Saturday, February 19, 2011

A drain on society

The thing that doesn't get mentioned when people whine about the cost of supporting people on disability and paying for Medicaid is that these measures give us more productive people to contribute to our society and economy.   All anyone calculates is the cost of the programs.  But there are dividends to the investment!

Actively sick people don't work as well or as much as they could.  People with stabilized conditions (say, someone who can afford their antidepressants) are going to be a lot more useful in the workplace, and pay taxes in to the system.  The same perverse system plays out with social security disability.  

You can't get social security for disability unless you're completely unable to do any work.  This forces some people to choose between working below their true capacity and not working at all.

If a pianist gets rheumatoid arthritis, she can probably still work some retail, so she's not eligible for any support, even as she gives up the prestige and pay of her old career.  Maybe she could be a successful music teacher, but if she loses her status in her profession (along with class status - dressing like the kind of person you'd pay well to teach your kid piano is tough to do on social security), it's going to be hard for her to get a foothold in a business suited to her talents, so she may well end up organizing the sweaters at Old Navy 15 hours a week.

Private-sector disability insurance sometimes works in terms of long- and short-term tiers of disability.  If you're disabled for only a little while, you have some support to get back into work.  If you are just relying on social security, you have to wait until you're completely disabled to get any income support (and then a couple of years to get through the process of applying).  Under-funded Medicaid is hard to rely on to bring you back to your previous capacity, especially if you are out of work while you're under the weather.  Living without income is not conducive to recovery.

This system is a lot more sustainable, since it keeps more people in the workplace and paying premiums for those who won't ever get back (e.g. the pianist who has a massive stroke and can't process language anymore).

An added bonus to the tiered system is that it works for parental leave as well.  You don't have to just cut ties with the working world if you need a year of maternity leave.  American men and women have shown that they're not willing to let work swallow up their entire lives, and the American workforce is fractured into a million dysfunctional pieces when having children means exiting the workforce, or even mommy-tracking your otherwise brilliant career.

But we can't have fakers suckling at the government's teat until they're ready to work again.  It's fraud!  And theft!  Who do these people think they are?  

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