Gary Farber Needs Your Help

Or stay right here at CT to enjoy the punitive attitudes that give rise to that lack of a social safety net.

Gary should definitely record a video message for the World Economic Forum in Davos and post it on YouTube. The organizers at WEF have said they would like to enlarge the conversation this year and include bloggers and v-loggers from around the world.

Gary’s predicament is exactly what is not discussed nearly enough at places like Davos.

I’m forwarding him links and invitations from several blogging who can help get his message out.

vavatch: And if someone is healthy enough to scream at the top of their lungs, there can’t be much wrong with them, can there?

If you read his post, the problem doesn’t seem to be a lack of a safety net but rather the hurdles involved in accessing it. If he qualifies, social security disability will support him for as long as he’s disabled. He says:

This is my past. I’m 48. Up until now I’ve still struggled in recent times with the question of whether I should continue to work on trying to get better, and more mentally healthy, and able to cope, and slowly grow back into a normal life, able to work and support myself — or whether to pursue trying to get Social Security Disability, on the basis of depression rendering me permanently disabled and unable to work.

I’ve always been extremely reluctant to pursue the latter course, for several reasons. Overwhelmingly, it seemed like a negative choice for the remainder of my life: a sort of giving up. A turning away from the hope of that normal life, and work, and supporting myself, and the other good things that go with it.

That is, up until now, he has consciously not applied for the program, because he did not want to live as a permanent ward of the state. In his current circumstances (having just lost his job), I don’t see why he wouldn’t apply for state unemployment benefits.

As for SS disability, it may be that it should be quicker and easier to qualify than it is, but certainly it cannot be too easy, because it is a program open to abuse. I mean, what should the attitude of the SS staffers be to a person who claims disability due to severe, recurring depression but who has diagnosed himself and has only a minimal, spotty history of having been treated by mental-health professionals? Now I’m not saying he’s faking or exaggerating his condition, only that those in charge of the program have to be cautious in handing out disability payments for life.

Bit of a Catch-22 there, slocum. How do you get treated by mental health professionals if you can’t afford it and either have no insurance coverage at all or none that covers mental health care?

All the states have community mental health services, for example:

http://www.michigan.gov/mdch/0,1607,7-132-2941_4868_4899-14792–,00.html

Medicaid provides health coverage for the poor (and it sounds like he qualifies as poor).

Maybe SS should pay for some visits and treatment. That might help them figure out whether the applicant is entitled to benefits or, even better, eliminate the need for benefits by helping the applicant become self-sufficient.

Perhaps they do — I’m not sure of the details of the process. But for a very-low income persons, state Medicaid programs seem a more likely source of coverage for medical treatment:

Aged, Blind, Disabled Medicaid is available to persons who are aged, blind, or disabled. There are income and asset tests. If the income is over the income limit, persons may incur medical expenses that equal or exceed the excess income and still qualify for this program. Most beneficiaries are enrolled in a Medicaid health plan and receive a comprehensive package of health care benefits including vision, dental, and mental health services. Contact the local MDHS office in your county to apply for this program.

http://www.michigan.gov/mdch/0,1607,7-132-2943_4860-35199–,00.html

(I’m not sure where he lives — I used Michigan as an example, because I live here).

What happens to someone in the US seeking social service help is this: Sooner or later, you run into someone interpreting the criteria for eligiblity in the most constrictive reading possible. And when you run into those people, you have a choice between being honest and losing the help you need, or lying. This is a damned hard choice. And even when outright lying isn’t needed, the whole system is set up to reward those prepared to downplay all of what would normally be strengths and play up all of what would normally be liabilities.

Take a fairly typical severely depressed person. She has no fixed sleep cycle. One week in four to eight, she has the equivalent of about 20 productive work hours, though it might actually be 40 30-minute episodes, and spread all through the day and night. In her typical weeks, she has the equivalent of perhaps 5-15 productive hours, spread through 40-60 hours of real time. In her bad weeks, she has 0 such hours. Medication raises the threshold at the cost of lowering the ceiling some, too – her productive time ranges from 10-15 hours per week, varying up and down at random, and she still has crashes that kill the week’s utility.

She will, I guarantee you, have run into someone who insisted that she is capable of office work, or at least of menial labor, and will regard her failure to hold down a regular office or warehouse job as a sign of malingering. The harder she works to make good use of her limited productive capacity, the more she’ll run into this. If, on the other hand, she simply gives up and makes no effort to work at all, the “you ought to be working in an office” judgment will be more quickly overturned. The more so if she stops paying attention to her grooming, making any effort to dress nicely, and so on. Showing any capacity will be a mark against her when it comes to seeking ongoing help, particulalry for a variable condition – if she can’t do something at all 25% of the time, can barely manage it 50% of the time, and can do it sort of okay 25% of the time, she will be eligible for less help than if she makes no effort ever.

I’ve come to believe that the restriction of access to social services along these lines is responsible for a lot of what’s wrong with the lower rungs of society. People go where the incentives are. If more help were simply guaranteed, there’d be incentive to be honest about one’s condition and to make use of one’s capabilities. Instead the systems estabilished by those who obsess about who’s actually worthy or not reward all kinds of vice.

Those who think Gary might be whining: Yeah, he is, in part. But I dare any of you to spend a year dealing with the system as he has and not do some whining yourself. It is degrading in countless ways, small and large, and it is, basically, that way by the design of all those who think that only the very worst cases maybe kinda sorta deserve help. It of course in many ways more expensive to run the system this way, requiring the employment of many people who will learn to downplay the needs of others, to treat any sign of health or vitality as a failure, to be bullies on demand. A social safety net is, among other things, a protection against both dishonesty among the needy and overbearing and caprice among the overseers.

A social safety net is, among other things, a protection against both dishonesty among the needy and overbearing and caprice among the overseers.

What are you arguing for? Dismiss all the safety net bureaucrats and offer benefits to anybody who applies with no questions?

Maybe it should be easier to access benefits than it is now, but clearly it would be possible to go too far. A system that was too trusting would be routinely exploited and a system that was routinely exploited would lose support among voters.

Slocum: Yes, I am in fact arguing for a lot of medical and other services to be available pretty much universally. The right kind of care, available without hassle, 20 years ago would probably have kept Gary from this predicament now, and some more complicated care available to him reliably 10 years ago. Saner standards even now would aim at supporting him in his desire to work while needing extensive care. And it would hav ebeen a net gain to the country’s productivity at any point to do so, because Gary’s hard-working and likes to wor, and were he able to work more, there’d be tax revenue and commerce coming from it.

Even in cases where it’s a wash economically, or a net loss of public money, I think it’s desirable from the viewpoint of not encouraging unnecessarily the mindset of helplessness, subservience, and dishonesty to officialdom.

The right kind of care, available without hassle, 20 years ago would probably have kept Gary from this predicament now,

Yes. This. The old saw about an ounce of prevention being worth a pound of cure is worth repeating here.

If we had universal (and decent) health care, many such hard-luck cases as Gary’s would not exist because they would get the treatment they need early on and their disabilities would not mushroom into not being able to work at all. Plus what others have pointed out – if you really need SSDI it’s often not worth it to even try to work or be functional.

Universal health care would also save money – again, by catching and treating potentially disabling conditions before they became disabling, thus keeping people in the workforce (and paying taxes) and cutting down on the number of people on the permanent disability rolls.

bruce baugh: Yes, I am in fact arguing for a lot of medical and other services to be available pretty much universally.

Medical services are one thing, but long-term disability payments are something else. We obviously can’t provide universal disability payments to anybody applies for them.

But you don’t have to be disabled to qualify for Medicaid coverage — you just have to be poor enough. It’s certainly possible to be on Medicaid and working (my wife sees such families every day).

And unless the rules have changed, it is also possible to work part time while on disability, because I have a family member who was in that situation a several years ago.

In Gary’s particular case, it’s not clear that he’s actually been turned down for anything. He’s lost his job — has he applied for unemployment compensation? He’s poor — has he applied for Medicaid? He has health problems that make it difficult to work — has he started the disability application process? I couldn’t tell that he’d done any of those things yet.

“Have a heart, Vavatch. ”

He has one. It’s stuffed into a crack in the wall where the light was getting in.

…has he applied for unemployment compensation? He’s poor—has he applied for Medicaid?

Not sure about unemployment insurance. Perhaps his benefits have run out already, or perhaps his last “job” was some sort of freelance/1099 deal and he’s not entitled to any. But in Colorado, where Gary lives, Medicaid is not available to to single people in their 40s no matter how low their income if they’re able-bodied. For now, at least, Gary is considered able-bodied, and therefore ineligible for Medicaid.