Tue March 26, 2013 5:43 pm
"In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government."
Tue March 26, 2013 6:24 pm
Wed March 27, 2013 2:17 am
Wed March 27, 2013 10:07 am
Wed March 27, 2013 10:46 am
it's always been here.harmless wrote:Yeah, so it looks like the anti-welfare propaganda is heading to the States. And why not, it's working so well here.
Wed March 27, 2013 12:43 pm
elliseamos wrote:it's always been here.harmless wrote:Yeah, so it looks like the anti-welfare propaganda is heading to the States. And why not, it's working so well here.
"Jahleel is a kid you can imagine doing very well for himself. He is delayed. But given the right circumstances and support, it's easy to believe that over the course of his schooling Jahleel could catch up.
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."
Wed March 27, 2013 8:03 pm
harmless wrote:Yeah, so it looks like the anti-welfare propaganda is heading to the States. And why not, it's working so well here.
Wed March 27, 2013 8:26 pm
this seems like the problem to me.broken iris wrote:It would threaten his family's livelihood. Jahleel's family primarily survives off the monthly $700 check they get for his disability.
Wed March 27, 2013 8:36 pm
Wed March 27, 2013 8:48 pm
Wed March 27, 2013 9:28 pm
cutuphalfdead wrote:harmless wrote:Yeah, so it looks like the anti-welfare propaganda is heading to the States. And why not, it's working so well here.
What's interesting to me is hearing this story broadcast on the radio (the link on the op is pretty much a transcript of the broadcast word for word) the tone wasn't anti welfare or deminizing of these people at all. Seems to be the opposite of what people are taking away from it in a different medium.
Wed March 27, 2013 9:34 pm
elliseamos wrote:thanks for that, McP, i'm sorry for the frustration the system is causing your family. do you know if anything in the Affordable Care Act will provide any relief? I thought it was supposed to reward more of the preventative measures (like treating toe sores)?
Wed March 27, 2013 11:02 pm
simple schoolboy wrote:cutuphalfdead wrote:harmless wrote:Yeah, so it looks like the anti-welfare propaganda is heading to the States. And why not, it's working so well here.
What's interesting to me is hearing this story broadcast on the radio (the link on the op is pretty much a transcript of the broadcast word for word) the tone wasn't anti welfare or deminizing of these people at all. Seems to be the opposite of what people are taking away from it in a different medium.
NPR isn't known for anti-welfare propaganda. At least part of this story is a partial explanation of why the unemployment rate isn't higher and why the labor participation rate is so low. The states have been doing their darndest to dump people from unemployment to (federal) disability coverage. The difference for the individuals involved is that its riskier returning to the workforce after being on disability than on unemployment.
Thu March 28, 2013 11:37 am
Thu March 28, 2013 11:40 am
i see. for the record, the "i can't wait to tell my legs" comment was just the right amount of humor to carry that story. thanks again for sharing.McParadigm wrote:elliseamos wrote:thanks for that, McP, i'm sorry for the frustration the system is causing your family. do you know if anything in the Affordable Care Act will provide any relief? I thought it was supposed to reward more of the preventative measures (like treating toe sores)?
The majority of preventative measures it incorporates for adults comes in the form of screening for things like cancer or heart problems, is my understanding.
Thu March 28, 2013 12:42 pm
elliseamos wrote:this seems like the problem to me.broken iris wrote:It would threaten his family's livelihood. Jahleel's family primarily survives off the monthly $700 check they get for his disability.
Thu March 28, 2013 1:12 pm
elliseamos wrote:i see. for the record, the "i can't wait to tell my legs" comment was just the right amount of humor to carry that story. thanks again for sharing.McParadigm wrote:elliseamos wrote:thanks for that, McP, i'm sorry for the frustration the system is causing your family. do you know if anything in the Affordable Care Act will provide any relief? I thought it was supposed to reward more of the preventative measures (like treating toe sores)?
The majority of preventative measures it incorporates for adults comes in the form of screening for things like cancer or heart problems, is my understanding.
Fri March 29, 2013 3:52 am
McParadigm wrote:My brother has severe Spina Bifida, which means (among other things) a shunt that runs through his head and a number of stunted mental processes. I'd like to use his situation to illustrate two points regarding efforts to "clean up" or police the Medicare/Medicaid systems:
1. Tight Policing of Such Programs Needs to Be Delicately Structured
It's unquestionable that people scam this system. But Ross tried for years to get a job, and could never find anything that paid as well as what he got from the government if he wasn't working. He even earned an Associates Degree online (we all chipped in to pay for that one), and had a decent work history (he got a job at a movie theater in high school, and continued working there until he turned 22). But nothing. Furthermore, when he DID manage to get work it would often cause huge problems down the line. For example, he managed to land a job working phones for Chicago's Civic Opera House during their up-season, and then was let go when the season ended. He wasn't able to find work after that, but was now officially on the government's "See, you can totally work, so fuck off" list. He's lucky enough to have family who can afford to send him money, or I have no idea what he would have done in the more than eight months it took to get his status returned. Seriously, at one point he was on the phone with some bureaucrat, who actually said "According to our records you are no longer disabled." "That's fantastic," he responded, "wait until I tell my legs."
So while it's important to engage greater control on the output of these programs, that control needs to take the form of something more complicated than "Pretty sure this dude can work, yo." A lot of the time, a topic becomes politicized, we all become very insightful bystanders, and decisions get made based on what looks good rather than what is going to be most effective....because effective is often more complicated, and a lot harder to explain.
2. What Seems Like Common Sense Rarely Is
Last year, Ross developed an open sore on his toe, and was told that unless it became infected (inevitable, as the toe is incapable of healing itself) amputation would be regarded as cosmetic and thus not eligible for government assistance. Basically, they could give him antibiotics and a wrap to help protect it, but unless he was willing to take on the bill himself he had to wait for an infection to manifest before doing anything more.
Of course, it did manifest eventually, and they took the toe. But that kind of waiting game is super duper Russian Roulette...several of the kids we met over the years through the Spina Bifida Association have died because of exactly that. One of them, a fun guy named Dusty, by the time the surgery to amputate his foot was set to occur they discovered it had spread up as far as his hips. A few days later he was dead. He'd had the open sore for several months, but, you know, sorry....can't operate yet. It's not actually a danger.
So, to recap, with Ross the government ended up paying for the amputation anyway and, because of the policies and procedures it currently relies on to protect itself from getting ripped off, it also ended up paying for multiple extra visits and tests, copious amounts of antibiotics, and is now preparing to face the entire situation all over again (not to mention being in a constant state of putting a person's life at risk) over what could have been a single, fairly simple, surgery.
Now, there again, Ross is just a single individual going through the system, and his experience is a little outside the norm because the range of Spina Bifida's outputs can be so enormous...you can be in really, really bad shape, or you can just be John Mellencamp (I....I mean...there.....is a difference there....right??). It's not a condition that lends itself to clearly defined parameters or fill-in-a-circle paperwork. But it's exactly the 'outside the norm' scenarios that make me cringe when pathos-based "Meet Carl. Imagine how much better Carl's life would be if B. See? B. End of story, and now that you know about Carl you can discuss the entire complicated issue by discussing what you know about Carl" journalism props up on any given issue.
Fri March 29, 2013 5:17 am
Dscans wrote:McParadigm wrote:My brother has severe Spina Bifida, which means (among other things) a shunt that runs through his head and a number of stunted mental processes. I'd like to use his situation to illustrate two points regarding efforts to "clean up" or police the Medicare/Medicaid systems:
1. Tight Policing of Such Programs Needs to Be Delicately Structured
It's unquestionable that people scam this system. But Ross tried for years to get a job, and could never find anything that paid as well as what he got from the government if he wasn't working. He even earned an Associates Degree online (we all chipped in to pay for that one), and had a decent work history (he got a job at a movie theater in high school, and continued working there until he turned 22). But nothing. Furthermore, when he DID manage to get work it would often cause huge problems down the line. For example, he managed to land a job working phones for Chicago's Civic Opera House during their up-season, and then was let go when the season ended. He wasn't able to find work after that, but was now officially on the government's "See, you can totally work, so fuck off" list. He's lucky enough to have family who can afford to send him money, or I have no idea what he would have done in the more than eight months it took to get his status returned. Seriously, at one point he was on the phone with some bureaucrat, who actually said "According to our records you are no longer disabled." "That's fantastic," he responded, "wait until I tell my legs."
So while it's important to engage greater control on the output of these programs, that control needs to take the form of something more complicated than "Pretty sure this dude can work, yo." A lot of the time, a topic becomes politicized, we all become very insightful bystanders, and decisions get made based on what looks good rather than what is going to be most effective....because effective is often more complicated, and a lot harder to explain.
2. What Seems Like Common Sense Rarely Is
Last year, Ross developed an open sore on his toe, and was told that unless it became infected (inevitable, as the toe is incapable of healing itself) amputation would be regarded as cosmetic and thus not eligible for government assistance. Basically, they could give him antibiotics and a wrap to help protect it, but unless he was willing to take on the bill himself he had to wait for an infection to manifest before doing anything more.
Of course, it did manifest eventually, and they took the toe. But that kind of waiting game is super duper Russian Roulette...several of the kids we met over the years through the Spina Bifida Association have died because of exactly that. One of them, a fun guy named Dusty, by the time the surgery to amputate his foot was set to occur they discovered it had spread up as far as his hips. A few days later he was dead. He'd had the open sore for several months, but, you know, sorry....can't operate yet. It's not actually a danger.
So, to recap, with Ross the government ended up paying for the amputation anyway and, because of the policies and procedures it currently relies on to protect itself from getting ripped off, it also ended up paying for multiple extra visits and tests, copious amounts of antibiotics, and is now preparing to face the entire situation all over again (not to mention being in a constant state of putting a person's life at risk) over what could have been a single, fairly simple, surgery.
Now, there again, Ross is just a single individual going through the system, and his experience is a little outside the norm because the range of Spina Bifida's outputs can be so enormous...you can be in really, really bad shape, or you can just be John Mellencamp (I....I mean...there.....is a difference there....right??). It's not a condition that lends itself to clearly defined parameters or fill-in-a-circle paperwork. But it's exactly the 'outside the norm' scenarios that make me cringe when pathos-based "Meet Carl. Imagine how much better Carl's life would be if B. See? B. End of story, and now that you know about Carl you can discuss the entire complicated issue by discussing what you know about Carl" journalism props up on any given issue.
I think that's the first time I've seen "amputation" and "cosmetic" in the same sentence.
Sat March 30, 2013 12:12 pm
it is a quandary, to be sure.broken iris wrote:elliseamos wrote:this seems like the problem to me.broken iris wrote:It would threaten his family's livelihood. Jahleel's family primarily survives off the monthly $700 check they get for his disability.
Well, sometimes it's hard to tell if perverse incentives are the problem or the symptoms.