Disability and Democracy

Our long national nightmare is almost over: today, after seven hard weeks of bowlin’ and shootin’ and drinkin’, the people of Pennsylvania will finally get to vote in our primary. It’s been a critical time in this electoral cycle, a time during which American news media were able to dig hard and deep into the issues that underlie the moral and constitutional crisis to which the Bush Administration has brought us: did Barack Obama meet <a href=”http://en.wikipedia.org/wiki/August_Spies”>August Spies</a> at a fundraiser in 1886 before founding the Muslim Brotherhood in 1928? And what about Cindy McCain – <a href=”http://politicalticker.blogs.cnn.com/2008/03/05/can-cindy-mccain-really-be-that-perfect/”>can she really be that perfect?</a>

So I thought I’d write a little something about the candidates’ policy positions on disability, because apparently (a) no one knows that the candidates have policy positions on disability and (b) policy positions on disability are not as important as flag pins. Granted, disability policy never swings an election. And why should it? Unless you yourself have a disability, or unless you know someone with a disability, or unless you’re concerned about things like employment or health care, or unless you might get sick or injured someday, or unless you’re planning on aging, disability policy is irrelevant to you.

Hillary’s disability policies are pretty damn good, especially when it comes to health care, which I’ve always considered (not that I’m alone in this) the issue on which she’s more solid than Obama. Why her campaign chose instead to emphasize her crossing of the Commander-in-Chief threshold with McCain, and the 3 am phone call from the wolves in the forest, is anybody’s guess. My own is that they’ve thoroughly internalized the belief that Democrats are weak on national security, and that as a result, they decided to run against Obama’s opposition to war in Iraq by talking dismissively of <a href=”http://www.thecarpetbaggerreport.com/archives/14843.html”>that speech he gave in 2002</a>, fluffing McCain, and claiming that <a href=”http://www.jedreport.com/2008/04/yes-obama-criti.html”>Hillary actually criticized the war before Obama did</a> – that is, if you start counting in 2005, if by “criticize” you mean “argue for a better war,” and if you use “before” in the sense of “after.” Thus we got Hillary as Iron Lady rather than Hillary as Health Care Provider and Disability Worker. Though it was probably crafted by Mark Penn, it sounds like a Democratic campaign devised by Maureen Dowd: <i>at all costs, do not be the mommy party – associate the candidate with big hard military strength</i>.

So over the past few months, I admit, I’ve had a hard time distinguishing between my own Hillaries: Hillary the capable policy wonk and Hillary the doubter of Obama’s patriotism and and general electability. (I assure you that if you’d told me, two months ago, that she would seek the <a href=”http://firstread.msnbc.msn.com/archive/2008/04/20/924127.aspx”>endorsement</a> of <a href=”http://en.wikipedia.org/wiki/Arkansas_Project”>the reclusive billionaire maniac behind the Arkansas Project</a>, I’d have told you that you were smoking some of the crack that Governor Bill Clinton flew into the Mena airport with the help of the Contras and Queen Elizabeth.) But despite the shenanigans of these past few months, I still can recall that Hillary the capable policy wonk is a very capable policy wonk.

OK, so go to Hillary’s web page, click on “Issues,” choose “Providing Affordable and Accessible Health Care,” then go over to the right sidebar – the one headed “Hillary’s Plans,” and go down to the subheading, “How Hillary’s plan affects:” and then click on “Americans with Disabilities.” <a href=”http://www.hillaryclinton.com/files/pdf/dis_impactreport.pdf”>You’ll get a .pdf</a> that reads, in part:

<blockquote>Employer-sponsored health care can present significant cost and coverage concerns for both employers and people with disabilities. Some insurance plans cap payments for durable medical equipment, which includes items such as wheelchairs, crutches, braces, and ventilators; in effect, making coverage for those items unavailable. The American Health Choices Plan prohibits insurance companies from denying coverage to limiting coverage for pre-existing conditions. In addition, insurers will be prohibited from charging significantly higher premiums based on medical conditions, age, gender, or occupation.</blockquote>

This is good stuff, though it painfully exposes the problem of relying on employer-sponsored health care in the first place – and doesn’t mention the fact that the unemployment rate for people with disabilities is . . . well, <a href=”http://www.ilr.cornell.edu/edi/disabilitystatistics/issues.cfm?n=4#Unemployment”>exceptionally difficult to determine, but quite high</a>. But then, there’s another problem here, and throughout Clinton’s website: because (as is so often the case), there’s no separate heading for policies affecting people with disabilities, you have to look around under other issues – in this case, health care – to see if disability is mentioned.

OK, putting disability under health care makes sense, of course. But then in the “Issues” section under <a href=”http://www.hillaryclinton.com/issues/education/”>”Improving Our Schools,”</a> there’s a subheading, “A Champion for Educators and Children,” which contains the critical passage:

<blockquote>Among her many efforts to fully fund IDEA [the Individuals with Disabilities Education Act], Hillary cosponsored the <i>IDEA Full-Funding Act of 2003</i> to finally fulfill the federal government’s long-standing promise to provide for 40% of the average per pupil expenditure for each and every child with a disability. In 2005, she offered an amendment to provide $4 billion additional to IDEA. The amendment failed by a narrow margin.</blockquote>

This too is good stuff. IDEA is notoriously underfunded; the next time you hear a conservative whingeing about the injustice of “unfunded federal mandates,” ask him (or her!) whether they’d vote for full funding for IDEA. That usually quiets ‘em down pretty quickly. But you really have to hunt around for this material on the Hillary website: I mean, who would guess that her position on IDEA is filed under the subheading “A Champion for Educators and Children,” but that the subheading <a href=”http://www.hillaryclinton.com/news/release/view/?id=6246″>“Giving Every Child a Chance”</a> doesn’t mention the subject?

Likewise, the wonderfully informative <a href=”http://www.hillaryclinton.com/feature/ada”>“Agenda to Expand Economic Opportunity for People with Disabilities</a> is, for some reason, filed under “Supporting Parents and Caring for Children,” even though it contains fine proposals like this one, which would seem to have relatively little to do with supporting parents or caring for children:

<blockquote><b>2. Re-establish the Clinton Administration Executive Order to Hire 100,000 Qualified Employees and Make the Federal Government a Model of Accessibility.</b></blockquote>

<blockquote>During the Bush administration, the federal government has failed to make jobs or information technologies fully accessible for people with disabilities. In her first month in office, Hillary Clinton will review all federal websites to ensure they are accessible. She will also re-establish Executive Order 13163 to hire 100,000 qualified employees with disabilities to federal employment over five years.</blockquote>

You get the idea. A Hillary Clinton Administration would be quite good on disability/ health and disability/ employment, and generally good for my kid – <a href=”http://www.michaelberube.com/index.php/weblog/acknowledgements/”>this one</a>, not the college senior who turns 22 today (happy birthday, Nick! Now get back to work). I have no substantial complaints about Clinton’s proposals, though of course I wish that her husband had issued that Executive Order to hire people with disabilities about seven and half years earlier than July 26, 2000. But someone should’ve told the campaign to reorganize that website so that Hillary’s disability policies are clearer and more . . . accessible.

And I have to admit that I’ve been mightily vexed by this phenomenon in recent years. Not by Hillary Clinton herself, mind you – by the phenomenon of the avoidance of disability <i>qua</i> disability. It’s as if we Americans have been talking about disability all our lives, as Molière’s M. Jourdain has been speaking in prose, without realizing it. Remember that debate about SCHIP? You know, <a href=”http://thehill.com/leading-the-news/bushs-schip-veto-holds-2007-10-18.html”>the one we lost on Bush’s veto</a>? What the hell was that about? It was about <i>disability</i>, folks – about children suffering catastrophic illnesses and traumatic injuries for which their parents couldn’t (and their parents’ dastardly, moustache-twirling health-insurance providers wouldn’t) provide. Vets returning from Iraq with PTSD or TBI (post-traumatic stress disorder or traumatic brain injury) and being warehoused and/or underserved and/or neglected by VA hospitals? Uh, well, once again, here we’re talking about <i>disability</i>. Why in the world do we frame these things as matters of “health” or “employment” or “veterans’ benefits,” when doing so prevents us from realizing that we’re all touching different appendages of the 8000-pound elephant in the room? The subject is disability, people. It’s about our common frailty and vulnerability. Get used to it.

Hillary’s overall <a href=”http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf”>American Health Choices Plan</a> (16-page .pdf) is about as good as a private-insurance-based plan can be. But if you’re looking for <i>disability policy</i>, you’ll look in vain. You’ll read about “eliminating insurance discrimination” (page 5) and “creating a retiree health legacy initiative” for “major American employers with workforces that face unusually high health care costs due to a high ratio of retirees” (a group that includes “our major manufacturers,” and, for Pennsylvanians like me, evokes “mine workers”) that will “provide a tax credit for qualifying private and public retiree health plans to offset a significant portion of catastrophic expenditures that exceed a certain threshold” (page 8). (That passage is followed by a qualifier: “Such reinsurance would be time-limited to reflect the short-term demographic need of the aging baby boomers, and would be devised in a manner that does not add to our long-term fiscal challenges.” Yes, well, good luck with that.) But the wonky point remains: if you’re interested in public policies for people with disabilities, the Clinton campaign offers you a series of sane, sound proposals – many of which would benefit people with disabilities, but few of which speak of “disability.”

Obama, by contrast, has a separate heading titled <a href=”http://www.barackobama.com/issues/disabilities/”>“Disabilities.”</a> This in itself is remarkable; but it turns out that this isn’t just a matter of better web design. Whoever is advising Obama on disability policy is really, really smart. The nine-page .pdf, <a href=”http://www.barackobama.com/pdf/DisabilityPlanFactSheet.pdf”>“Barack Obama’s Plan to Empower Americans with Disabilities”</a>, says many of the same things Hillary does – about supporting full funding for IDEA, providing health coverage for the most vulnerable among us, and hiring 100,000 people with disabilities in the federal government (except that someone needs to tell the Obama camp that it’s Executive Order <a href=”http://www.jan.wvu.edu/cap/13163.htm”>13163</a> Obama needs to reinstate, not <a href=”http://en.wikisource.org/wiki/Executive_Order_13173″>13173</a>, which created an Interagency Task Force on the Economic Development of the Central San Joaquin Valley; reinstating 13173, whatever its merits, probably won’t do much for disability policy in the United States). But the plan is, remarkably enough, at once broader and more specific than Clinton’s.

It promises $10 billion in early intervention programs for children with special needs, via Early Head Start, Early Learning Challenge Grants, and <a href=”http://www.nectac.org/partc/partc.asp”>IDEA Part C</a>.

It proposes “a comprehensive study of students with disabilities and transition to work and higher education” – something that (a) has never been done and (b) is of great interest to teenagers with disabilities and their loved ones. “As president,” we’re told, “Barack Obama will initiate such a study and task his Secretary of Education with researching: the barriers that keep students with disabilities from seeking and completing higher education; the barriers that prevent students from making a direct transition to work; the extent to which students with disabilities are able to access loans and grants; reasons college students with disabilities drop out at a higher rate; and best practices from schools that have effectively recruited and graduated students with disabilities that can be implemented more widely.” This is, as you might imagine, a (cough) <i>special interest</i> of mine. But that’s not just because I have a 16-year-old with Down syndrome. In recent years I’ve had many fine students at Penn State – twenty-year-olds with dyslexia, or Asperger’s Syndrome, or arthritis, or mild cerebral palsy – request “reasonable accommodation” from me on final exams. And I’ve been amazed and appalled at how few many of my colleagues (here or elsewhere) seem to believe that they’re under no obligation to provide reasonable accommodation for everyone. (Guess what? If you teach in the United States, you have that obligation! It’s a real federal law!) So I’m thinking that “a comprehensive study of students with disabilities and transition to work and higher education” might not be a time-wasting exercise for disabliity-policy wonks. I’m thinking that it might actually make a world of difference for students with disabilities – in high school, in transition, and in college.

It pledges support for Tom Harkin’s ADA Restoration Act, which would “overturn the Supreme Court decisions that limit the ADA’s coverage and effectiveness.” (This is <i>huge</i> for those of us who follow disability law. Don’t get me started on <a href=”http://www.law.cornell.edu/supct/html/99-1240.ZS.html”>University of Alabama v.. Garrett</a> or <a href=”http://www.law.cornell.edu/supct/html/97-1943.ZS.html”>Sutton v. United Air</a>, because if you do, I’ll break the 4000-word blog-post barrier, as I used to do at my windy old blog.)

It has a subsection devoted to flexible work plans, ranging from an expansion of the Family and Medical Leave Act to protection against “caregiver discrimination.” “Workers with family obligations often are discriminated against in the workplace,” it notes. “This is a growing problem, as evidenced by the skyrocketing number of discrimination suits being filed: there has been a 400 percent increase in the number of family responsibility discrimination lawsuits in the last decade.” Again, though, this is of no interest to you unless you know someone with a disability, or know someone who might someday have a disability.

It promises to make the U.S. a signatory to the U.N. Convention on the Rights of Persons with Disabilities.

And it informs us that “Barack Obama is a cosponsor of the Genetic Information Nondiscrimination Act (GINA), which prohibits discrimination on the basis of genetic information by employers and health insurers. The Act also applies health information privacy regulations to the use and disclosure of genetic information.”

The funny thing is that Hillary Clinton is among the bill’s other cosponsors in the Senate, but you won’t learn that from her website (why, I can’t imagine). More importantly, if you have genes, or if someone you know and love has genes, you should be interested in genetic privacy. Because you never know when <a href=”http://www.concurringopinions.com/archives/2008/02/a_hold_on_democ.html”>your employers might require you to submit to blood tests so that they can take a peek at whether you have any genetic susceptibility to debilitating conditions</a>. Down that road lies the world of <a href=”http://www.imdb.com/title/tt0119177/”>Gattaca</a>, my friends, and that’s why it passed the House last year by a vote of 420-3. Unfortunately, Tom Coburn (R- Outer Wingnuttia) has blocked it in the Senate, and since Coburn is apparently one of Obama’s Friends From the Fringes, now would be a good time for Obama to ask his friend to do us all a great big favor.

Oh, and the rhetorical appeal to “my friends” reminds me! I’d almost forgotten all about that John McCain fellow. Apparently he’s become the nominee of the Grand Old Party, on the grounds that he is not a barking lunatic who will promise to double Gitmo and build a tall fence to defend us against the Gay Immigrationist Mexislamofascist Menace. Yes, well, McCain’s disability policy is much easier to summarize: <a href=”http://www.johnmccain.com/Informing/Issues/19ba2f1c-c03f-4ac2-8cd5-5cf2edb527cf.htm”>(a): we need to cut costs; and, following from (a), (b): don’t become disabled</a>:

<blockquote>Controlling health care costs will take fundamental change — nothing short of a complete reform of the culture of our health system and the way we pay for it will suffice. Reforms to federal policy and programs should focus on enhancing quality while controlling cost.</blockquote>

This means you, solider – and you too, person with autism, you, person with Alzheimer’s, and the rest of you malingerers. Buck up! Your job is to control health care costs for the rest of us.

McCain 2008: Because People Who Talk About Health Care and Disabilities Are Just Taking <a href=”http://thinkprogress.org/2008/04/21/mccain-cheap-shot-health-care/”>Cheap Shots</a>.

<i>Cross-posted at <a href=”http://tpmcafe.talkingpointsmemo.com/2008/04/22/disability_and_democracy/”>TPM Café.</a></i>