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>[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 bet

>[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...
    - DoodleBuggy 10y ago
      It's OK, you have a strong opinion with little basis in fact. That's an opinion in truest form. Like I said I totally hate escargot, never even tried it, but can you imagine eating snails? So disgusting.
- icantdrive55 10y ago
  Rebuttal on paragraphs: 1) SSDI is determined by a medical doctor. The patient has the decision to apply, but after that it's a judgement call by "professionals". I used quotes because the system is severely flawed. Getting a dissability lawyer involved early is prudent planning. It shouldn't be this way, but the system is severely flawed. 2) Just rambling? 3) agree 4) not totally free. Agree "lots of providers won't let you in the door." 5) I belive you get Medicare after two years on SSDI? The people I knew who were on dissability were all relied on state medical benefits. In California, they relied on Medi-Cal. Most doctors won't accept medi-cal. Sure, they got free hospital visits. Depending on where you live, a hospital might be your only recourse. Yes it's free, but it minimal quality of help. Many drugs are not on an approved Formuliary. They purposely make getting benefits very difficult. Going to a hospital should be the last resort? The system forces some people into going to the emergency room. Still not fixed, even after Obamacare? I don't know. Let me ask you something? Why would you pay a hospital bill you have absolutely no control over? I see some noble people trying to pay off their padded hospital bills, and I don't get it. I would understand it if their wasn't collective bargaining, and some standard way of computing hospital costs. Right now they can charge you whatever. My father was given a gift basket by the hospital staff. Months later he looked at the bill. That gift basket was $300.00. He refused to pay even his 10% of the adjusted bill. (Had great Union insurance.) If someone qualifies for free medical care; why do you care? Our medical system is not a free market entity. We like to think it is, but it's a closed system. My congrats to any collective barging entity(like Medicare, and many private party insurance companies) that keeps prices down for its members. Actually, they just refuse to pay the bill on many cases because they can. Obamacare gave us a few rights. They look like they will be history though?

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...
  - DoodleBuggy 10y ago
    It's OK, you have a strong opinion with little basis in fact. That's an opinion in truest form. Like I said I totally hate escargot, never even tried it, but can you imagine eating snails? So disgusting.
icantdrive55 10y ago
Rebuttal on paragraphs: 1) SSDI is determined by a medical doctor. The patient has the decision to apply, but after that it's a judgement call by "professionals". I used quotes because the system is severely flawed. Getting a dissability lawyer involved early is prudent planning. It shouldn't be this way, but the system is severely flawed. 2) Just rambling? 3) agree 4) not totally free. Agree "lots of providers won't let you in the door." 5) I belive you get Medicare after two years on SSDI? The people I knew who were on dissability were all relied on state medical benefits. In California, they relied on Medi-Cal. Most doctors won't accept medi-cal. Sure, they got free hospital visits. Depending on where you live, a hospital might be your only recourse. Yes it's free, but it minimal quality of help. Many drugs are not on an approved Formuliary. They purposely make getting benefits very difficult. Going to a hospital should be the last resort? The system forces some people into going to the emergency room. Still not fixed, even after Obamacare? I don't know. Let me ask you something? Why would you pay a hospital bill you have absolutely no control over? I see some noble people trying to pay off their padded hospital bills, and I don't get it. I would understand it if their wasn't collective bargaining, and some standard way of computing hospital costs. Right now they can charge you whatever. My father was given a gift basket by the hospital staff. Months later he looked at the bill. That gift basket was $300.00. He refused to pay even his 10% of the adjusted bill. (Had great Union insurance.) If someone qualifies for free medical care; why do you care? Our medical system is not a free market entity. We like to think it is, but it's a closed system. My congrats to any collective barging entity(like Medicare, and many private party insurance companies) that keeps prices down for its members. Actually, they just refuse to pay the bill on many cases because they can. Obamacare gave us a few rights. They look like they will be history though?