How Americans Game The $200 Billion
Ronald Reagan, conservative hero, did much to loosen the eligibility criteria for Social Security… disability benefits, thereby increasing the possibilities for waste, fraud, and abuse.
If youre a regular reader of this blog, you know that Americas health-care entitlementsMedicare, Medicaid, and Obamacareare the biggest drivers of our exploding federal debt. What you may not know is that there is a fourth program, that pays disability benefits through the Social Security Administration, that is also growing at an alarming pace. While part of that growth can be explained by the aging of the U.S. population, the largest factor in the proliferation of disability spending comes from the fact that Congress has dramatically expanded the definition of who gets called disabled. As a result, many able-bodied Americans have been granted government paychecks for life, crowding out our ability to direct needed resources to the genuinely infirm.
Disability insurance has replaced welfare
As the below chart shows, the last three times the unemployment rate has gone up due to recessionin the early 1990s, the early 2000s, and the late 2000sapplications for Social Security Disability Insurance have spiked. The green line is the unemployment rate; the blue line is the number of disability applications per 1,000 adults.
Reagan relaxed disability eligibility criteria
The other big driver is increased disability payments
SSDI program to go bankrupt in 2016; reform is urgent
What Are The Most Common Causes
The most common causes of intellectual disabilities are:
Genetic conditions. Sometimes an intellectual disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. Examples of genetic conditions are Down syndrome, Fragile X syndrome, and phenylketonuria .
Complications during pregnancy. An intellectual disability can result when the baby does not develop inside the mother properly. For example, there may be a problem with the way the babys cells divide. A woman who drinks alcohol or gets an infection like rubella during pregnancy may also have a baby with an intellectual disability.
Problems during birth. If there are complications during labor and birth, such as a baby not getting enough oxygen, he or she may have an intellectual disability.
Diseases or toxic exposure. Diseases like whooping cough, the measles, or meningitis can cause intellectual disabilities. They can also be caused by extreme malnutrition, not getting appropriate medical care, or by being exposed to poisons like lead or mercury.
We know that intellectual disability is not contagious: you cant catch an intellectual disability from anyone else. We also know its not a type of mental illness, like depression. There are no cures for intellectual disability. However, children with intellectual disabilities can learn to do many things. They may just need take more time or learn differently than other children.
The National Adult Literacy Survey
The first national database on adults in the general population was in response to the Adult Education Amendments of 1988 that required that the U.S. Department of Education assess the literacy proficiency and practices of adults in the nation. The National Center for Education Statistics was then charged with the task of identifying concretely the basic educational skills needed for literate functioning and in conjunction with the Education Testing Service developed the National Adult Literacy Survey . The survey was administered to a national representative sample of 26,000 individuals 16 years or older. It included direct assessment of literacy skills and activities, language background, educational and work experiences, health problems, and disabilities, if any. In regard to health problems and disabilities, participants were asked whether they had a physical, mental, or other health condition that kept them from participating fully in work, school, housework, or other activities. Twelve percent said “yes” to the above question and were then asked a series of follow-up questions to determine the specific disability. In response, three percent of the participants said they had a learning disability.
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What Is An Intellectual Disability
Intellectual disability is a term used when a person has certain limitations in cognitive functioning and skills, including communication, social and self-care skills. These limitations can cause a child to develop and learn more slowly or differently than a typically developing child. Intellectual disability can happen any time before a child turns 18 years old, even before birth.
Intellectual disability is the most common developmental disability.
According to the American Association of Intellectual and Developmental Disabilities, an individual has intellectual disability if he or she meets three criteria:
What Is The National Household Travel Survey And How Does It Cover Disability
The NHTS, conducted by the Federal Highway Administration , is the primary source of data on household travel behavior in the United States. FHWA conducted the latest version in 2017 and earlier versions in 2001 and 2009.
The NHTS asks respondents if they have a temporary or permanent condition or handicap that makes it difficult to travel outside of the home. If they respond yes, the NHTS asks follow-up questions about the mobility devices they use, such as canes or wheelchairs. It also asks follow-up questions about how the condition affects their travelfor example, by limiting their driving to daytime.
Some respondents have disabilities that might not limit travel, but the NHTS asks only about travel-limiting disabilities. The estimates in this report will therefore differ from disability-related estimates from other sources, such as the Current Population Survey or the National Health Interview Survey. For the rest of this report, people with disabilities refers to people who report having travel-limiting disabilities. The NHTS also does not include people living in nursing homes or other group quarters.
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How Does Mode Choice Differ
People use personal vehiclesas drivers or as passengersfor most trips regardless of disability status, but people without disabilities use them more often. People age 18 to 64 with disabilities use personal vehicles for 74.8 percent of trips; people without disabilities use them for 83.9 percent. People with disabilities travel as passengers for a greater share of personal vehicle trips than people without disabilities .
Figure 7 shows how mode share varies by worker status and disability status for people age 18 to 64. Workers without disabilities drive for more of their trips than workers with disabilities . Similarly, non-workers without disabilities drive for more of their trips than non-workers without disabilities .
Figure 7: Mode Share by Worker and Disability Status , 2017
NOTE: Other modes includes bicycles, golf carts, recreational vehicles, school buses, private or charter buses, city-to-city buses, Amtrak or commuter rail, taxis and limos , rental cars, airplanes, boats, and ferries.
: U.S. Department of Transportation, Federal Highway Administration, 2017 National Household Travel Survey.
Walking is the second most common mode after personal vehicles. Workers age 18 to 64 with disabilities walk for a slightly greater share of trips than workers without disabilities . This finding may seem counterintuitive. One possible explanation is that workers with disabilities are more likely to live in zero-vehicle households than workers without disabilities .
United Nations Disability Inclusive Strategy
In June 2019, the UN Disability Inclusion Strategy was launched by the UN Secretary-General to promote sustainable and transformative progress on disability inclusion through all pillars of the work of the United Nations. This strategy requires all UN agencies to ensure that disability inclusion is consistently and systematically mainstreamed into all aspects of work.;
WHO welcomes UNDIS and is currently preparing a comprehensive WHO Policy on Disability and Action Plan, committing WHO to become an organization inclusive of people with disabilities in all their diversity and to systematically integrate disability in all programmatic areas, including at the country-level.
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Stigma And The Social Construction Of Disability
If baby boomers who have not learned electroniccommunication become a despised, as opposed to merely statistical,minority, and if, as a result, they become cut off from friends andacquaintances who rely on email and social media for long-distancecommunication, and who dismiss them as luddites and fogeys, they willlearn something about the social construction of disability. They willlearn even more if they cannot cross the digital divideor can do so only at considerable economic cost or cognitive strain,or if they are still regarded as luddites and fogeys even when theydo. They will experience something of the stigma and discriminationthat cut across impairments.
The second type of disability experience, then, is of attitudinalbarriers to ordinary activity that are facts of life for people withdisabilities. According to the social model, which highlights thesebarriers, the disability experience that links peoplewith cystic fibrosis to people with epilepsy, learning disabilities,or cerebral palsy is one of having to deal daily with the largelynegative responses of others. These negative responses involve severalelements. The most discussed is overt stigmatization anddiscrimination: being treated as a social outcast, losing out on jobs,friends, or partners, because other people do not want to interactwith a person with a disability, or enduring grossly inadequateaccommodation because reasonable accommodation is thought too costlyor troublesome.
D Summary Of Recent And Current Federal Efforts In Health Promotion And Disease Prevention For Women With Disabilities People Who Are Blind Or Have Vision Impairments People Who Are Deaf Or Hard Of Hearing And People With Intellectual And Developmental Disabilities
1. Women with Disabilities
AHRQ, CDC, NIDRR, the National Cancer Institute , and the National Institute of Mental Health have undertaken or supported recent research related to health disparities experienced by women with disabilities. CDC has undertaken a qualitative study to explore the barriers to breast cancer screening for women with disabilities and has developed and is testing the Right to Know campaign. NIDRR has supported research to develop group therapy interventions for women with physical disabilities who experience symptoms of depression. NCI supported research for a pilot study to develop and test methods of identifying women of screening age with physical and sensory disabilities, as well as a questionnaire to identify barriers in screening mammography for these women. NCI also funded a study on the effects of disability on the diagnosis of breast cancer. NIMH has funded HIV/AIDS prevention curriculums for women with intellectual disabilities.
2. People Who Are Blind or Have Vision Impairments
3. People Who Are Deaf or Hard of Hearing
4. People with Intellectual and Developmental Disabilities
5. Effectiveness of Federal Efforts at Health Promotion and Disease Prevention for People with Disabilities
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How Does An Intellectual Disability Happen
Intellectual disabilityformerly known as mental retardationcan be caused by injury, disease, or a problem in the brain. For many children, the cause of their intellectual disability is unknown.
Some causes of intellectual disabilitysuch as Down syndrome, Fetal Alcohol Syndrome, Fragile X syndrome, birth defects, and infectionscan happen before birth. Some happen while a baby is being born or soon after birth.
Other causes of intellectual disability do not occur until a child is older; these might include severe head injury, infections or stroke.
Report Released To Coincide With 22nd Anniversary Of The Ada
About 56.7 million people 19 percent of the population had a disability in 2010, according to a broad definition of disability, with more than half of them reporting the disability was severe, according to a comprehensive report on this population released today by the U.S. Census Bureau.
The report, Americans with Disabilities: 2010, presents estimates of disability status and type and is the first such report with analysis since the Census Bureau published statistics in a similar report about the 2005 population of people with disabilities. According to the report, the total number of people with a disability increased by 2.2 million over the period, but the percentage remained statistically unchanged. Both the number and percentage with a severe disability rose, however. Likewise, the number and percentage needing assistance also both increased.
This week, we observe the 22nd anniversary of the Americans With Disabilities Act, a milestone law that guarantees equal opportunity for people with disabilities, said Census Bureau demographer Matthew Brault. On this important anniversary, this report presents a barometer of the well-being of this population in areas such as employment, income and poverty status.
Other highlights:
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The Washington And Kansas State Studies
The most recent attempts to answer this question focused on yet a different segment of the population, namely, adults who were receiving Temporary Assistance for Needy Families previously called Aid to Families with Dependent Children and those who participated in the Job Opportunities Basic Skills programs . The projects were designed along similar lines in order to provide cross-validation of their findings. Not surprisingly, the prevalence rate for adults with LD among TANF recipients was approximately 30% in both states. Thus, by adding poverty and under-employment or unemployment along with low literacy functioning and educational attainment, the prevalence of LD doubles, i.e., from 15% to 30%.
About the Author: Susan A. Vogel, Ph. D., is professor of special education in the Educational Psychology, Counseling, and Special Education Department at Northern Illinois University and is currently President of the International Academy for Research in Learning Disabilities. She has served on several national boards including the National Institute for Literacy in Washington DC, and The International Dyslexia Association, and is on the editorial board of many journals including IDA’s Annals of Dyslexia. Her research interests include faculty attitude and practices toward students with LD in higher education, college LD support services, and postschool outcomes.
Paul H. Brookes Publishing 1998 ISBN 1557663475
Social Security Works Aggressively To Prevent Detect And Prosecute Fraud
Social Security, along with the Office of the Inspector General, identifies and aggressively prosecutes those who commit fraud. Our zero tolerance approach has resulted in a fraud incidence rate that is a fraction of one percent.
One of our most effective measures to guard against fraud is the Cooperative Disability Investigations program. Under the program, we investigate suspicious disability claims early, before making a decision to award benefits. In effect, we proactively stop fraud before it happens. In fiscal year 2018, with the help of state and local law enforcement, the program reported nearly $188.5 million in projected savings to the disability programs. This resulted in a return on investment of $17 for each $1 spent.
Eradicating fraud is a team effort. We need people who suspect something to say something. If you suspect fraud, please visit the Office of the Inspector General and select Report Fraud, Waste, or Abuse or call 1-800-269-0271.
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E Conclusion And Recommendations
The extensive network of Federal programs that provide health care and prevention services to people with disabilities serves as a critically important safety net for many, including children and adults with disabilities. Some other HHS agencies and programs, such as MCHD’s LEND program, have established unique health delivery models for certain people with disabilities. However, health disparities research has been limited.
The Federal biomedical research effort has historic roots in a philosophy of disability and disease prevention, and most current biomedical research still aims to achieve these goals. However, a recent shift has taken place that acknowledges the fact that some people living with disabilities experience poorer health than the general population and that research is required to understand the causes of these health disparities. While this shift is in evidence in Focus Area 6 of “Healthy People 2010” and in seminal reports by the Surgeon General and the IOM, people with disabilities are still largely excluded from the major Federal health disparities research initiatives. As a result, there has been limited investigation that illuminates the reasons for health disparities in this population. Moreover, almost no resources have been devoted to exploring the extent to which barriers in the built environment and the lack of accommodation in health care delivery settings contributes to health disparities experienced by people with disabilities.
Health Coverage And Benefits
- The health care system in the United States is complex, highly fragmented, and sometimes overly restrictive in terms of program eligibility. This leaves some people with disabilities with no health care coverage and others with cost-sharing obligations and limits on benefits that prevent them from obtaining health-preserving prescription medications, medical equipment, specialty care, dental and vision care, long-term care, and care coordination.
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Models Decisions And Policies
The medical and social models suggest different views about the impact of disability on well-being, anddifferent views about how disability is relevant to reproductivedecisions, medical interventions, and social policy. Those who accepta social model of disability regard the association between disabilityand well-being as highly contingent, mediated by a variety ofenvironmental and social factors. They question conceptions ofwell-being that give a central role to the possession or exercise ofthe standard array of physical and mental functions, as thoseconceptions imply, or are often taken to imply, that well-being isprecluded or diminished merely by the absence or limitation of thosefunctions. As a result, theygenerally see the disadvantages of disability not only as externallycaused, but as less formidable than they appear to people who viewdisability in largely biomedical terms. These differences arereflected in the conflicting assessments of life with disabilitiesfound in the bioethics and public policy literature on the one hand,and disability scholarship on the other .
Who Reports Having Travel
An estimated 25.5 million people have travel-limiting disabilities, accounting for 8.5 percent of the population age 5 and older in 2017. People with travel-limiting disabilities accounted for 8.5 percent of the population in 2001 and 10.2 percent in 2009. An estimated 13.4 million Americans age 18 to 64 have travel-limiting disabilities, accounting for slightly more than half of people with disabilities in 2017 and 6.7 percent of their age group. An estimated 11.2 million Americans age 65 and older also have travel-limiting disabilities; they accounted for 43.9 percent of people with disabilities in 2017 and 23.5 percent of their age group.
The percentage of people reporting travel-limiting disabilities increases with age . Before age 50, the percentage is less than 10. It increases to 18.4 percent by age 70 and to more than 31.9 percent by age 80. Most of these disabilities are long-term: 79.1 percent report having a disability for more than 6 months and another 13.8 percent report having a life-long disability.
Figure 1: Disability Reporting Rate by Age , 2017
: U.S. Department of Transportation, Federal Highway Administration, 2017 National Household Travel Survey.
Over half of all respondents with disabilities use one or more medical devices:
- Walking canes
- White canes for visual impairments
- Seeing-eye dogs
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