I was writing on another blog's comments page about disabilities when it occurred to me, just as unemployment insurance produces perverse incentives, actually increasing the number of unemployed, so too do government run (and private) disability insurance.

I know this from first hand experience. As most know, I have had some health issues which cause me pretty severe pain and have left me unable to drive, and often cause difficulty in walking, typing, and other activities. However, I have continued to work throughout this. However, I can also admit that, a I have private disability insurance, which is much easier to collect than the same type of coverage from social security, when work is bad, or when my pain is bad, I am tempted to claim my pain is just too much and start collecting money for not working. And the same is certainly true of government disability insurance. The mere existence of SSI, SSDI, and the like makes it easier for workers suffering some ailment to decide to simply stop working.

Now, I am not saying most workers would, nor am I saying all those on disability are slackers, I am simply saying the incentives are contrary to what most people want. Given a tolerable ailment, most workers will continue to work, just as i have. However, the fact that they can get paid at an acceptable rate without working suddenly makes the definition of what is tolerable and intolerable much different. Faced with starvation, most of us would continue working despite quite immense difficulties. On the other hand, facing 60% of my salary per month, the line dividing what is and is not tolerable shifts a little bit. And I am sure it does for most people.

Now some will respond that just because I can work does not mean everyone can, and that is true, I happen to be fortunate that my job can be done from home. However, if I were facing starvation, or eviction of my family, I think I would find some sort of work I could do. Be it medical transcription, returning to bar tending, whatever, I would have to do it. Yes, there are some who cannot do that, whose disability does prevent them from doing any job, but I also know from the years when I worked in social services, there are a lot of other cases, people who can't work because of "bipolar disorder" who still manage to go out, beg on the streets, collect cans and get arrested for drug charges or burglary, or construction workers whose back problems flare up whenever building slows down. They may not be the majority, but the flexible definition of "disabled" does invite such abuse.

But even if it were not being abused, disability still simply pushes people in the wrong direction. As I said, once you know you can be paid for not working, it becomes easier to see your problem as worse than it is. Lower back pain may be painful, and all your background may be in manual labor, but I also know there are jobs in nice soft chairs you can get without experience (I have held several in the past). Being unable to do your old job does not mean you are disabled. However, once the money is there, it is very tempting to ignore the alternatives, to see your problems as larger, and simply accept the payment for doing nothing. Few of us work out of love for work, so the promise of money and free time is a tempting one. And thus disability insurance provides a very perverse incentive, pushing people toward seeing themselves as less able, rather than encouraging them to overcome their problems.

There is also a flip side to this. People who suffer from severe health problems but must work to support themselves. I saw several cases in my time at social services where a person had a horrible health condition (a lung removed due to cancer, bone cancer in an 18 year old), people to whom the state would not grant medical assistance, as the fact that they somehow continued to work "proved" they were not disabled.  On the other hand, drug addicts who claimed depression were granted not just medial assistance, but cash benefits as well, because they had no job. Again, the system was designed to encourage reliance rather than independence. Anyone claiming disability was discouraged from even trying to become independent, as, unlike other welfare, benefits were not pro-rated, but stopped entirely the moment they worked one hour.

And that is the problem with most government programs, whatever their goal, whatever their motives, in the end they tend to encourage behaviors they claim to want to discourage. Just as welfare encouraged out of wedlock births, disability insurance tends to encourage those with illnesses to exaggerate their problems and to take fewer steps to adjust to their new circumstances.

POSTSCRIPT

Please don't take that penultimate paragraph to mean I support the idea of medical assistance. However, if we must throw our money down that hole, I would rather support the school bus driver recovering from cancer and the teen with a bone graft holding down a job, rather than the drug addict who never worked before he became depressed. I would prefer to support none of them, but if we have to, and apparently we have, I fall on the side of those trying to support themselves.