5 ms·

I think it's the exact opposite of UBI. The key defining feature of UBI is that everyone gets it. You don't lose it if you are able to work. Whereas the key fe

by zaroth 10y ago

I think it's the exact opposite of UBI. The key defining feature of UBI is that everyone gets it. You don't lose it if you are able to work. Whereas the key feature of SSDI is not really being "disabled" as TFA explains, but rather that you must not have any substantial gainful activity -- no more than $1,170 per month. SSDI has become less of a form of insurance against a set of particular diseases, and more a kind of insurance for where someone decides it's no longer viable to work, as long as there's an associated physical scapegoat. Either because work is not available, or not reliable enough, or because your body is not reliable enough for the jobs that are available, it's a steady check that you can get, only if you don't work. The issue is confounded by the fact that after about 3 years of qualifying for SSDI you also become eligible for Medicare, which can provide more value in reduced healthcare costs than any locally available job could ever hope to.

WhitneyLand 10y ago
>[disability is] where someone decides it's no longer viable to work How did you conclude that viability to work is a "decision"? You also imply that it's better to have medicare than any insurance through a job. Medicare actually really sucks compared to many alternatives. Lots of providers won't even let you in the door with it.
- zaroth 10y ago
  "Viable to work" is almost always a decision. A potential employee must decide if it's viable for them to get their ass to work and if they would end up, at the end of the day, economically advantaged for having done so. As in, "I am sick and hurting but I will get my ass to work anyway because I need to to survive." versus "I am sick and hurting and fuck this, lets see what the alternatives are." Of course there are cases when it is cut and dry. I think the thesis of TFA is that the rapid expansion of SSDI program is because the way the program works now it's not cut and dry at all. Now the operative part of better w.r.t Medicare is free. Medicare is the biggest insurance network in the world. "Lots of providers won't let you in the door" is equally true with private insurance too. But if you are earning just your SSDI check, you also qualify for Medicaid in states with Medicaid Expansion. I'm not exactly sure how it works, but I think you do actually get both, and Medicare is the primary payer and Medicaid pays second. Which basically means you can walk into any hospital in your state, for any reason, and pay nothing.
  - DoodleBuggy 10y ago
    > I'm not exactly sure how it works Basically you're making all sorts of unsubstantiated claims about something you openly admit not knowing how it works. At least you admit it. That's OK, I'm like that with some things too. For example I have never tried escargot but I am pretty sure it is disgusting.
    - zaroth 10y ago
      I usually add more references to avoid the impression I'm making shit up. I do have significant experience dealing with SSDI; the application process, the approval process, the payment calculations, and the SGI requirements. It's also something I've researched extensively along with the ACA as a kind of public policy hobby. The "I'm not sure exactly how it works" statement was specifically related to having both Medicare and Medicaid at once. But my claim that Medicare is primary and Medicaid is secondary was based on [1]. EDIT: In reply to 'icantdrive' which needs 'showdead' to see; Getting SSDI is not guaranteed, you have to get through the approval process. But it's clearly not insurmountable if 20% of a county can be on it. Certainly everyone does not have a qualifying condition. But many people have qualifying conditions but who are not currently on SSDI. Many people have SSDI with a qualifying condition (not fraud) but who might otherwise be able to earn more than $1,170 / month. This is the population we are studying, and trying to understand why they ultimately decide to forgoe working and get on SSDI. Medicare premiums for someone on SSDI will be almost nothing. But importantly the co-pays are still 20%. You qualify for Medicare 29 months from the time you were deemed disabled and you also stopped working (later of the two). You are absolutely correct that Medi-Cal is what most people are relying on. For the first 29 months it covers everything at no cost, and after Medicare kicks in it covers the Medicare co-pays. Of course not everyone will take Medi-Cal. But major hospitals and their doctors on staff do take it, so you can walk into Stanford, Lucile-Packard, UCSF, etc. and get fantastic care at zero cost. I care about the system mostly due to the warped secondary effects it creates. SSDI is an incredible program and an essential benefit for millions of Americans. It has the right heart, but like most things governmental, goes about it all wrong. When a crucial benefit comes with a condition that you can't work more than $1,170 / month, that is broken. People who are disabled and legitimately qualify for SSDI should not have an economic gun to their head keeping them from working at all. They should be free to work as much as they are willing and able to. The program claims to provide benefits to people unable to work. But increasingly (for about 50% of enrollees) what it really does is provide benefits to people willing to not work. Because of the broad range of ailments that are covered, the most important factor becomes the applicants willingness to just give up on working. Actually, more to the point, the spectrum of programs (SSDI, Medicare, Medicaid, TANF, etc.) actually drive people to give up working, because the economic value of giving up on work is astronomical. [1] - https://www.medicareinteractive.org/get-answers/programs-for-people-with-limited-income/medicaid-and-medicare/how-does-medicaid-work-with-medicare-to-cover-my-health-care-costs https://www.medicareinteractive.org/get-answers/programs-for...

by zaroth 10y ago

WhitneyLand 10y ago

>[disability is] where someone decides it's no longer viable to work How did you conclude that viability to work is a "decision"? You also imply that it's better to have medicare than any insurance through a job. Medicare actually really sucks compared to many alternatives. Lots of providers won't even let you in the door with it.

zaroth 10y ago
"Viable to work" is almost always a decision. A potential employee must decide if it's viable for them to get their ass to work and if they would end up, at the end of the day, economically advantaged for having done so. As in, "I am sick and hurting but I will get my ass to work anyway because I need to to survive." versus "I am sick and hurting and fuck this, lets see what the alternatives are." Of course there are cases when it is cut and dry. I think the thesis of TFA is that the rapid expansion of SSDI program is because the way the program works now it's not cut and dry at all. Now the operative part of better w.r.t Medicare is free. Medicare is the biggest insurance network in the world. "Lots of providers won't let you in the door" is equally true with private insurance too. But if you are earning just your SSDI check, you also qualify for Medicaid in states with Medicaid Expansion. I'm not exactly sure how it works, but I think you do actually get both, and Medicare is the primary payer and Medicaid pays second. Which basically means you can walk into any hospital in your state, for any reason, and pay nothing.
- DoodleBuggy 10y ago
  > I'm not exactly sure how it works Basically you're making all sorts of unsubstantiated claims about something you openly admit not knowing how it works. At least you admit it. That's OK, I'm like that with some things too. For example I have never tried escargot but I am pretty sure it is disgusting.
  - zaroth 10y ago
    I usually add more references to avoid the impression I'm making shit up. I do have significant experience dealing with SSDI; the application process, the approval process, the payment calculations, and the SGI requirements. It's also something I've researched extensively along with the ACA as a kind of public policy hobby. The "I'm not sure exactly how it works" statement was specifically related to having both Medicare and Medicaid at once. But my claim that Medicare is primary and Medicaid is secondary was based on [1]. EDIT: In reply to 'icantdrive' which needs 'showdead' to see; Getting SSDI is not guaranteed, you have to get through the approval process. But it's clearly not insurmountable if 20% of a county can be on it. Certainly everyone does not have a qualifying condition. But many people have qualifying conditions but who are not currently on SSDI. Many people have SSDI with a qualifying condition (not fraud) but who might otherwise be able to earn more than $1,170 / month. This is the population we are studying, and trying to understand why they ultimately decide to forgoe working and get on SSDI. Medicare premiums for someone on SSDI will be almost nothing. But importantly the co-pays are still 20%. You qualify for Medicare 29 months from the time you were deemed disabled and you also stopped working (later of the two). You are absolutely correct that Medi-Cal is what most people are relying on. For the first 29 months it covers everything at no cost, and after Medicare kicks in it covers the Medicare co-pays. Of course not everyone will take Medi-Cal. But major hospitals and their doctors on staff do take it, so you can walk into Stanford, Lucile-Packard, UCSF, etc. and get fantastic care at zero cost. I care about the system mostly due to the warped secondary effects it creates. SSDI is an incredible program and an essential benefit for millions of Americans. It has the right heart, but like most things governmental, goes about it all wrong. When a crucial benefit comes with a condition that you can't work more than $1,170 / month, that is broken. People who are disabled and legitimately qualify for SSDI should not have an economic gun to their head keeping them from working at all. They should be free to work as much as they are willing and able to. The program claims to provide benefits to people unable to work. But increasingly (for about 50% of enrollees) what it really does is provide benefits to people willing to not work. Because of the broad range of ailments that are covered, the most important factor becomes the applicants willingness to just give up on working. Actually, more to the point, the spectrum of programs (SSDI, Medicare, Medicaid, TANF, etc.) actually drive people to give up working, because the economic value of giving up on work is astronomical. [1] - https://www.medicareinteractive.org/get-answers/programs-for-people-with-limited-income/medicaid-and-medicare/how-does-medicaid-work-with-medicare-to-cover-my-health-care-costs https://www.medicareinteractive.org/get-answers/programs-for...