One question I get every day is why is the U.S. the only developed country without universal health care? A related question is why is the gap between rich and poor increasing? & why does the U.S. have such a different attitude towards the poor than the rest of the world? This is but a cursory answer, and it begins with a little comparative history.
In Europe, there was an almost total lack of social mobility prior to the 20th century. The socio-economic class into which you were born completely determined your opportunities in life. This was understood by everyone rich and poor, aristocrat and commoner.
In the U.S., (leaving aside for our purposes legal discrimination based on sex, race, etc.) the class system was formally abolished. Everyone was entitled to 40 acres & a mule and, if you worked hard enough, you could pull yourself up by your bootstraps. A boy born dirt poor in a log cabin could become president. A barefoot child laborer could rise to become factory owner and robber-baron capitalist. It is the myth of the American dream.
Now think about what attitudes toward poverty are shaped by these two scenarios. In Europe, poverty is an accident of birth, so the poor deserve help to level the playing field. And Europe has created social welfare programs that were designed to overcome socio-economic barriers. The problem in the 21st century is that those barriers are long gone. It has been nearly 100 years since people were forbidden to attend university if they hadn't been born into a high enough class. Even the heir to the throne in Great Britain has married a commoner. But the attitude that there is nothing you can do to better yourself persists and it is a problem that Europe needs to sort out, along with immigration, but that is another post entirely.
In the U.S., the myth that the playing field is level, that everyone has an equal chance to succeed if they work hard enough, has resulted in a blame-the-poor mentality. There is a belief that, in this land of opportunity, it is your own fault if you are poor, so why should people who have worked hard for their own success help you? This is why there is universal health care in every other developed country except the U.S. Americans blame the poor for not being able to afford health care and other necessities.
In the post-war era, when the social welfare programs that we do have in the U.S. were launched, there was a temporary shift in attitude because of the Great Depression and WWII. There was a shift in Americans looking to the federal govt. rather than the states to solve problems because the problems during the Depression were too large for states to handle individually. The frontier had closed at the beginning of the 20th century, the population was increasing, and urban slums filled with poor immigrants working for obscenely low wages in dangerous working conditions were growing during industrialization. As the population urbanized, we went from a self-sufficient agricultural economy to a dependent urbanized one -- i.e., instead of producing what they needed to survive, people worked for wages, which they spent to buy these necessities. Living in crowded conditions near employers, they could no longer produce goods for themselves, so they became dependent upon wages.
All of these things (closing of frontier, immigration, population increase, urbanization, industrialization, Depression) led Americans to take a more European attitude towards poverty, that it was not laziness on the part of the poor, that the playing field was not level with equal opportunity for all. There was also a different attitude towards women working outside the home. So-called welfare was originally meant to support widowed and abandoned wives with children, who were expected to stay home with their kids.
Now, fast forward to the 21st century. These social programs were created before most people living today were born. There are families where succeeding generations have been born to mothers on welfare. There is an argument that dependence upon social welfare has become a way of life rather than a temporary safety net for the truly needy. Those who oppose aid to the poor, including universal healthcare, believe that the playing field is now level, that those in poverty are simply too lazy to work and earn money for themselves.
The reality, of course, is that the playing field is far from level. A child born into an urban ghetto with failing schools and gangs does not have an equal chance of financial success as a child born into a middle-class suburban community with good schools and Scouting.
Most of the debates between proponents and opponents of social welfare policies dance around this central ideological difference, but it is simply that those who oppose helping the poor believe poverty is their own fault and those that favour helping the poor believe that their socio-economic circumstances are beyond their control. & n'er the twain shall meet.
The way to end poverty is not to continue the social welfare programs of the past (most of which have been updated already) but to look at the root causes and address them with a "teach to fish" not "give a fish" model of assistance. But that is not going to happen as long as society is split in where it places the blame. As I always say, you can have your own opinion but you can't have your own facts. Both sides need to come to the table with the same set of facts before meaningful discussions about solutions can occur.