Social programs hit budget woes. Spending constraints make near-term solutions unlikely
On a broad range of issues from welfare reform to homelessness to AIDS, American society made modest forward steps in 1987. Yet at year's end, ultimate solutions appear as elusive as ever. Despite areas of progress, overall the plight of society's outcasts, its hungry and its homeless, has deepened. And the number of people with AIDS continues to rise in the United States and in the rest of the world.Skip to next paragraph
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The budget deficit problem has sabotaged efforts of some politicians to provide bigger federal programs in several areas, including welfare, low-income housing, child care, and nursing-home care.
The year was 1967, the place the American South. A welfare worker had just left the dilapidated shack of an impoverished family whose members were barely subsisting on welfare. They had little education, no jobs, and little hope of becoming self-sufficient.
Defeated families such as this one, the welfare worker said, were why the federal government would soon dramatically reform the welfare system: ``It can't continue like this much longer.'' Most experts thought he was right.
But for 20 years there has been no major reform, although the US came close during the early 1970s. Early this year it looked as if 1987 would finally produce major reform that would help the nearly 11 million Americans toward self-sufficiency.
Early in 1987 a broad bipartisan consensus for change seemed to exist. Yet the 12 months have come and gone, and reform is as elusive as ever. As the year began to unwind, the consensus began to lose its force, often superseded by partisanship. Skeptics noted that a vote for welfare reform, unlike most issues Congress considers, has few political benefits.
President Reagan, who had insisted on welfare change nearly two years ago, this year wound up mostly standing on the sidelines, to the frustration of conservatives as well as liberals.
The age-old distrust most liberals and conservatives have for each other on this issue quickly resurfaced and led to failure to pass wide-ranging legislation. The House did approve one relatively liberal measure amid bitter partisanship; the Senate, where more compromise has existed, is to vote next year on a more modest proposal.
In sharp contrast to the federal government, several states are making major progress in experimenting with ways to end welfare dependency.
Reform programs in Wisconsin, California, New Jersey, Massachusetts, and Illinois, among others, may wind up pointing the way for the federal government eventually to go.
In the United States, as in the rest of the world, modest progress has been made in dealing with acquired immune deficiency syndrome, as those not afflicted struggle to assist those who are. But immense challenges remain.
On the positive side, medical scientists now feel certain that they know the several ways by which virtually all cases of the disease spread.
They agree that the principal effort to stop the spread of the disease should be to educate Americans to change their behavior. The federal government spent $59.5 million this year to educate members of high-risk groups - homosexuals and intravenous drug abusers.
Many gay men have changed their sexual practices in ways that physicians believe will dramatically slow the spread of AIDS among them. Polls show the public is compassionate to AIDS victims, although individual concerns about contracting the disease show a lack of knowledge about its transmission.
Perhaps most important, federal experts are cautiously optimistic that AIDS may never spread widely among American heterosexuals.
``We're quite sure,'' US Surgeon General C.Everett Koop says, ``there isn't going to be'' an explosion of AIDS among heterosexuals. He notes that the number of Americans who contracted the disease through heterosexual sex this year remained at the same low 4 percent of AIDS cases that it had been. Experts warn, however, that the most likely transmission route into the heterosexual community would be through people who either are intravenous drug users or are the sexual partners of those who are.
And most experts continue to say it is extremely difficult to win the confidence of intravenous drug users, one of the highest-risk groups for AIDS, in order to change their behavior in ways that prevent spread of the disease.
To date some 30,000 Americans are estimated to have AIDS; the best estimate worldwide is between 100,000 and 150,000. No one knows exactly how many people harbor the virus that ultimately triggers the disease; the best guess is between 1 million and 1.5 million Americans, and between 5 million and 10 million people worldwide.