For the past six months, I've been reporting on the growth of federal disability programs. I've been trying to understand what disability means for American workers, and, more broadly, what it means for poor people in America nearly 20 years after we ended welfare as we knew it. Here's what I found.
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People don't seem to be faking this pain, but it gets confusing. I have back pain. My editor has a herniated disc, and he works harder than anyone I know. There must be millions of people with asthma and diabetes who go to work every day. Who gets to decide whether, say, back pain makes someone disabled?
As far as the federal government is concerned, you're disabled if you have a medical condition that makes it impossible to work. In practice, it's a judgment call made in doctors' offices and courtrooms around the country. The health problems where there is most latitude for judgment -- back pain, mental illness -- are among the fastest growing causes of disability.
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After sitting in the waiting room of his clinic several mornings in a row, I met Dr. Timberlake. It turns out, there is nothing shifty about him. He is a doctor in a very poor place where pretty much every person who comes into his office tells him they are in pain.
"We talk about the pain and what it’s like," he says. "I always ask them, 'What grade did you finish?'"
What grade did you finish, of course, is not really a medical question. But Dr. Timberlake believes he needs this information in disability cases because people who have only a high school education aren't going to be able to get a sit-down job.
Dr. Timberlake is making a judgment call that if you have a particular back problem and a college degree, you're not disabled. Without the degree, you are.
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Over and over again, I'd listen to someone's story of how back pain meant they could no longer work, or how a shoulder injury had put them out of a job. Then I would ask: What about a job where you don't have to lift things, or a job where you don't have to use your shoulder, or a job where you can sit down? They would look at me as if I were asking, "How come you didn't consider becoming an astronaut?"
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Scott tried school for a while, but hated it. So he took the advice of the rogue staffer who told him to suck all the benefits he could out of the system. He had a heart attack after the mill closed and figured, "Since I've had a bypass, maybe I can get on disability, and then I won't have worry to about this stuff anymore." It worked; Scott is now on disability.
Scott's dad had a heart attack and went back to work in the mill. If there'd been a mill for Scott to go back to work in, he says, he'd have done that too. But there wasn't a mill, so he went on disability. It wasn't just Scott. I talked to a bunch of mill guys who took this path -- one who shattered the bones in his ankle and leg, one with diabetes, another with a heart attack. When the mill shut down, they all went on disability.
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"That's a kind of ugly secret of the American labor market," David Autor, an economist at MIT, told me. "Part of the reason our unemployment rates have been low, until recently, is that a lot of people who would have trouble finding jobs are on a different program."
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As I got further into this story, I started hearing about another group of people on disability: kids. People in Hale County told me that what you want is a kid who can "pull a check." Many people mentioned this, but I basically ignored it. It seemed like one of those things that maybe happened once or twice, got written up in the paper and became conversational fact among neighbors.
Then I looked at the numbers. I found that the number of kids on a program called Supplemental Security Income -- a program for children and adults who are both poor and disabled -- is almost seven times larger than it was 30 years ago.
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Let's imagine that happens. Jahleel starts doing better in school, overcomes some of his disabilities. He doesn't need the disability program anymore. That would seem to be great for everyone, except for one thing: It would threaten his family's livelihood. Jahleel's family primarily survives off the monthly $700 check they get for his disability.
Jahleel's mom wants him to do well in school. That is absolutely clear. But her livelihood depends on Jahleel struggling in school. This tension only increases as kids get older. One mother told me her teenage son wanted to work, but she didn't want him to get a job because if he did, the family would lose its disability check.
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A person on welfare costs a state money. That same resident on disability doesn't cost the state a cent, because the federal government covers the entire bill for people on disability. So states can save money by shifting people from welfare to disability. And the Public Consulting Group is glad to help.
PCG is a private company that states pay to comb their welfare rolls and move as many people as possible onto disability. "What we're offering is to work to identify those folks who have the highest likelihood of meeting disability criteria," Pat Coakley, who runs PCG's Social Security Advocacy Management team, told me.
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"You might imagine a courtroom where on one side there's the claimant and on the other side there's a government attorney who is saying, 'We need to protect the public interest and your client is not sufficiently deserving,'" the economist David Autor says. "Actually, it doesn't work like that. There is no government lawyer on the other side of the room."
The Social Security Administration says disability hearings were never meant to be adversarial. In these courtrooms, the judges are employees of Social Security. So the judges are supposed to both represent the government and make a fair and objective determination. But the judges themselves say this role can be difficult.
If Dr Timberlake is defining disability as the inability to find work which can accomodate their limitations, then he's absolutely right. Contrast with this: But, in most cases, not going on...
Exemplary
Dr. Timberlake is making a judgment call that if you have a particular back problem and a college degree, you're not disabled. Without the degree, you are.
If Dr Timberlake is defining disability as the inability to find work which can accomodate their limitations, then he's absolutely right.
But, in most cases, going on disability means you will not work, you will not get a raise, you will not get whatever meaning people get from work.[3] Going on disability means, assuming you rely only on those disability payments, you will be poor for the rest of your life. That's the deal. And it's a deal 14 million Americans have signed up for.
Contrast with this: But, in most cases, not going on disability means you will work precarious jobs, you will not get a raise, you will not get to do whatever gives meaning to people who have the time. NOT going on disability means, assuming you rely only on that minimum wage salary, you will be poor for the rest of your life. That's the deal. And it's a deal most Americans did not sign up for.
Going to a job means paying for insane medical insurance, gas and wear on the car, putting your body and mind through the wringer, not having time off for your kids' summers, and having to live with the indignity of being laid off over and over and over again. We just saw how GameStop employees didn't get AC in oppressive heat where glue and tape fails. UPS trucks have no AC. The mines are killing their employees. For many of us, a job comes with just enough money that we trade all this for a way out. For others, I marvel that they don't all choose disability.
Edit: the Social Security retirement fund and disability funds will both run out within 10 years. That's nearly no time at all.
Considering that the article is 12 years old, I guess we're already screwed :) On a more serious note: If Congress would not have raided Social Security funds again and again over the years, it...
Edit: the Social Security retirement fund and disability funds will both run out within 10 years. That's nearly no time at all.
Considering that the article is 12 years old, I guess we're already screwed :)
On a more serious note: If Congress would not have raided Social Security funds again and again over the years, it would be in better shape. If we could get laws passed to make our oligarchs pay their fair share, we'd also be perfectly fine. The "funds running out" thing is largely an artificial construct by fascists. Not to the same degree as the USPS pre-funding retirement thing, but almost.
Also, if we could have a discussion about universal health care and universal basic income, we could go a long way toward solving these issues, especially with the continual rise in employee productivity.
All we have to do is remove our oligarchs from power and kick out the fascists. Well, not so simple, no, but it's what we need to do to solve this.
I'm not afraid to call a fascist a fascist, but the average conservative that wants to gut social entitlements is not a fascist. In fact, many modern fascists want to increase entitlements for the...
I'm not afraid to call a fascist a fascist, but the average conservative that wants to gut social entitlements is not a fascist.
In fact, many modern fascists want to increase entitlements for the right groups while cutting benefits for "those people" that don't deserve them. Many political scientists argue that recent fascist groups are more in line with Third Position neo-nazis; groups that support social entitlements.
I think if someone supports fascist government, that makes them a fascist. Do I think that the average citizen in Italy or Germany decades ago was the same as Mussolini or Hitler? Nope, but I do...
I think if someone supports fascist government, that makes them a fascist.
Do I think that the average citizen in Italy or Germany decades ago was the same as Mussolini or Hitler? Nope, but I do think that makes them fascist.
So I would simply say that the average conservative in the US is a fascist.
lol, I'd noticed the graphs didn't show past 2011 or so, but then when I got to that's what caught my eye. Then the copyright statement at the bottom of the page is 2013. But yeah, no dateline,...
lol, I'd noticed the graphs didn't show past 2011 or so, but then when I got to
The reserves in the disability insurance program are on track to run out in 2016,
that's what caught my eye. Then the copyright statement at the bottom of the page is 2013.
But yeah, no dateline, which is odd.
I wonder what's happened since then?
I'm gonna go out on a limb and say "shit got worse" lol
Unless UBI completely replaces disability, there's still an incentive to go on disability. Only some UBI proposals completely replace all social benefits.
Unless UBI completely replaces disability, there's still an incentive to go on disability. Only some UBI proposals completely replace all social benefits.
Up until this moment I had been in the camp of wanting a UBI to be at a level that would allow anyone, regardless of disability, to live a life of basic dignity. But thinking about it, there's a...
Up until this moment I had been in the camp of wanting a UBI to be at a level that would allow anyone, regardless of disability, to live a life of basic dignity. But thinking about it, there's a good reason why there should still be disability payments on top of UBI: for many disabilities, there are real additional needs that need to be covered one way or another. Whether it be a carer, specific household appliances/furniture, or other ongoing costs, being disabled should come with extra money to handle those issues.
Of course, if there was a UBI for everyone I'd support a more thoughtful standard for apportioning disability care. If someone has a bum knee but can otherwise take care of themselves just fine, that's no longer so pressing a rationale for disability payments if their day to day expenses are covered.
Many socialists and UBI purists argue that there should be one, true UBI standard for everyone which meets all essential needs. Necessary healthcare expenses can be handled separately in a way...
Many socialists and UBI purists argue that there should be one, true UBI standard for everyone which meets all essential needs. Necessary healthcare expenses can be handled separately in a way that avoids creating UBI tiers.
If you create UBI tiers and supplemental benefits for subjective criteria like disability, then congratulations, you've added means testing to a "universal" program and recreated the existing systems just with a different name.
Since we don’t have UBI, there are different ways we could imagine it working. As I imagine it, a nice thing about UBI is that you don’t have to apply for it and nobody has to make tough decisions...
Since we don’t have UBI, there are different ways we could imagine it working.
As I imagine it, a nice thing about UBI is that you don’t have to apply for it and nobody has to make tough decisions to determine eligibility. That doesn’t mean that there couldn’t be other benefits that you need to apply for. Also, if it’s taxable income then it could still be part of a progressive tax regime.
Ok, but what are those other ways that avoid something that some people would call UBI tiers? With a flat payment either you're giving absolutely everyone enough to pay for any possible need, or...
Ok, but what are those other ways that avoid something that some people would call UBI tiers? With a flat payment either you're giving absolutely everyone enough to pay for any possible need, or you're giving some people enough to cover their needs while giving other people an insufficient amount. Do we want equal contributions to everyone, or do we want equality of outcomes?
As others mentioned, essential healthcare expenses can be handled via healthcare reforms. If someone needs a wheelchair, insurance should pay for it rather than UBI.
As others mentioned, essential healthcare expenses can be handled via healthcare reforms. If someone needs a wheelchair, insurance should pay for it rather than UBI.
And now, quoting this out of context, I can imply that you now no longer wish them to life a life of basic dignity. ;-) I think ideally (making a serious reply), having a disabiity shouldn't cause...
Up until this moment I had been in the camp of wanting a UBI to be at a level that would allow anyone, regardless of disability, to live a life of basic dignity.
And now, quoting this out of context, I can imply that you now no longer wish them to life a life of basic dignity. ;-)
I think ideally (making a serious reply), having a disabiity shouldn't cause financial strain. And yes, "ideally" is doing a lot of work - but I mean, we're already talking about UBI, so why not? heh. Ideally, universal healthcare would already be taking care of support for life with a disability (i.e. PT/OT and support finding work), equipment, et cetera.
But as far as the details of how we'd set that up — there are a number of ways that'd be fine, more or less. I just want to see us use our government for the purpose for which it should exist: Taking care of its people. Meaning using taxes for defense, infrastructure, health, et cetera. Lifting up those that need lifting up, using the strength of the strong.
It's funny how I think most of us think about our ideal government, and how it sounds like some of the Communist ideals. We can argue about how to do things, and what to call things, but at the end of the day - we're already doing some of what we need, we just need to stop ripping money out of the hands of the poor to give to the richest of the rich that don't need it.
The US, as a country, seems to function on indignities that roll down hill: the lower you are on the hill, the more indignities run you over. The higher you are on the hill, the more blessed a...
The US, as a country, seems to function on indignities that roll down hill: the lower you are on the hill, the more indignities run you over. The higher you are on the hill, the more blessed a life you lead.
It is as though our country's "preservation of life, liberty, and the pursuit of happiness" has evolved to represent a neoliberal cult of secular Prosperity theology. If you're worthy, you are wealthy. If you are poor, you clearly are not worthy.
Our economy requires a minimum amount of unemployment. Our economy requires people to accept poverty wages for dehumanizing labor—and largely succeeds there on the back of the undocumented immigrants that the current government is trying so hard to eject.
Ironically, so much of the reason that we need UBI is because the capitalist workplace has become so passive aggressively and toxically hostile to workers.
OK, and the education system that has not kept apace with the rest of the world. And a culture where ignorance is increasingly celebrated while intellect is labeled as "elitist".
I don't see how UBI comes to exist in any form in this America. Maybe once we fully arrive at Idiocracy. Maybe we're already there?
One potential path is that enough people are hurt by medicare/medicaid/other benefit rollbacks that there's a groundswell of support for taxing the wealthy and converting these various more...
One potential path is that enough people are hurt by medicare/medicaid/other benefit rollbacks that there's a groundswell of support for taxing the wealthy and converting these various more complex health programs into a simpler single payer healthcare system and UBI. There can be no "waste, fraud, or abuse" on an individual level if everyone gets the same benefit. I can see ways to discuss the matter such that people on both sides of the aisle can get behind it, assuming a certain level of rational self-interest from the right.
It's an optimistic story, but it doesn't seem entirely wild?
No system is entirely free of fraud. For example, suppose someone died and it were somehow not reported? Someone could try to claim a different person's benefits. Also, people receiving government...
No system is entirely free of fraud. For example, suppose someone died and it were somehow not reported? Someone could try to claim a different person's benefits. Also, people receiving government checks can be vulnerable to fraud.
But these are relatively straightforward crimes and it would likely be no worse than social security.
From the article:
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If Dr Timberlake is defining disability as the inability to find work which can accomodate their limitations, then he's absolutely right.
Contrast with this: But, in most cases, not going on disability means you will work precarious jobs, you will not get a raise, you will not get to do whatever gives meaning to people who have the time. NOT going on disability means, assuming you rely only on that minimum wage salary, you will be poor for the rest of your life. That's the deal. And it's a deal most Americans did not sign up for.
Going to a job means paying for insane medical insurance, gas and wear on the car, putting your body and mind through the wringer, not having time off for your kids' summers, and having to live with the indignity of being laid off over and over and over again. We just saw how GameStop employees didn't get AC in oppressive heat where glue and tape fails. UPS trucks have no AC. The mines are killing their employees. For many of us, a job comes with just enough money that we trade all this for a way out. For others, I marvel that they don't all choose disability.
Edit: the Social Security retirement fund and disability funds will both run out within 10 years. That's nearly no time at all.
Considering that the article is 12 years old, I guess we're already screwed :)
On a more serious note: If Congress would not have raided Social Security funds again and again over the years, it would be in better shape. If we could get laws passed to make our oligarchs pay their fair share, we'd also be perfectly fine. The "funds running out" thing is largely an artificial construct by fascists. Not to the same degree as the USPS pre-funding retirement thing, but almost.
Also, if we could have a discussion about universal health care and universal basic income, we could go a long way toward solving these issues, especially with the continual rise in employee productivity.
All we have to do is remove our oligarchs from power and kick out the fascists. Well, not so simple, no, but it's what we need to do to solve this.
I'm not afraid to call a fascist a fascist, but the average conservative that wants to gut social entitlements is not a fascist.
In fact, many modern fascists want to increase entitlements for the right groups while cutting benefits for "those people" that don't deserve them. Many political scientists argue that recent fascist groups are more in line with Third Position neo-nazis; groups that support social entitlements.
I think if someone supports fascist government, that makes them a fascist.
Do I think that the average citizen in Italy or Germany decades ago was the same as Mussolini or Hitler? Nope, but I do think that makes them fascist.
So I would simply say that the average conservative in the US is a fascist.
Weird that there's no date on the article. I confirmed it using the Wayback Machine.
I wonder what's happened since then?
lol, I'd noticed the graphs didn't show past 2011 or so, but then when I got to
that's what caught my eye. Then the copyright statement at the bottom of the page is 2013.
But yeah, no dateline, which is odd.
I'm gonna go out on a limb and say "shit got worse" lol
Feel like I'm commenting more than I normally do, but just another reason that a UBI (universal basic income) would be actually useful.
Unless UBI completely replaces disability, there's still an incentive to go on disability. Only some UBI proposals completely replace all social benefits.
Up until this moment I had been in the camp of wanting a UBI to be at a level that would allow anyone, regardless of disability, to live a life of basic dignity. But thinking about it, there's a good reason why there should still be disability payments on top of UBI: for many disabilities, there are real additional needs that need to be covered one way or another. Whether it be a carer, specific household appliances/furniture, or other ongoing costs, being disabled should come with extra money to handle those issues.
Of course, if there was a UBI for everyone I'd support a more thoughtful standard for apportioning disability care. If someone has a bum knee but can otherwise take care of themselves just fine, that's no longer so pressing a rationale for disability payments if their day to day expenses are covered.
Many socialists and UBI purists argue that there should be one, true UBI standard for everyone which meets all essential needs. Necessary healthcare expenses can be handled separately in a way that avoids creating UBI tiers.
If you create UBI tiers and supplemental benefits for subjective criteria like disability, then congratulations, you've added means testing to a "universal" program and recreated the existing systems just with a different name.
Since we don’t have UBI, there are different ways we could imagine it working.
As I imagine it, a nice thing about UBI is that you don’t have to apply for it and nobody has to make tough decisions to determine eligibility. That doesn’t mean that there couldn’t be other benefits that you need to apply for. Also, if it’s taxable income then it could still be part of a progressive tax regime.
Ok, but what are those other ways that avoid something that some people would call UBI tiers? With a flat payment either you're giving absolutely everyone enough to pay for any possible need, or you're giving some people enough to cover their needs while giving other people an insufficient amount. Do we want equal contributions to everyone, or do we want equality of outcomes?
As others mentioned, essential healthcare expenses can be handled via healthcare reforms. If someone needs a wheelchair, insurance should pay for it rather than UBI.
Ok. I think our disagreement was based on terminology rather than how people would be cared for.
And now, quoting this out of context, I can imply that you now no longer wish them to life a life of basic dignity. ;-)
I think ideally (making a serious reply), having a disabiity shouldn't cause financial strain. And yes, "ideally" is doing a lot of work - but I mean, we're already talking about UBI, so why not? heh. Ideally, universal healthcare would already be taking care of support for life with a disability (i.e. PT/OT and support finding work), equipment, et cetera.
But as far as the details of how we'd set that up — there are a number of ways that'd be fine, more or less. I just want to see us use our government for the purpose for which it should exist: Taking care of its people. Meaning using taxes for defense, infrastructure, health, et cetera. Lifting up those that need lifting up, using the strength of the strong.
It's funny how I think most of us think about our ideal government, and how it sounds like some of the Communist ideals. We can argue about how to do things, and what to call things, but at the end of the day - we're already doing some of what we need, we just need to stop ripping money out of the hands of the poor to give to the richest of the rich that don't need it.
The US, as a country, seems to function on indignities that roll down hill: the lower you are on the hill, the more indignities run you over. The higher you are on the hill, the more blessed a life you lead.
It is as though our country's "preservation of life, liberty, and the pursuit of happiness" has evolved to represent a neoliberal cult of secular Prosperity theology. If you're worthy, you are wealthy. If you are poor, you clearly are not worthy.
Our economy requires a minimum amount of unemployment. Our economy requires people to accept poverty wages for dehumanizing labor—and largely succeeds there on the back of the undocumented immigrants that the current government is trying so hard to eject.
Ironically, so much of the reason that we need UBI is because the capitalist workplace has become so passive aggressively and toxically hostile to workers.
OK, and the education system that has not kept apace with the rest of the world. And a culture where ignorance is increasingly celebrated while intellect is labeled as "elitist".
I don't see how UBI comes to exist in any form in this America. Maybe once we fully arrive at Idiocracy. Maybe we're already there?
We don't, because the eugenics premise the story is based on doesn't work IRL.
One potential path is that enough people are hurt by medicare/medicaid/other benefit rollbacks that there's a groundswell of support for taxing the wealthy and converting these various more complex health programs into a simpler single payer healthcare system and UBI. There can be no "waste, fraud, or abuse" on an individual level if everyone gets the same benefit. I can see ways to discuss the matter such that people on both sides of the aisle can get behind it, assuming a certain level of rational self-interest from the right.
It's an optimistic story, but it doesn't seem entirely wild?
No system is entirely free of fraud. For example, suppose someone died and it were somehow not reported? Someone could try to claim a different person's benefits. Also, people receiving government checks can be vulnerable to fraud.
But these are relatively straightforward crimes and it would likely be no worse than social security.