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comment by blackbootz
blackbootz  ·  2952 days ago  ·  link  ·    ·  parent  ·  post: How To Be Mean To Your Kids [The Last Psychiatrist]

    THING 1) My neighbors are on disability. It took one of them 28 months, the other 18, with constant investigations and denials, before they were approved. One of them legit had an I-beam fall on him at the shipyard. This whole "you have anxiety, therefore we'll slap you on SSI forever" thing is BS.

It's probably unfair to bring up something the author said outside of this original post, but in this case it's so relevant that it bears bringing up (NB this link is to a rehost of the article, since TLP later took it down). The Terrible, Awful Truth About Supplemental Security Income:

(where TLP responds to the criticism that "Fed Gov't as pez dispenser" doesn't work for me, because I can't walk in and just collect disability payments)

    II. "That's not how it works for me!"

    ...you might say, which brings us to the whole point: it's not for you. It is for the entire class of people we label as poor, about whom comic Greg Geraldo joked: "it's easy to forget there's so much poverty in the United States, because the poor people look just like black people." Include inner city whites and hispanics, and this is how the government fights the War On Poverty.

    In the inner cities, the system is completely automated. Poor person rolls in to the clinic, fills out the paperwork (doc signs a stack of them at the end of the day), he sees a therapist therapist, a doctor, +/- medications, and gets his benefits.

    There's no accountability, at all. I have never once been asked by the government whether the person deserved the money, the basis for my diagnosis-- they don't audit the charts, all that exists is my sig on a two page form. The system just is.

For a less brooding/sardonic and more academic and sourced take on the phenomenon federal disability payments doubling over the last 15 years, check out "Trends with Benefits", an episode from This American Life.

My point, your neighbors's experiences notwithstanding, the disability payment system has and is massively expanding. Like in Hale County, Alabama, where nearly one in four working adults is on disability.

    THING 2) A buddy is on disability. He's got Lyme disease. While he can occasionally work, he has to do it under the table because if his social worker can verify any real income, she yanks his payments in their entirety. Yeah - there's a government employee whose caseload includes making sure my buddy earns no money. This whole "wander from doctor to doctor like a leaf on the winds" thing is BS.

I understand. I've met dishwashers who got paid under the table not because they were illegal immigrants trying to evade authorities but because any above-the-table income would threaten their disability checks. Freakonomics, though a flawed book, stated quite blandly that weird incentives create weird behaviors.

As for your Thing the Third, I admit: This blogger oftentimes loses me with his essays that seem more like free associations than a rigorously researched and sourced argument. And if TLP gets going on Narcissism, then all bets are off and after reading it, you can't help but conclude that everyone everywhere in the United States is living a fake life of self-curated branding with FaceSnaps and foodie pics.

But I'm fascinated with the concept of medicalizing poverty and I don't know if I have encountered anyone discussing the merits of such a hypothesis.





kleinbl00  ·  2952 days ago  ·  link  ·    ·  

Goddamn it.

    An inner city psychiatrist sees 20-40 people a day. 15 minute med checks, which in a city is 5 or 10 minutes. "Any major symptoms? Suicidality? Side effects? Here's your refill." You try and pull that off in a suburban area and the Feds will be shooting your dog to access your backdoor.

I knew that guy. Compass Mental Health. There, and he was also the one lone psychiatrist at the rural clinic in Gray's Harbor County. He also did some private practice for the rich kidz. Rich kids? 90 minutes. Downtown Seattle? 10 minutes each. Gray's Harbor? 5-7 minutes, once a week. In '97.

    And there's plenty of money to be made for the entrepreneurial. If you want to be rich in inner city psychiatry (and you don't have to be a doc), you open a clinic and hire 1 psychiatrist and lots of (talk) therapists, usually social workers. Medicaid will pay for 1 therapy visit per week (around $60/hr) and a 15 minute med check with the doc ($40/visit). The doc usually gets salaried but proportionally takes 50% of that. Let him have it all. The therapist, however, gets very little-- $20/hr.

Goddamn it. Yep. Social workers were making $17 an hour. And he was making enough to justify driving eight hours round trip every week for one day a week. Doing state work.

Fuck you. Badged.

blackbootz  ·  2952 days ago  ·  link  ·  

Fuck me? I just wanna hear you think out loud kb. ;)

I'm having difficulty contributing to your hipster-hate post. Because although I feel like I have something to say, I don't know what it is. Why is that?

And even curiouser, I feel somehow these two disparate conversations related.

kleinbl00  ·  2952 days ago  ·  link  ·  

Hmm. You may have provoked me into listening to an episode of This American Life, and I've hated that prick for ten years.

user-inactivated  ·  2952 days ago  ·  link  ·