Monday, August 12, 2013

Disabling Workplace Obstacles

Government programs:  bad.

Private industry:  good.

These are the two golden rules of Republicanism, and for the most part, they're fairly accurate.  There hasn't been a government in the history of mankind that has been able to sustain a society as well as capitalism can.  No matter the quality of their intentions, the more a government's programs, the more they tend to defray the benefits of personal responsibility, which then undermines a society's moral fabric.  Meanwhile, market forces tend to efficiently reward honest work with a relatively honest wage, which tends to perpetuate a peaceable stability conducive to even more economic growth.

So, at first glance, a article by Marvin Olasky entitled "Be Less Than You Can Be" fits what you'd expect from a morally and politically conservative publication.  Olasky's piece explores evidences of flagrant fraud and mismanagement in two rapidly-growing government programs, Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).  Specifically, Olasky discusses how these two programs have effected the Americans with Disabilities Act (ADA), which was supposed to streamline everything from bricks-and-mortar infrastructure to employment logistics to help disabled citizens work as much as they're able.

It's not particularly surprising that none of these three behemoth initiatives are working the way they were designed to work, although it's still disappointing.  Olasky takes great pains to chronicle both the promises made by politicians and bureaucrats, and the incentives they've inadvertently built into these government systems to instead discourage the disabled from seeking employment.  In other words, considering all of the bureaucratic hurdles and red tape, illogical rules, and people still falling through the cracks, SSI, SSDI, have contributed to ADA becoming a tragic trophy to governmental ineptitude, fiscal waste, and most importantly, the diminished morale of disabled Americans who were hoping to derive some personal satisfaction from being able to perform what work they physically can.

As Olasky summarises, "official Washington, through ADA, said one thing - "We’ll help you to work" - but created incentives not to work."

It's classic government largess.  When I was an intern for the City of New York one summer, the executive secretary for the director of the program on which I'd been assigned told me she had been earning more living on welfare than she was drawing a paycheck.  The only reason she didn't want to go back on welfare was because she was trying to teach her children about the value of work and personal integrity.  Unfortunately, not everybody on welfare wants as much dignity for themselves as my executive secretary friend.

The thing with many disabled Americans, on the other hand, is that they've spent their entire lives physically depending on somebody else for something.  Maybe it's going to the bathroom, or putting on their clothes, or being transported someplace, or needing to have work surfaces at an unconventional height.  Imagine the discouragement, if not downright embarrassment, particularly in our culture, where personal accomplishment is so highly valued.  ADA was supposed to provide a leveling of the workplace playing field so that people could compete for jobs regardless of any physical limitations they might have.  Maybe they couldn't play professional sports, or paint houses, or perform brain surgeries, simply because of the physical demands involved, but they should at least be able to contribute what they can without being ostracized for something they can't control.

As Olasky shows in his article, the same problems every other government anti-poverty program has experienced have crippled the ADA, and threatens to shift an entire class of people searching for dignity through work into morale-sapping exercises in bureaucratic futility.  Olasky's solutions?  Provide federal block grants to states for them to explore their own solutions, make families shoulder a greater burden of the work process, and farm out some ADA processes to private insurers for them to manage.

Basically, he wants to get the federal government out of the picture.  Which is the typical, traditional conservative response to any governmental problem, and yes, often, that's the best answer.  Additionally, in this case, it's likely that some states with greater concentrations of cutting-edge healthcare providers can be more innovative than the federal government.

However, that's a solution that will only benefit people fortunate enough to live in those specific states.  What about people needing help in less medically-robust states?  Actually, it's a similar type of non-solution as expecting families to provide even more resources for their disabled members, a blind assumption made without understanding how such families are already stretched thin financially and emotionally.  Some families are more resilient than others, are larger than others, or are wealthier than others, and they can handle the extraordinary challenges of caring for disabled loved ones.  But that's not always the case.

Olasky also points to Holland as a model for shifting the caseload of disabled workers into private insurance programs, but Holland is far smaller than the United States, with a far more homogeneous population, and state-sponsored healthcare to boot.  We conservatives complained when Obamacare supporters pointed to small, homogeneous European countries as perfect examples of socialized medicine, rightly squawking that it was like comparing apples and oranges.  Plus, so far, America's private insurance companies have exhibited little eagerness to explore more profit centers in an intensive form of occupational therapy.

So, what's left?

Well, the private enterprise Olasky mentions regarding insurance is still his best idea, but only because market forces have a better track record with the overall subject of healthcare than government ones.  But does it really address the root cause for why disabled people can't get jobs?  After all, that's the central issue here, not the fact that disabled people end up languishing on SSI and SSDI.  If the disabled were welcomed into America's workforce - since so many of them actually want to work - we wouldn't need to be having this conversation.

Which points to a disturbing reality:  private enterprise has no motivation to help people with chronic, prominent health problems.  Hey - it's hard enough for people without disabilities to find work these days.  Complicate the hiring process by presenting a potential employer with a list of physical limitations, such as mobility issues, being energetic for only a couple of hours at a time, or anything else that an employer can't help but view as an economic liability, and see what happens.  With private enterprise, it's all about the bottom line.  It's all about maximum productivity at minimum cost.  Having to accommodate any fluctuations, special cases, or extenuating circumstances only whittles away at profitability.

The very reason why ADA was necessary stemmed from the need for our government to help people towards whom private enterprise didn't want to be proactive.  To the extent that ADA helps equalize access to America's workplace by mandating accessible facilities and penalizing overt discrimination, it's probably still better than nothing.  However, whenever the government creates a program, as ADA's sprawling legislation proves, it has to account for as many contingencies as it can think of to avoid abuse.  And even then, as Olasky proves, abuse happens.

Frankly, isn't it virtually impossible to design any type of public "welfare" program that can meet everybody's needs effectively?  Considering how vast and lethargic all three of these programs have become, undoubtedly some efficiencies can be wrung out of them, and Olasky is right to encourage that process.  Obviously, we're not getting the equity we thought we were getting, and that needs to change.

Then too, maybe part of the problem isn't the welfare benchmarks that seem overly generous, and appear to be de-incentivizing employment for the disabled, but the fact that private employers simply don't want to pay what the disabled think they're worth.  If that's the case, then welcome to the club - this problem afflicts a lot of workers outside the scope of the ADA.  Maybe we need to be more realistic about the capabilities of the disabled, even if it means more bad news for people who really need a respite from it.

Regardless of all these considerations, however, at the root of this issue must be some sort of incentive for people to help each other, for employers to work with the limitations of their ADA employees, for insurance companies to be flexible, and for the healthcare industry to be more affordable.  Employers will have to evaluate all employees - not just potential hires who may be differently-abled - based on what they provide the company, instead of what they cost.  Insurance companies could look for innovations in workplace therapies so disabled employees can stay on the clock longer.  And if anybody's hoping Obamacare will actually lower healthcare costs for the disabled, think again:  most of America's disabled are already on some sort of publicly-funded health program, and nobody's found anything in the tons of Obamacare literature that proves the government has any idea about how seeing a medical professional is going to cost any less money than it does today.

Perhaps it was unrealistic to expect the disabled to integrate seamlessly into our performance-oriented culture.  Maybe we're going to have to learn how to accommodate the stark realities that we are all different - and some far more than others.  Being racially colorblind, for example, is as much an attitude and conviction as anything.  Being physically colorblind, however, will realistically exclude you from certain jobs regardless of any law, or best intention, or moral code, or until technology invalidates the condition.

Meanwhile, the humanity our disabled desire isn't so much in the province of a government to provide, as much as it is the employer for whom they'd like a chance to work.

If that humanity is too expensive for our employers, what might that say about our society?

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