I think the “Scrooge of the Day” award has to go to Nicholas Eberstadt:
In recent years, the biggest increases in disability claims have been for “musculoskeletal” problems and mental disorders (including mood disorders). But as a practical matter, it is impossible for a health professional to ascertain conclusively whether or not a patient is suffering from back pains or sad feelings. The government’s disability-insurance programs were intended to address genuine need.
It might come as a surprise to Mr. Eberstadt but despite its expansion in recent years it’s pretty difficult to qualify for Social Security Disability. It would be nice if he treated us to some actual statistics on the rate of fraud and abuse in the program rather than smearing all recipients. Some people actually have “genuine need”.
It would be nice if he treated us to some actual statistics on the rate of fraud and abuse in the program rather than smearing all recipients. Some people actually have “genuine needâ€.
True, that would have been a worthwhile addition to a commentary that was otherwise chalk-full of statistics dealing with not only the incredible rise of people participating in means-tested programs, but also the increase noted in the ‘flight of men’ from the work force. He correlated this last facet with being even more problematic in the 30-something age group, than was seen in Greece.
Now, that is troubling!
Eberstadt also built his thesis around a back drop of trillions of dollars annually going towards the welfare state we’ve created here, calculating that SS disability funds are projected to ‘run out’ before the conclusion of our president’s second term.
That is more than troubling!
As for ‘smearing’ any genuine needs of people — I think his sensitivities were being over-ruled by the boulder of fiscal unsustainability, shown in his piece, to indefinitely support anybody’s need, whether they are real or fraudulent.
I intermittently try to read on disability as an issue. I have never found very good sources. I really dont know how difficult it is to get on disability. The surge in numbers makes me think it is more than just an increase in the number of people disabled. I keep boping someone(s) will do a good series on the topic sans some ideological point scoring.
Steve
What bugged me about has jabs at disability was the misdirection. Fund accounting in the federal government is a fiction from the get-go. Nobody really believes it. It’s like a Soviet-era joke.
The Social Security Administration estimates benefit overpayments in the amount of about $2 billion on outlays of more than $600 billion. If Mr. Eberstadt has evidence of fraud, it’s his duty as a citizen to report it. That he hasn’t suggests he’s got nothing other than outrage. The same is true of the economists who’ve been beating this drum—David Autor and I forget the name of the other chap. To the best of my knowledge they’ve never filed an actual complaint. Which means they’ve got nothing.
To the extent that there’s a problem it’s with the Congress that voted to widen eligibility for SSDI back in 1984. Why blame the people who qualify?
Just for the record neither I nor anybody in my family nor any friends collect SSDI or have applied for it. I have, however, corresponded for years with people who have done so.
When I referred to Scrooge, this is what I meant: “If they would die they should hurry up about it and decrease the surplus population”.
For me the key point is that accusing people of crimes without specific evidence is slanderous. It’s wrong.
Obviously Eberstadt hit a nerve. However, after reading the link you provided, I saw his derisive disorder references as more of a judgmental side bar, rather than a pivotal part of the piece. His main point was directed towards the fiscally unhealthy leaps and bounds that welfare benefits are growing, which is where he laid the groundwork of statistical proof. He definitely suggests that the perimeters of eligibility may be too slack. However, I’ve read and heard plenty anecdotal stories of people, supporting his less-than-subtle insinuations, about people qualifying for disability, visa vie an alleged physical malady, who then go on and engage in work or play openly disputing these impairment claims.
Examples of my own: A good friend’s brother, after an emotional break-up with a girlfriend, applied and received disability as a young man. My second cousin’s husband, a sensitive artist, has been unable to steadily maintain employment. He too is applying for SSDI (he’s in his mid 40’s), and Susan, my cousin (an attorney) has no doubts he will get it. An insurance agent friend relayed how a client’s son, who suffered from lingering side effects of a heavy drug problem, eventually was able to get disability. All of these younger men cited mental/emotional disabilities, and it has been a fairly easy process for them to navigate the government bureaucracy and become a disability recipient.
Finally, if Eberstadt’s figures were correct in saying that ” For every 17 people in the labor force, there is now one recipient of Social Security disability program payments”, I would say that not knowing someone on disability is more of a rarity than a norm.
Well from a logic stand point, based on what Eberstadt wrote that would be tough, no?
BTW, off topic but hey this is the internet….
Radley Balko has been doing a “Raid of the Day” series on his blog at HuffPo. He has done 3-4 so far. Just for you guys who think keeping drugs legal is such a great idea you might want to read them. So far, every raid has been drug related. Todays:
Marijuana residue. Translation: pure bullshit, but who cares stupid judges will sign of just about anything for a no-knock warrant.
Wow, how the zeitgeist changes. Just a few weeks ago, a therapist had the ability to predict mass murders. This week, a therapist cannot tell whether or not someone has sad feelings (by which I assume is meant “depression”).
From a logic standpoint his complaint is against Congress that set the standards and goes unmentioned in his op-ed rather than against the people on disability he’s whinging about. Steve V., he’s charging fraud. IMO that’s a serious charge that deserves, you know, actual evidence and stuff.
PD Shaw brings up a good point. Depreession isn’t just “sad feelings”. It’s a genuine disability.
Thanks for explaining the obvious Dave. Now let me return the favor. If it is “it is impossible for a health professional to ascertain conclusively whether or not a patient is suffering from back pains or sad feelings” then you can’t really determine when there is fraud.
So when you ask for evidence, providing said evidence is going to be problematic. Of course, at the same time, that cuts against Eberstadt since he can’t prove those people really don’t belong on some sort of disability.
I suppose one could argue that something with a ripe potential for abuse shouldn’t be made into policy, but that is a rather different question and does not imply any specific allegations of fraud either.
I think Eberstadt falls down with the above. Social Security and Medicare are transfer programs pure and simple. Insurance is for things that are “bad” and “rare”. Retirement is neither perceived as bad or rare. As such, Social Security is not a retirement program, it is, has been, and always will be a transfer program. Same for Medicare. Health expenditures when you get old, while often “bad” are not rare, generally speaking. As such Medicare is a transfer program as well. Always has been and always will be.
That’s precisely my point.
Perhaps its a reflection of a personal bias, but I found Eberstadt’s statement to be more dismissive of the health professionals charged with making the evaluation than the recipients. Health professionals are expected to have specialized knowledge used to diagnose a recognized condition; the person seeking an expert opinion may not know whether their back conditions or feelings of grief qualify as a treatable impairment.
“Steve V., he’s charging fraud. IMO that’s a serious charge that deserves, you know, actual evidence and stuff.”
I agree with your overall sentiment, but I also think that the numbers themselves constitute a form of evidence. Epidemiology can tell us that there is a problem, if not the cause. The numbers are large enough that we should be looking for evidence. My sense is that an industry has grown up around getting disability, including health professionals as PD notes. That is just a sense, with the numbers as support. I think we need some real investigations to see if there is something amiss.
Steve
At FRIDAY NIGHT VIDEOS there’s something for everyone…
http://www.commoncts.blogspot.com/2013/01/friday-night-videos.html
steve makes a good point with the epidemiology analogy. And sometimes one can just take a look around and see something is wrong.
Example: I didn’t understand it when everyone started having a conniption about steroids in baseball. I had known baseball players were juicing in significant numbers since the early 1990s. All I had to do was watch the baseball highlights during nightly news casts (I still watched nightly news casts back then) and you could see it. The players were looking more and more massive, more and more like BIG linebackers on NFL teams. Did that constitute proof? Not really. But the suspicion was sure as Hell justified.
Incidentally, there are other sports that now have steroid problems, and the only real evidence one needs as a fan (as opposed to a legal proceeding) is a set of eyes and experience as a fan. As a citizen I don’t see why someone can’t point out what looks to be flagrant abuse of a government program. The increase in usage of the SSDI program doesn’t pass an immediate smell test.
That may be what Eberstadt is thinking. However, there’s another explanation that doesn’t involve wrongdoing on the part of either physicians or people receiving DI. When they’ve got a job, many people soldier on, even when they legitimately meet the qualifications for disability insurance. When they lose those jobs, they apply for SSDI.
That would explain an increase in the numbers of people applying and qualifying for SSDI without resorting to criminal accusations. As I wrote above, the Social Security Administration doesn’t claim so high a rate of fraud and I think that Mr. Eberstadt needs more evidence than increase in the number of those qualifying for disability. If his complaint is against the Congress for broadening the qualifications for SSDI, he should write that. If his complaint is that people who qualify for SSDI have some sort of obligation to drag themselves to work, he should write that.
There have been complaints over the use of performance-enhancing drugs in baseball nearly as long as there’s been baseball. Long before people complained about baseball players being role models and setting bad examples, there were complaints about use of alcohol or opium as unfair to players who didn’t rely on them.
As well as anyone can tell the use of steroids in athletics goes back to the Russian Olympic teams in the 1950s. U. S. teams began using them shortly thereafter. Their use was banned in the Olympics in 1975.
It’s known that there was systematic use of steroids in professional football in the 1960s so I think it’s a reasonable conjecture that they were used before then.
It’s been claimed (and denied) that Mickey Mantle used steroids in 1961. They were neither illegal nor banned in baseball then but their use was considered “unsporting”.
I’m not a sports fan and can only conjecture. For well over a century there’s been a tension between sports being games played by gentlemen and being an industry using industrial methods of production. I think that tension is the source of the “conniption”.
I’ve not thought about people “soldiering on” with a disability while employed. I would also add that losing a job is a major life stressor and one would expect job loss to contribute to mental health issues, and possibly even aggravate physical issues.
I also agree w/ steve that people seeking disability are increasingly able to organize and share informaton on which health professionals are sympathetic to finding a disability. Over time and with more opportunities to network and share information, they can take increasing advantage of such knowledge. Disability lawyers might be helping, but I don’t know.
The Mickey Kaus arguement here I believe is that you don’t want the most stringent legal criteria for fear that too many of the truly deserving are excluded, so instead our social contract needs to rely upon stigma and informal controls. He opposes government and community organizing efforts to eliminate/reduce stigma from welfare.
It’s known that there was systematic use of steroids in professional football in the 1960s so I think it’s a reasonable conjecture that they were used before then.
I’m not aware of any systematic use in the NFL until the Pittsburgh Steelers team use in the 1970s. Prior to that it was one-off individual use, such as Lyle Alzado.
Incidentally, it looks like “immigration reform” is going to swell the ranks of those on Medicaid and covered under various aspects of Obamacare.
Use of steroids was a regular part of the training program for San Diego Chargers linemen as early as 1963.
Ah, that’s the first I’ve heard of this! Figures it would be Sid Gillman, that man was very savvy. I still prefer his style of offense – throw the long ball!
Bernstein has some nice stats on disability.
http://jaredbernsteinblog.com/disability-rolls-and-the-makerstakersfakers-nonsense/
Steve
You might notice that Bernstein’s charts largely support what I’ve said here: that the DI applications reflect a lack of jobs more than they do criminal fraud and that it’s relatively hard to qualify.
I’m all for weeding out crime and fraud. What gripes me is the assumption of crime and fraud without substantial proof.
The real underlying problem is, obviously, not enough jobs being created. There are all sorts of views on why that is: inadequate aggregate demand, a lazy and ignorant workforce, currency manipulation, excessive reliance on consumer spending, healthcare rising as a proportion of the economy, and (one of my favorites) a level of domestic investment that is inadequate to produce enough jobs for our working age population (that’s circular, by the way).
As far as I’m concerned there are no “A”s for effort. No politician gets a pass. None of ’em should get paid until they do their damned jobs.
The real underlying problem is, obviously, not enough jobs being created.
Meanwhile, Obama will campaign in state with highest unemployment for more immigration to fill the jobs Americans just can’t get. (H/T Steve Sailer, though I think I phrased it a little better)
No politician gets a pass. None of ‘em should get paid until they do their damned jobs.
Oh, please. The American people just decided that the politicians are doing the best fucking job in the history of fucking jobs. (Move over Marilyn Chambers and John Holmes.) Michael even gives the President a B+ for presiding over the shittiest economy since my parents were young during the Great Depression. Poor unemployed people voted to remain poor and unemployed, and rich assholes like Reynolds voted for poor people to remain poor and unemployed, immigrants on welfare voted for more immigrants on welfare, et cetera. This is what the majority wants. So fuck the majority, and to hell with everyone that voted for these assholes. I hope bad things happen to them and their families, because they’ve voted for bad things to keep happening to me and mine. To Hell with them all.
“The real underlying problem is, obviously, not enough jobs being created. ……”
Lack of jobs as well as the rest of the problems cited in that paragraph are all reasonable components of rising disability claims. I would add misuse of drugs to the list as well, including alcohol. Two of the three examples I posted earlier were substance-abuse oriented, leading to these people applying for disability.
“The real underlying problem is, obviously, not enough jobs being created. There are all sorts of views on why that is: inadequate aggregate demand, a lazy and ignorant workforce, currency manipulation, excessive reliance on consumer spending, healthcare rising as a proportion of the economy, and (one of my favorites) a level of domestic investment that is inadequate to produce enough jobs for our working age population (that’s circular, by the way).”
I think this is correct, though note that Bernstein’s numbers dont explain all of the increase in DI. I think that we have limited public policy tools for dealing with these problems. I think your first and last problems are probably the most important for a growing economy. With private levels of debt remaining close to record highs (much of the decrease coming from foreclosures and not paying down debt), I don’t see us having the tools we need. I dont even know what they would be. Economic growth is the key, but we certainly dont know how to make this happen in the short term.
Steve
Really nice review on DI and some of its mechanics.
http://www.cbpp.org/files/8-9-12ss.pdf
Steve
If that is your point, then asking for proof is rather…disingenuous, no?
I was thinking something like this too, but didn’t have enough knowledge of the relevant areas to know if this was a reasonable position to take.
I recall reading somewhere regarding autism that when you see a rapid rise in the rate of incidence over time that is a strong indicator of misdiagnosis, or at least something to consider. Seems to me we could use that same logic here. If there is a large rise in the rate of incidence over time, then that might suggest a problem…
BTW, Dave I think you are unduly unfair to David Autor. I was reading a couple of his articles, his complaint is that there is rampant free lunch eaters, but that the current system is unsustainable with the current trajectory. That could and may include fraud, but it may also include bad policy design as well.
Dave,
You are being highly inconsistent here.
1. We can’t tell if there is fraud.
2. The reported rates are very low.
You can’t believe in 1 and then point to 2, at least not without noting that 2 comes with a shovel full of salt.
No, not really. Try again. Look at the big increase circa 2000-2005. There was a second increase around the time unemployment tanked, but taking that data and doing some basic correlations probably wouldn’t give as good a fit as some might think.
See here is the problem, if going on DI is relatively easier than it was in the past, then there could be several explanations:
1. People are treating DI as an form of unemployment insurance: i.e. they go on DI cause it is so “easy” and there isn’t a time limit. Further, they might qualify for both, although I would hope that these programs would not allow such “double dipping”.
2. They qualified earlier for DI, but “soldiered on” and only when they became unemployed did they turn to DI.
3. Some mixture of both is occurring.
Add to that guys like Autor who, by what I’ve read so far, seem to be saying, irrespective of 1, 2, or 3 above the system is not sustainable.
“employment tanked…”
Dammit, I hate it when I do that when typing fast.
Because you can’t, IMO. We need to drop the “engineer” mentality when it comes to the economy.