffered from the Regan, Clinton, and Bush cutbacks. Rolling back the Bush tax cut alone could help so much— Medicaid, Section Eight Housing, etc.

But until we do roll back the taxcuts, there will still be me and the other health advocates, doing making the limited System work for people who are working hard, struggling, living check to check, and occasionally Pimping the System themselves.