Last weekend “This American Life” and “Planet Money” ran a story by Chana Joffe-Walt examining the growth of the U.S. disability insurance system. Her report found that one in four residents of Hale County, Ala. get disability benefits. It was a thought-provoking and heart-wrenching report, but Century Foundation Fellow Harold Pollack says there is more to the story. Pollack, also an expert on disability policy at the University of Chicago’sSchool of Social Service Administration, says while the Joffee-Walt’s piece struck many good points, it oversimplified the disability insurance program. He chatted with WonkBlog’s Brad Plumer about the piece and his thoughts on America’s disability insurance program. Read the full interview on Washington Post’s WonkBlog. A short excerpt can be found below:
Brad Plumer:One of the big themes of the “This American Life” segment was that as the U.S. economy has slumped and jobs have vanished, disability insurance has essentially become the safety-net program of last resort. More people are now qualifying for disability than ever before — it now costs $260 billion per year. Is this really what the program is designed to do?
Harold Pollack: These tensions go back to the very beginning of this program. It has always been a matter of deep controversy and anxiety about how to draw the boundaries between eligibility and non-eligibility. And the worry among fiscal conservatives has always been that it would become a backstop income guarantee for people who couldn’t find a job.
If you go back to 1985 and look at Jerry Mashaw’s book “Bureaucratic Justice,” even then there’s an interesting account of how the agency has tried to deal with these problems, and how one can fairly and accurately make determinations for hundreds of thousands of applicants. It’s not feasible to stage an OJ-style trial for everyone who applies for disability, but you still want real and defensible standards for who qualifies and who doesn’t.
But the program is also a lot more stringent than that “This American Life” piece would have you believe. The fact is, the majority of applicants are denied, and there are qualified diagnoses that are very stringently applied.
BP: One thing we’ve seenis that more and more people have qualified as disabled during the recession. Some of that is simply due to the unavoidable fact that America’s getting older. But some is due to unemployment. If there are strict standards, how can that be?
HP:Disability really does need to be thought about in the context of economic opportunities. If you have a bad back, and the only jobs available are manual labor, that’s a real limitation. You’re unable to work. So it very much matters that we’re in a deep recession, and a lot of the opportunities people faced are limited.
You can’t remove the economic context from the disability conversation. I don’t know about the particular physician they discussed [in Hale Country, where one in four residents qualified for disability], that might not be totally consistent with what the program’s intended to do. But I can certainly see where he’s coming from.
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