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devil duck

For the three people I know who don't listen to NPR...

this story is mind-boggling. It's about the Social Security disability program, how it is being abused, and how it begs to be abused.

Comments

The podcast scooped a series of posts I was working on. I think Chana Joffe-Walt did a great job with it, though she clearly doesn't get the full import of what she's reporting.

But nothing in it constitutes "abuse". It's not being abused. The SSDI program is working exactly how it's supposed to.

It just happens to be functioning in real-reality, not the la-la make believe reality that the college-educated, college-teaching, white-collar middle-class playing let's pretend is, is all.

The economy, eduction (both primary and secondary), the American class system, the governments, the city you live in, all of it works vastly differently than most people in your socio-economic class would ever have imagined.

For one thing, the American class system has become so extreme, so stratified, that it's possible for one class to be this ignorant of what is going on in another.

(In fairness, there are two slices of the Ivory Tower who figured it out long ago. One is the medical and social service providers who work in those places and we mostly just talk amongst ourselves about this[*]. Or drink heavily.)

The awful, terrifying thing you need to understand is they really are all disabled. Social Security has a program for identifying disabled people and putting them on the dole, and it is working great. The problem is that we have developed a society in which the definition of "abled" has been a skyrocketing standard, that the percentage of people who can meet that standard is shrinking and can only ever shrink -- but it's still a capitalist system, in which people who cannot successfully prostitute themselves in the market for labor have no choice but to starve.

The Federal Disability system is simply, perfectly, reflecting that, and providing relief to the starving. The absolute least relief they can get away with.

[* http://thelastpsychiatrist.com/2010/11/the_terrible_awful_truth_about_1.html ]

Edited at 2013-03-25 02:22 am (UTC)
The awful, terrifying thing you need to understand is they really are all disabled.

As witness this quote: "if you have a particular back problem and a college degree, you're not disabled. Without the degree, you are."

But it's clearly not the "book solution" to the problem. In the "right" solution, a disability program would solve medical problems, while a jobs-training-and-poverty program would solve job-market problems. Whether somebody can get help with the job market shouldn't depend on one's medical symptoms and which doctor one sees.

But I get it: SSDI is not a disability program, it's a poverty program that calls itself a disability program in order to pass Congress. And it works moderately well as a poverty program. It wastes some resources on medical exams that an "honest" poverty program wouldn't need, but it gets some money and some health care to people who need them.

OTOH, there's got to be a better way to handle kids in poverty. The perverse incentives in the "Kids" section aren't what anybody intended or wanted to happen: sure, some of these kids will never qualify as "employable", but many of them could, if they were allowed to.

Edited at 2013-03-25 03:04 am (UTC)
As witness this quote: "if you have a particular back problem and a college degree, you're not disabled. Without the degree, you are."

And that's the tip of the iceberg.

I think she needed to present the idea that way -- not that it's wrong, mind you, but that it's got a particular expression -- because, well, "Let them get educated" has been the middle class' paraphrase of "let them eat cake" for 40 years at least. (I remember that from TV when I was four!)

White-collar professionals do not ever want to ask the question, "Why aren't they educated?" Because that's red pill stuff.

But it's clearly not the "book solution" to the problem. In the "right" solution, a disability program would solve medical problems, while a jobs-training-and-poverty program would solve job-market problems.

Nah, ya aint getting it. "a disability program would solve medical problems". No. Disability is not a medical problem. Disability is an employment problem. "Disability" is how our society says "essentially unemployable". And by "essentially" I mean "intrinsically": it is a property of this person that they are so undesirable to employers that requiring them to compete on the labor market is a death sentence.

Did you read the article I linked?

And the perverse incentives in the "Kids" section aren't what anybody intended or wanted to happen.

I don't know about anybody; at my most paranoid, I have to admit there are industrial interests which are served by those.

Also, if that was shocking to you, I must assume you missed the Boston Globe articles about how a lot of those kids who are on SSDI for psychiatric disabilities are put on and have to stay on neuroleptic medications -- meds which have never been tested for safety on minors, meds which have tremendous side effects, meds which are addictive, meds which are suspected in shortening the lifespans of adult patients -- or risk losing their family's incomes.

The series as a whole was called "The Other Welfare".

(ETA: Uh, I should just warn you that I am just full of links about this. Somebody once joked that all my posts come with "homework", and I was slowly preparing to write an N-part series on this, where N was something between 6 and 12.)


Edited at 2013-03-25 03:23 am (UTC)
Disability is not a medical problem. Disability is an employment problem. "Disability" is how our society says "essentially unemployable". And by "essentially" I mean "intrinsically": it is a property of this person that they are so undesirable to employers that requiring them to compete on the labor market is a death sentence.

Did you read the article I linked?


Yes, after my original reply; see edits.

Yes, "disability" means you can't work, for whatever reason. But it still seems we should be able to distinguish between disability due primarily to individual medical problems and disability due primarily to job-market problems -- either mismatches between the market and the workforce, or an overall shortage of jobs.

(The example combining back problems and no college degree is both, and has potential solutions on both medical and education sides.)

Yes, some of these disabilities (of both types) are incurable... but some can be cured, and we're more likely to find cures if we identify the problem correctly.
But it still seems we should be able to distinguish between disability due primarily to individual medical problems and disability due primarily to job-market problems

That's what I'm trying to encourage you to relinquish. There is no distinction between "due primarily to individual medical problems" and "disability due primarily to job-market problems". Because there is no concept of disability except as pertains to the exigencies of making a living in a society.

Disability is entirely socially constructed by what avenues our society provides for earning a living.

The belief that there are "medical" and "non-medical" disabilities is a fond fancy of the middle class. White collar people want urgently to believe a set of things (which are not true) for reasons of reassurance:

1) The infinite fungibility of human talent, i.e. "I could grow up to be anything I want to." Projected onto people who lose their jobs due to changes in society, it becomes, "Just become something else, the way I know I could if it happened to me; prove my fantasy that anybody can do anything."

2) That the category of "disabled" is well bounded, and that they're not in it unless something physically catastrophic happens, i.e. "I am secure in my professional identity and it would take nothing less than a hugely traumatic injury or shattering illness to take it away from me; certainly not that I could wake up tomorrow and discover that my profession requires me to use a technology which I will be at a profound disadvantage in learning or using." (Which, btw, has been the basis of some quite good SF stories.)

3) That the difference in classes is education, i.e. "Well, they should just get education and they'll be like me, safe from being disabled". Keep begging the question of why they don't already have "educations".

The example combining back problems and no college degree is both, and has potential solutions on both medical and education sides.

Here's a magic wand, it simultaneously cures back problems and grants college degrees, to everyone on SSDI who has back problems and no college degree. Use it and tell me what changes.

we're more likely to find cures if we identify the problem correctly.

We know what the problem is, we've know what the problem is for over 100 years. The range of variety of human endeavors at which one can make a living in an increasingly industrialized capitalist society will only shrink; as the variety of types of work shrinks, people without aptitude will find themselves rendered uncompetitive and the remainder will have to compete ever harder for the remaining jobs; as competition increases in the labor market, wages plummet.

The jobs went away and are never, ever, ever coming back, and a lot of the people who relied on those jobs are not repurposable.
OK, I get that "disability" for this purpose means "unable to get and keep a job, for whatever reason(s)." I get that many, perhaps most, of those reasons have nothing to do with the individual (e.g. most of the industry has left your town). I get that many of those reasons won't change in any likely near-future economy.

What I'm saying is that some of those reasons are connected to the individual, and some of those reasons (individual or not) are remediable, and some of the people currently on SSDI could, with the right intervention, have meaningful jobs, and would be happier there. And declaring them to be medically disabled just because it's simpler than doing a more thorough analysis won't produce "the right intervention".

Here's a magic wand, it simultaneously cures back problems and grants college degrees, to everyone on SSDI who has back problems and no college degree. Use it and tell me what changes.

Some of them get physically-demanding jobs in the service sector (which is largely minimum-wage already, so this doesn't further depress wages for the people already working there). Some of them get desk jobs for which they are now qualified. Both of these groups are now making more money than on SSDI, and contributing more to the local consumer economy.

And yes, a lot of them still don't get jobs.

How many drummers does it take to screw in a light bulb?

I get that many, perhaps most, of those reasons have nothing to do with the individual (e.g. most of the industry has left your town).

It's always individual+context. Disability is the interface where personal traits meet social context.

Some of them get physically-demanding jobs in the service sector (which is largely minimum-wage already, so this doesn't further depress wages for the people already working there)

1) From the story [27:48]: "About thirteen thousand a year. But if your alternative is a minimum wage job that will pay you fifteen thousand a year? A job you may not be able to get, a job you may or may not be able to keep, that probably won't be full time, and that will, very likely, not include health insurance?"

2) It won't depress nominal wages. But it sure will depress the average wages, won't it? There's only so many jobs and magically pulling someone out of the disability pool and putting them back into the labor pool doesn't cause there to be more jobs to go around. It just increases the supply of labor.

And so what happens is that if not this guy, then some other guy gets popped off the left end of the bell curve as Least Able To Get And Keep Employment. And we have a name for that. It's "disabled."

Patching up the current batch of disabled and dumping them back in the labor pool just moves the goal posts.

Some of them get desk jobs for which they are now qualified.

In Hale County? The place there are so few desk jobs, most people there can't imagine such a thing exists?

Okay, so they move. Let's say you have a 40-something who had a back injury and now she has a degree. Has two: gets a masters in, I dunno, something clerical... library science. Moves to New York. Find herself applying for library jobs, in direct competition to people like your lovely lady wife. Whom do they hire? The candidate with the 20 years pertinent professional experience or the candidate fresh out of grad school with 20 years experience gutting chickens?

Well, she'll just have to get an entry-level librarian position. There's lots of those, right, and she won't have any trouble getting a job with a degree, right? Thank goodness the magic wand took care of any student loans. That would have really sucked.

So....

Both of these groups are now making more money than on SSDI

...no, actually.

Here's the thing. It's not that I disagree with you in the slightest that investing in people is a good thing; I don't disagree in any way that SSDI provides demoralizing, grinding poverty, better than which is most employment.

The thing I disagree with is your insistence that there is "medical" and "non-medical" unemployment, and that attempting to discriminate cases on that basis will do anybody a damn bit of good. Whether the reason you make it to 40 without a college degree or other entry into white-collar work is because you have dyslexia, or are blind, or spent your childhood in an oncology ward, or ate paint chips, or have ADHD, or were busy holding together the family farm while a parent died, or because you just weren't very good at school work and opted out in 8th grade, or because the money was good enough at the factory when you were 20, or were failing classes through elementary school because your drunk parent was beating the crap out of you, at 40 that reason is now a part of you as much as any tumor, and as disabling.

We live in a capitalist society which means we compete for jobs which means that there will always be losers as well as winners. Whatever qualities hirers choose as their job criteria, there will always wind up a bell curve distribution of those qualities in the labor market. There will always be some people hanging on to the left end of the curve.

In a society -- I hear post-Plague Europe was like this -- with much, much more work than workers, this is fine: even the least able human is still able to contribute labor of value to the market sufficient for him to earn money.

But we don't live in that society. We live in an industrial society, where nothing is quite so useless as a merely able-bodied person.

Nitpick

"Library science" != "clerical" :-)

Since You Asked....

White-collar professionals do not ever want to ask the question, "Why aren't they educated?"

Whether librarians fit your definition of "white collar professional" remains to be seen, but here's my answer:

"They" aren't "educated" because the USAian system makes it almost impossible for anyone who isn't already in a position of some privilege to fund an education (unlike other first-world nations which make university education available tuition-free).

According to articles I've read in our local paper, a common scenario goes something like this: Unless s/he is brilliant (or has a gifted Guidance Counselor, or an extended family willing to work themselves to death to give their next generation a better life), if a Working Poor-class student gets into college, s/he has to take out huge student loans, and work full-time while taking classes. Then, the student's grades suffer from the workload, or there's a family crisis, or the student hirself becomes ill/injured, and s/he has to drop out--and after that, it's well-nigh impossible to go back because the student loan payments have kicked in, leaving the erstwhile student with crippling debts and nothing to show for it but a semester or two of mediocre GPA at a state school or community college.

[I may live in an Ivory Tower, but I'm not blind :->]

...which is not to say that I've never met anyone who successfully worked full-time and went to college part-time, or took a semester off and came back--I have, but those folks generally came from middle-class families and had more of a familial "safety net" in place.

As to what could be done about it: making public university tuition free for all who meet the entry requirements (even if some restrictions applied, e.g. free for in-state students) would be great (although convincing the citizenry to pony up more tax dollars for it might be challenging). It would also be a good idea to insure that college-bound students from every stratum were adequately prepared in secondary school for college coursework. Finland seems to have the right idea....

Re: Since You Asked....

These things are all true, and they are terrible and I am glad that you know them.

But they aren't the answer to the question. Any answer to the question "Why aren't they $likeUs?" which presupposes that the only reason they are not $likeUs must clearly be because some injustice prevents them from turning into "normal" people like Us, should be squinted at, very carefully.

The middle class thinks that the solution for the working class is to give up being working class and become middle class.

How do you think the working class feels about that?

Our society tells us quite clearly that being a receptionist at $9/hr is superior in social status to being a mechanic at $30/hr. Do you think the people who have chosen to be mechanics agree?

Surely, at some point in your educational career, possibly in grade school, you encountered people who were pulling C/D averages, for whom book learning was endless struggle. Did you ever ask yourself what became of them when they grew up?

Some of them had aptitudes and interests that don't manifest behind a desk.

It's easy for those of us with college degrees to treat degrees as if they were universally desirable, to treat our desk-work, physically inactive life style as the envy of all who work with their backs and their hands.

It's not.

The thing that's terrifying about this is that so long as we in the middle class can define the working class as "middle class minus stuff", we can take comfort that we have the talismans -- our sacred diplomas -- which will safe us from what happened to them.

But if the working class is simply a class of people with a set of talents, aptitudes, interests, and values that differs from ours, equally honest, but simply, sadly obsolesced....

Then it could happen to us, too.

In fact, it is happening to us.

Edited at 2013-03-27 05:55 am (UTC)
We're well on the way to Brave New World, whever everyone gets their soma ration, aren't we?

PS - I keep running into your fascinating posts on my flist, may I friend you?
Don't you two know one another (say, from Boston twenty-mumble years ago)?
Almost certainly, but I've been going nuts trying to match the name to a face. I *think* I've placed her, ~waves~, but I'll need to meet or see a photo to be sure.
Yes, we've met and it's been about 20 years! When last you were in Boston I was the provost of Mitgaard and/or the director of the instrumental ensemble of the Jongleurs' Guild (I succeeded Eliane Esperance.) I have a journal under my SCA name, too.
We're well on the way to Brave New World, whever everyone gets their soma ration, aren't we?

In one comparatively optimistic scenario, I suppose. :/ It's been a very long time since I read BNW, but I seem to recall it was short on the sort of man's-inhumanity-to-man which was so well showcased by the 20th century.

I thought this comment over at Metafilter to be likely prescient:
I have grave misgivings about how this story will be received. To put it simply, which of the following reactions do you think Congress and pundits in Washington are likely to have?

(A) This is unfortunate. In the absence of a true social safety net, many of our most vulnerable fellow Americans are turning to disability benefits as a last resort. We should consider more cost-effective alternatives, such as strengthening unemployment benefits, wage subsidies, or even a basic income, so that people who have been left behind can have some measure of dignity.

(B) This is unfortunate. We need to kick these deadbeats off the rolls tout de suite. We're a nation of makers, not takers.


PS - I keep running into your fascinating posts on my flist, may I friend you?

Sure, of course!
I have grave misgivings about how this story will be received. To put it simply, which of the following reactions do you think Congress and pundits in Washington are likely to have?...

Yes, I had the same thought. Indeed, if I had heard the same story on Fox News, I probably would have dismissed it as a right-wing rant against "welfare queens". When I hear it on NPR, I'm more inclined to take it seriously (which I guess says something about my prejudices....)