Friday, April 27, 2012

Why Do 1 in 20 Americans, Ages 25 to 64, Collect Disability?

Many of the people receiving mental health services in NC have Medicare and most (those who have received disability insurance payments after two years, also receive Medicaid).

There's a fascinating article in the NYT April 25, 2012, as associated with the yearly meeting of the trustees of Social Security and Medicare:

*Under Reagan (you know, one of those spendthrift Republicans), "....In the mid-1980's Congress softened the criteria which usually required medical diagnoses.....(and) opened the door for applicants who reported mental ailments...collecting disability became even easier as rejected applicants were allowed to appeal before an administrative judge without anyone from Social Security present to defend its decision....."

*Thus, this became the point in time when people with mental health challenges began receiving a great deal of disability insurance

*Prior to that, it was difficult to get into the program

*When unemployment goes up, applications for disability goes up

* Disability insurance payments account for almost $1 our of $5 spent by Social Security

* This past year, the government paid $128.9 billion to 10.6 million disabled workers, 25 percent mroe than it received from payroll taxes

*On top of that (the Times doesn't say this but I know that these two populations overlap as some of my disabled clients received both SSDI and SSI disability checks every month): 5 million adults receive $33 billion from SSI, Supplemental Security Income

*Medicare spent more than $90 billion on benefits for disabled workers (as a provider, that is where the bulk of my money comes from, those Medicare benefits)

*Medicaid spent $110 billion more on the poor disabled (as a provider, Medicaid is more difficult to manage ,particularly with the advent of this idiot Medicaid waiver being launched in NC, and in particular, as associated with one of the first LME's to utilize this, namely the local Western Highlands Network LME).  I dare say that most of that Medicaid money will have been consumed by the ADMINISTRATION rather than the actual treatment of Medicaid beneficiaries----which will make Medicaid in NC the most inefficient health care of all----far less efficient even than the Medicare Advantage plans e.g., Humana, which are progressively being defunded by the Obama administration given their 15+% administration fees versus Medicare's less than 5% administrative fees.

*The population of disabled adults is growing, particularly for men of all ages

*Disability outlays have grown about 5.6% a year after inflatio in the past two decades compared with 2.2 percent for other Social Security spending

*the Disability fund will be exhausted by 2016, two years earlier than previously estimated (after that, this fund will be supplied by diverting money from older recipients receiving Social Security Benefits

*people living on Disability can earn up to about $1000/ month and retain benefits but only 1 in 10 makes any extra money

*"The good news is that the disability program is easier to fix.  Unlike Social Security and Medicaid, whose financial strains are driven mostly by demographic forces, the disability program suffers from artificial woes that can be corrected.  Fixing the system requires providing incentives to enable disabled workers to continue working if they can..."

And HOW, pray tell, will these jobs be found in a jobless economy----particularly joblessness in rural western NC, where there are fewer and fewer jobs?

Nice work, if you can get it.



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