Hillbilly Elegy - Explaining the rural vote

I voted for Trump because he’s going to make America great again and that makes me proud to live in America!

Sure, there are legitimately good reasons for subcontracting in construction. I don’t have an issue with it in general. Construction (especially residential) has a definite seasonal pattern and you can’t employ a bunch of guys throughout the winter when you do most of your work in the summer.

I was just explaining that the subcontractors, often being on the edge financially, sometimes cut safety corners and burn through low-level employees causing a lot of medical/disability claims. Lots of those guys aren’t in trade unions and never will be.

Well, residential will never be union. Too costly. It would kill new home sales at a certain level.

But subcontractors, as with any business, are run by good guys and bad guys, guys with business acumen and guys who have no clue. I don’t deny there are probably some who cut safety corners, although I think you would find that many employees do that themselves because they will often take the easy way instead of the right way.

But even the best of workers will develop physical problems from repetitive actions. Elbow problems from pounding nails, shoulder problems from lifting sheetrock etc. Many of the injuries are “part of the job”.

But you haven’t actually proved otherwise. In order for these to be scams, the physicians would have to go along with it, they would have to say something is wrong with the patient when that’s not true. What makes the population think there are massive scams going on? Maybe it’s the same reason some people harass random people with disability plaques based only one what they can SEE which has no relevance on a person’s health. Even your document does not suggest what you’re saying… because it doesn’t say there is widespread scams at all which is what the common talking point is… it says this:

This goal was progressive for its time but is no longer aligned with current societal objectives.

Which is very different. This does not imply abuse so much as a change… so you can’t say people are abusing or miss using the system just because the goal of the system maybe shifting but no one has really bothered to do the work to actually change the system itself.

So again, despite the lawyers, despite the bureaucrats, to imply abuse and scam you’d have to have the physicians falsifying their documents. Where is the proof of that being widespread?

Unfortunately, if you can pay you can find a doctor to sign off on just about anything. Once you’ve got a license to practice, it is really difficult to get it revoked and few resources are devoted to policing doctors. There are doctors whose entire practice are referrals from class action attorneys, from disability attorneys, from medical marijuana dispensaries, and from on-line pharmacies. For evidence, you only need to look at the opioid epidemic.

I think that you hold physicians and the bureaucracy that accepts their recommendations to a bit too high of a standard.

I was just told I am not allowed to use anecdotal evidence to support my argument. Where is the proof that we have hundreds if not thousands of physicians basically scamming the system? The number of people on the system going up does not equate to all those cases being fraudulent. Physicians documenting correctly and the system accepting it when people don’t think they should is also not fraud.

I don’t know what you are asking for here, I am saying that your anecdote can’t be used to say everyone on disability is genuinely disabled. The proof is the massive explosion in disability claims that don’t match the population trends.

Calculations from Duggan and Imberman (2008) reveal that, holding age-specific rates of receipt of disability benefits at their 1984 base, the aging of the population between1984 and 2004 explains only 6 percent of the increase in the fraction of non-elderly adults receiving Disability Insurance through 2004. The contribution of aging to program growth is numerically overwhelmed by the growth of SSDI recipients within given age groups. For example, if one divides males between ages 25 and 64 into five-year age groups, SSDI receipt increased within each group by an average of 41 percent. This increase was especially sharp for males ages 40 to 49, for whom the rate of receipt rose by 65 percent.

Whether it is scammy doctors, scammy state programs to move people off welfare, scammy citizens faking claims, or a broken economic system leaving the working class poor behind. It is clear this problem is getting worse, and it is clear that we should do something about it.

I honestly think you need to disabuse yourself of the notion that physicians are saints. Where did the Opioid epidemic come from?

Pill-mill doctors were and are a real thing. I have to assume that physicians willing to prescribe lethal doses of painkillers to patients certainly wouldn’t be above a kickback for a disability diagnosis.

Is it possible that it isn’t anyone scamming the system but a general change in how society identifies disabilities.

That’s not proof that the cases are not genuine. The document you linked to says the number of disability claims has gone up. The conclusion from the document you linked to does not say this is fraud or scams or anyone is doing anything wrong at all. Did you read their conclusion? Objectives changing is a completely different ideal than what you’re trying to argue.

I don’t know if it falls under the definition of scam but I thought it was documented that some states were “pushing” people to disability claims in order to change where the funds were coming from. I know I have read and heard claims like that over the last couple years.

And it does seem that the definition of “disabled” has broadened over the last several years. And I mean no ill will towards anyone fitting the definition.

There are a lot of factors here. One is how one defines disability, and if that definition matches the one the government uses. A lot of people have a definition of disability that is not the same as what the government uses, and this can go either way in terms of whether your personal view is more or less restrictive than the governments. Another is the sheer complexity of the disability claims process. If you have ever applied for disability, or known well people who have, you know it’s a nightmare, and many people are denied outright one or more times before they ever get approved, if they do, and often it takes getting and paying for legal counsel. If there is an increase in granted disability claims, it would help to break that down by which sort of disability claim we are talking about (Social Security or state or whatever), and the portion of those claims that are accomplished by individuals without legal counsel. There is indeed a huge business in helping people get disability claims approved, and it could well be that the real reason more people have not been granted disability in the past has nothing to do with the merits of their case; it could be instead that more folks are realizing that you need a lawyer to do it.

I know that the paper is not about disability claim scams, I never said that, but the data in the first few pages of that paper is there to give a background of the huge spike in rates of those on disability. It isn’t what the paper is about, but the data is there, linked from another study, that I don’t have a copy of. And that data says that we can’t explain the drastic increase in claims on the aging boomer population (a popular theory) I don’t know why you are sticking on that point, just because a paper isn’t about something doesn’t mean it can’t have backing data and research related to that claim.

To the point, It is also likely true that the increase in claims probably has to do with more properly diagnosed mental disabilities.

I also don’t think it is fair for people to complain about those on welfare, or those on disability, because the vast majority of people need these safety net programs. But you are kidding yourself if you don’t think that there aren’t people gaming the systems, and companies set up to fast track people from welfare to disability. There is money there, and that typically goes hand in hand with greed and fraud.

I think, that this huge increase isn’t that people are scamming the system, But the reports of states hiring companies to scour through welfare rolls to get people onto disability certainly seems scammy, but that couldn’t explain the monumental jump in those on disability. I think it is that there are a lot of rural area folks who can’t find 9-5 desk job work, and through years of blue collar labor have ended up with injuries, severe back pain, and many other ailments that make it impossible to land a job, and they lack the qualifications to land jobs that are more white collar and disability friendly.

If you look at the rural WI county I went to high school in, in the last 13 years, the number of folks on disability is over 100% increased. That is insane! I think that the huge increase is probably due a number of factors. From the economy, to the loosening of the definition of disability, to the lack of jobs in rural areas.

https://www.bloomberg.com/news/features/2016-12-16/mapping-the-growth-of-disability-claims-in-america

All very interesting reading, and it is 100% certain that the current administration is going to do nothing to fix this.

I didn’t say you didn’t have the data to back up scams either. I also didn’t claim to worship the ground physicians walk on . I spoke about scams and gave an example of someone on disability whom a layman might look at and just assume they’re part of the scam problem. You address my example and my question about scams with data that… doesn’t address scams at all.

You quoted me and gave me data that has nothing to do with scams after I challenged the idea that somehow paying a lawyer auto means the claim is not genuine… if not’s not genuine, you’re implying it’s fraud. Then you told me my one example was worthless because it didn’t contain data that covers millions, and then proceeded to tell me why you aren’t talking about scams… let’s get back to the part where you quoted me when I was referring to… scams, or this idea that lawyers getting paid to help people file claims is somehow inherently bad.

If you want to proceed with omg, the numbers of claims are increasing at a rapid rate and we should look at it, go head. Don’t tell me it’s a rigged system set-up to reward fraud though when you haven’t proven that.

This is from your Bloomberg aritcle:

But outright fraud is unlikely to explain all the program’s growth. The OIG reports that its fraud units saved the fund $416 million in 2015; total payments that year were $89 billion.

That’s a fraction of the increase, a very small fraction.

And that low end disposable jobs no longer exist.

If you couldn’t hold down a job, you just worked a lot of them. Now you’re competing with college grads to work at Dennys.

A person that could have worked menial shit and stayed alive in the 80’s would die on the streets nowadays.

There are counties in NC where half of the working-age population is on permanent disability. Nationwide the number is about 10% on some disability. If you believe those numbers are just normal and don’t indicate systemic abuse of the classification, then our intuition is very different. Disability is becoming the new welfare, and the physicians are glad to help people onto it because it is a “victimless crime”. There are no consequences for them, and it absolutely helps people who otherwise would end up indigent or worse.

I’m not the one who demanded data to back up a claim. Since I was called on it, I’m going to ask you the same thing. Where are the academic or economic studies for the counties you’re talking about?

I have referenced https://www.disabilitystatistics.org and http://disabilityplanningdata.com

The last time I had this conversation it was about this article

This doesn’t mean they’re committing fraud. It could mean what JonRowe’s linked data document actually says, that the program itself is essentially too broad, that the scope needs to change in order to function how people think it should function. We already know the numbers are on the rise, but it doesn’t mean those numbers aren’t “normal” and that abuse is the cause.

Good article. Some takeaways.

It’s a mix of jobs available and abilities:

During her approval process, a vocational expert testified that Cossey could perform sedentary work, such as at a call center, with frequent breaks. No jobs fitting that description are available in Van Buren County, and Cossey and her husband—who gets disability payments for his cerebral palsy—don’t want to move away from family.

There are some disincentives:

the way the program is structured can trap people who live in low-wage areas like Van Buren County. Recipients are often hesitant to look for full-time employment because they don’t want to risk losing the financial cushion and access to health care that disability insurance provides. “It’s scary to try to work,” says Cleveland, herself a quadriplegic after surviving a car accident at 17. “I talk to people who could work, and they’re crying.”

While there is some fraud, it appears to be fairly minimal:

In 2015 it required Social Security’s Office of the Inspector General (OIG) to open joint fraud investigation offices with local officials in all 50 states. These offices first opened in the late 1990s. In 2013 fraud made up a little more than 70 percent of the OIG’s caseload; it’s now 86 percent. But outright fraud is unlikely to explain all the program’s growth. The OIG reports that its fraud units saved the fund $416 million in 2015; total payments that year were $89 billion.

Age and women in the workforce becoming eligible have changed it:

He says the program’s growth is mostly a consequence of demographic change. Older workers are more likely to get sick, and as women have entered the workforce, they too have become eligible for benefits.