September 7, 2011

How To Be Mean To Your Kids

rum_drunk.jpgstabilize the price, whatever it takes


A reader sent me a link to an article written by psychiatrist Steve Balt, How To Retire At Age 27, in which he describes a typical patient in his practice, a 27 year old named Keisha:

During the interview, she told me, "I just got my SSDI so I'm retired now." I asked her to elaborate. "I'm retired now," she said [boldface in the original].  "I get my check every month, I just have to keep seeing a doctor." When I asked why she's on disability, she replied, "I don't know, whatever they wrote, bipolar, mood swings, panic attacks, stuff like that." She had been off medications for over two months (with no apparent symptoms); she said she really "didn't notice" any effect of the drugs, except the Valium 20 mg per day, which "helped me settle down and relax."

I misspoke when I said "typical patient." She's slightly unusual for his inner city population, because she actually graduated high school and even took nursing assistant classes.

She dropped out, however, because "I got stressed out." She tried looking for other work but then found out from a family member that she could "apply for disability."

A psychiatrist and a lawyer later and she's awarded a pension of $700 a month. No retirement party, though.  And she'll have to buy her own watch.

The rest of his post is a thoughtful back and forth about what constitutes disability, and whether a) giving them this easy way out isn't actually doing a disservice to the human being in front of you; b) whether these false diagnoses aren't artificially inflating disease prevalence estimates; c) the extent to which it contributes to bureaucracy (and cost.)

II.

So when he emailed me the link to the article, How To Retire At Age 27," the reader asked me a tongue-in-cheek question:  "Now why didn't I think of that twenty years ago?"

Thing is, he probably did think of that, or some brief fantasy of something like it, but figured he could make much more money doing something else.  Therein we have the problem:

Evidently, this woman Keisha doesn't think she could make substantially more than $700/month doing something else, so regardless of whether she is truly disabled or not, her conception of her opportunities is seriously limited.  That's social policy problemo numero uno. 

Note that she even took classes to be a certified nursing assistant, and still doesn't think it's worth it.  So either CNAs don't get paid enough (over SSI) to merit giving up all your free time to work with the belligerent poop machines at the hospital, or else SSI pays too much to make that decision even worth considering.  There are no other possibilities.  Choosing between those without sparking riots is social policy problemo numero dos.

Then there's a subtle semiotic issue.  She calls it "retired."  Not disabled, but retired, which means in the language of social policy she has understood that she has somehow "worked"/contributed to society to merit some retirement benefits, and also tacitly accepts she's not unable to work, rather that she's done working.  So what could she have done to merit retirement? The answer probably is nothing.  Right?  But no one has tried to correct her thinking about this because, well, it just isn't worth arguing with some unemployed black woman at a psychiatrist's office because you'll be branded uncaring and racist, not just by her but by some other busybody with a progressive agenda, free time, and a government/media job.   You will also likely get punched.   Besides, you and anyone who values work as a moral good and an end in itself don't have time to explain it to an unwilling Keisha, you actually have to get back to work.  So she's left with her comforting lies that go unchallenged-- bellay that: they are encouraged.  That's social policy problemo numero tres.

III.

But now we have to take three left turns to get at the truth.

There is a significant misconception of what "disability" means, and I'm not going to say what you think I might.  Dr. Balt, and I'll wager most people, think Keisha is probably able to work.  However, the issue isn't whether she can work, but whether any employer would be willing to take a chance on her ability to work. Would you hire Keisha to run your office?  Do billing?  In the spacious comfort of an internet comment you might hire a woman like Keisha to work at a hypothetically inefficient McDonalds, but in practice, are you willing to tolerate "3-4 absences a month due to illness?"  McDonalds neither, which is why the SSI application form asks that exact question.

You will observe the Keisha does not even have the enthusiasm to know what is written on the most important economic documents of her life.  "I don't know, bipolar, panic attacks, whatever they put on there."  She can't be bothered to handle those papers, someone else is in charge of that.  How attentive will she be to the frier?  McDonalds doesn't want to find out.

That specific issue reveals an important bias and misunderstanding America has when it talks about employment.  Yes, there is an issue about people wanting to work but the other issue is that the global economy is too quick and efficient to tolerate your idiotic car troubles or your imbecilic grandmother's death or your moronic lack of child care (cue Scandinavia) or, and mostly, your stupid health.  The economy was a Ferrari and now it's only a Honda, but either way, not much time for absences and no time at all for Keisha's learning curve.  Keisha isn't just unemployed, she is completely unemployable.   We can argue whether auto plants should pay $20/hr or $50/hr, but for certain there is no market for unskilled labor at all.   Let me correct another grand mistake of the politicians and the talking heads in the media:  this problem is likely to get much, much worse, not better, as the economy improves.   There are no typos in that sentence.   Read it again.

The jobs employers would be willing to take a gamble on are jobs that pay too little for it to be worth her showing up at all.  Hence SSI.  Sure, maybe you could work at Walmart for $7 an hour but they don't offer benefits so ultimately, what's the point?  A rich guy may think he pays his Mexican housekeeper good money, but the fact is if Juanita doesn't show up one Tuesday morning he doesn't miss a step, which is why he was willing to hire her.  You send the suits to tell him he has to hire her legally, pay her wage taxes and offer her health benefits and still take the risk she doesn't show up and he'll release the doberman on you and just hire four high school kids to each work a block of two hours a month.  Is that fine with you?  Then go see what Juanita's next step is.

All of this comes down to a very important point: the country's economy understands these issues on an unconscious level, and it has created a system to absorb 10% of the unemployment, i.e. pay them off so they don't riot, exactly like Saudi Arabia buys off its people.  Yes, America is a Petrostate, but instead of oil money it's T-bills.  However, as is evident throughout history, rich white people riot too, hell, they'll overthrow a King because the rum prices fell too much or shoot a President because he wanted a third term; and they'll for damn sure John Galt the Senate if they think poor people are getting free handouts, so the system pretends to offer benefits based on medical disability, just as it pretends on your behalf to be appalled by Mexican illegal immigration even as every restaurant in Arizona employs illegals, and everyone knows it, including the politicians and the Minutemen who eat at every restaurant in Arizona, not to mention California, not to mention America.  Dummy, the sign says "Authentic Mexican Food"--oh, never mind.

For fun, let me point that that another 10% of the unemployed in America are relabeled as "incarcerated", so total you have a real rate of 15-20% unemployment, and this does not include the unemployable who have been relabeled as "military personnel" thanks to two endless wars, or those who manage ten hours a week at the Buy-n-Large who are relabeled as employed and thus are of no consequence;  all of which is good because if the unemployment rate printed higher than "9%" the credit rating of the US would have to fall to C-.   "But you need at least a 3.0 in your major to graduate."  There's your grade inflation.

Psychiatry is the unsuspecting but intentional handmaiden of this process.  Never once thinking it was being pulled into a long con, it self-righteously accepted its grownup label as "medical specialty" and began ostentatiously fighting for "mental health parity" and the Medicaid funds that it thinks it deserves, "we care about patients, about people!"  And it comforted itself with the knowledge that 25 medications and nine academic journals must signify they are scientists, which means that all my Foucaltian ranting couldn't possibly apply to them.  And yet, here we are.  Dr. Balt is obviously earnest and even optimistic when he tries to articulate cause and solution to these social issues, and he's to be commended for seeing through the Fog Of Prozac; but, lamentably, he is too late for change to come from within psychiatry.  Note that-- and this is neither an exception nor a criticism of him--  even though he sees this truth he cannot stop, he can't refuse to participate, and neither can I, or the other psychiatrists who are eyeballs deep in a system none of us conceived yet all of us are responsible for.  The system has been vaccinated against dissent.

I can sense you pulling away from my abstractions, "that's all very clever and all that, but how does it actually work in real life?"  This is what I'm trying to tell you: it doesn't work in real life.  It only works in theory.

He closes, "Using psychiatric labels to help patients obtain taxpayers' money, unless absolutely necessary and legitimate, is wasteful and dishonest."  Maybe, but if you change the system he will lose 100% of his "patients"; and never mind him, you do not want to know how the system will relabel the patients when that happens, or who will be in charge of that relabeling.   I am sure he will not believe me.  Fortunately for him, he will never have to find out.

IV.

And this brings us to the essence of the problem, of all of the social policy problems that we currently face.  "How did this happen?  How did it get so bad?"  The answer is that it has always been this bad.  We didn't care.

Narcissism has been on a steady rise since the end of WWII and went parabolic in the 1980s; all social policies have to be understood in the context of that psychology, that culture.  Hence SSI isn't altruistic but narcissistic, its every (no sic) purpose was not to serve others but to serve us.

Stop thinking of SSI as money.  SSI isn't taxed, and if you recall the First Law of Harbors, "taxation=representation": not taxing them is the same as not giving them representation.  So for $700/month they don't call you to account for all the rest of the money.  "Yeah, but don't they vote?"  HA!  You kill me.  I meant actual representation: lobbyists.

As long as they-- and the inmates and the etc-- are munching on food stamps, weed, and Xboxes, nearly illiterate but keeping their nonsense within their neighborhoods, the rest of us can go on with our lives.  Which means that every unconscious force exists to keep this state of affairs going until we no longer need it.  And if that requires printing money or releasing oil reserves to keep prices down or insisting there's a shortage of psychiatrists, "how about some NPs?", so be it, because the system must be preserved, including and especially at the expense of the future.  It's a popular political refrain that Social Security will soon be bankrupt, but that's meaninglessly obfuscating: it won't be around for the kids when they grow up  because it wasn't for them, it was for the people who were around when it was conceived.    There was never any way it could last forever, no credible way of funding it-- especially the moment productivity went parabolic compared to wages.
 

productivity and compensation.jpgyou don't have to be a labor theorist to recall what else went parabolic at the same time


Don't say that taxes needed to be higher because it was never about funding it, it was always about temporarily buying their apathy.  Truth be told, it stayed solvent longer than it was supposed to-- one of the benefits of having a reserve currency, aka a private meth lab.  But you knew that, didn't you?   Temporary measures, just like a psychiatry that is for the "management of acute symptoms"-- or are you going to tell me you expect/want it to look like this in 30 years?  Then why is it like this now?  And so this is the terrible, awful truth of it all: we created the system only for us, and will last for as long, but only as long, as we are alive, and that was as far as anyone ever thought it out.  That means that any kids under 10, rich and poor, will be left to make do with rubble-- on purpose.    That's what they will inherit from the Dumbest Generation Of Narcissists In The History of The World, who say with not the least bit of irony, "may as well spend it because you can't take it with you!"  No kidding.  You've created a gigantic Ponzi scheme which is not just morally sketchy but downright mean to your kids, but what do you care: you'll be dead.  

In some Bible story Ford Prefect warns the humans, "two million years you've got and that's it, at the end of that time your race will be dead" and he meant it as a fait accompli but that was a guy who took the long view; and when the response came back with a soothing smile, "well, still time for a few more baths!" that was a guy also taking the long view, the difference being his long view was exclusively to justify his present frivolity.  It should be no surprise that this second guy's brilliant solution to a fiscal crisis was to call leaves legal tender and then burn down all the forests.  They didn't survive the winter.   But the warning I offer the younger generations who have to clean up our messes even without the benefit of forests or a functioning psychiatry is what consequently happened to the first guy: he went mad.   It is inevitable.

----

Previously:  The Terrible, Awful, Truth About SSI









Comments

You focus on SSI, because t... (Below threshold)

September 8, 2011 4:09 AM | Posted by Dave Pinsen: | Reply

You focus on SSI, because that's in your wheelhouse, but similar accommodations have been made at higher socioeconomic levels. The USPS, for example, is largely a jobs program. And it goes beyond the USPS. Consider the featherbedding and generous benefits in K-12 school systems, public transit monopolies, etc.

Consider also the psychiatrists who wouldn't have livelihoods if it weren't for these SSI patients, whose bills are paid for by the government. There's a scene in Tom Wolfe's Bonfire of the Vanities where a Bronx assistant DA sees paddy wagons disgorge their criminal defendants and he likens it to the "chow" being fed into the maw of the criminal court house, which in turn employs DAs such as him, judges, bailiffs, etc. Those SSI patients are the chow line for lots of psychiatrists, admins, pharmacists, etc.

None of this is new, as you note, but what's new is that we can no longer afford it all so easily: the USPS, for example, is on track to go belly up by next summer, absent a bailout.

As long as the world is willing to gobble up our T-bills (and T-notes and T-bonds) for record low yields, so we'll be able to bailout the USPS with and keep everything else limping along with borrowed money. If the bond market loses its appetite for our paper though, it could get ugly.

Vote up Vote down Report this comment Score: 21 (31 votes cast)
Brilliant stuff as usual. B... (Below threshold)

September 8, 2011 5:22 AM | Posted by tipthewink: | Reply

Brilliant stuff as usual. Bringing in the 'B Ark': simply genius.

Thanks Alone.

Vote up Vote down Report this comment Score: 5 (9 votes cast)
I thought psychiatrists wer... (Below threshold)

September 8, 2011 5:43 AM | Posted by E Sharp: | Reply

I thought psychiatrists were supposed to help people sleep, not scare the living shit out of them.

Vote up Vote down Report this comment Score: 64 (70 votes cast)
I need a drink.... (Below threshold)

September 8, 2011 7:10 AM | Posted by Anonymous: | Reply

I need a drink.

Vote up Vote down Report this comment Score: 41 (41 votes cast)
Very poor analysis. Far too... (Below threshold)

September 8, 2011 7:21 AM | Posted by Anonymous: | Reply

Very poor analysis. Far too many curlicues and ornaments, not enough numbers or even real insight.

For example, to view the entire incarcerated population as essentially unemployable is nonsense, but even if it were so the unemployment rate would rise from 9.1% to 10.75% if the entire incarcerated population of the US were released en masse and not one of them found a job. Keep in mind that the entrepreneurial spirit is what landed a goodly number of them there in the first place.

Math is hard!

It is unsurprising that you expend so many innocent electrons on silly flourishes, but foolishly repeat the often debunked lie the Social Security will somehow disappear ("won't be around for the kids") barring legislation to actually end it. This is of a piece with the treatment of the most important part of your post - the gap between productivity and wages earned, which is (as usual with these types of rants) given the force of natural law. Or something. Frankly, it is hard to tell. What is a little odd is that someone who seems to have gotten some kind of education cannot resist the urge to extrapolate some aspects of the current situation endlessly into the future, much as we expect the force of gravity to be here for us tomorrow. The kids will live in rubble!

Still, you craft these things in a way that is guaranteed to keep the hits coming (disparaging sneers at "money printers", natch.) I know I'll be back!

Vote up Vote down Report this comment Score: 11 (93 votes cast)
Wait. What?... (Below threshold)

September 8, 2011 8:42 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

Wait. What?

Vote up Vote down Report this comment Score: -7 (17 votes cast)
Dr. Balt never said Keisha ... (Below threshold)

September 8, 2011 10:44 AM | Posted by Anonymous: | Reply

Dr. Balt never said Keisha was black.

Vote up Vote down Report this comment Score: -14 (36 votes cast)
"There was never any way it... (Below threshold)

September 8, 2011 11:26 AM | Posted by Anonymous: | Reply

"There was never any way it could last forever, no credible way of funding it-- especially the moment productivity went parabolic compared to wages."

The problem with these studies (and I'm not sure which one in particular you're referencing) is that they're comparing wages & productivity while ignoring the rise in non-wage benefits.

Secondly, there's an issue with how wage deflators are selected. For those interested, Google '"consumer real wage" "producer real wage"'. After you finish reading, what you'll find is that measure of productivity that find 'parabolic' divergence aren't measuring the wage cost relative to firms. Thus, producer real wages are undervalued. This error, when combined with the undervaluing of wages in terms of benefit, explains the supposed divergence. Turns out Spencer is still right: wages & prices are (relatively) sticky.

So no, evil corporations/governments/what-have-you are not growing fat off your surplus value.

Vote up Vote down Report this comment Score: -10 (22 votes cast)
"Stop thinking of SSI as mo... (Below threshold)

September 8, 2011 11:31 AM | Posted by Anonymous: | Reply

"Stop thinking of SSI as money. SSI isn't taxed, and if you recall the First Law of Harbors, 'taxation=representation': not taxing them is the same as not giving them representation. So for $700/month they don't call you to account for all the rest of the money. 'Yeah, but don't they vote?' HA! You kill me. I meant actual representation: lobbyists."

SSI *does* have lobbyists, and some of the best. Ever hear of AARP?

Vote up Vote down Report this comment Score: 2 (16 votes cast)
Anyone care to explain why ... (Below threshold)

September 8, 2011 11:40 AM | Posted by Anonymous: | Reply

Anyone care to explain why this can't last forever? Is there any problem at all if you're morally fine with healthy people sitting at home who receive money to keep them from rioting?

Vote up Vote down Report this comment Score: 2 (14 votes cast)
TLP never said he was white... (Below threshold)

September 8, 2011 11:55 AM | Posted by Anonymous: | Reply

TLP never said he was white.

Vote up Vote down Report this comment Score: 8 (18 votes cast)
He isn't talking about Soci... (Below threshold)

September 8, 2011 1:25 PM | Posted, in reply to Anonymous's comment, by Methossa: | Reply

He isn't talking about Social Security. SSI is entirely different, not related at all. http://en.wikipedia.org/wiki/Supplemental_Security_Income

He's talking about the system as a whole, and on that note he's pretty damn accurate. I agree that he extrapolates on both the incarcerated and the military. But I don't see any numbers from you other than the one about the unemployment rate with incarceration. Except he isn't just talking about the prisoners. He's talking about the guards. The people who prepare the meals, repair the buildings, manage the prisons in the first place, the net economic impact of our prison system. Even then I think he's inflated, but the point stands.

If you feel like doing numbers, do them and throw them out and explain why he's wrong, in detail. Don't just be a snide jackass deriding him because you incorrectly infer that he's against a program like Social Security that you support.

Here's a good starting point for what he talks about when he's referring to the system as a whole.
http://partialobjects.com/2011/06/staggering-thought-of-the-day/

Vote up Vote down Report this comment Score: 12 (18 votes cast)
A quick caveat: By not rela... (Below threshold)

September 8, 2011 1:28 PM | Posted, in reply to Methossa's comment, by Methossa: | Reply

A quick caveat: By not related at all, I'm talking about the source of the money, not who handles it. Mr. Wiki tells us all that it's ran by the Social Security Administration.

Vote up Vote down Report this comment Score: 0 (2 votes cast)
I doubt you're going to lis... (Below threshold)

September 8, 2011 2:46 PM | Posted by anon: | Reply

I doubt you're going to listen to a first time anonymous commentator, but just for the hell of it I'm going to post anyway.

Your posts are incredibly insightful about psychiatry, social institutions and culture, but you are woefully ignorant about economics and government finances. These systems aren't Ponzi schemes (in particular they don't promise returns and investment is compulsory,) we're not broke unless we decide to be, and if we leave future generations standing in the rubble it will be because we decide to do so.

I don't want to go on and on about this, so I won't. I just want to say that I think your blog would be much better if you focus on your comparative strengths. Sections 1-3 of this post are brilliant and insightful in ways that I rarely see. Writing those sections adds a lot of value and provokes a lot of thought, even when I don't entirely agree with everything written in them. By contrast, section 4 just seems tacked on-a desperate attempt to tie everything together and bring your usual scapegoat of narcissism into the mix while trying to be both condescending and prophetic. It's unbecoming and tarnishes what would be an otherwise great entry.

Of course, it's your blog and you can write whatever the hell you want on it, but I think you'd have a larger impact if you stuck to what you're truly great at. Maybe that's not what you want/why you write this thing, but if it is you should think about playing more to your strengths.

Vote up Vote down Report this comment Score: 26 (56 votes cast)
People like Keisha make peo... (Below threshold)

September 8, 2011 3:38 PM | Posted by Cat: | Reply

People like Keisha make people like my mom, who is legitimately physically disabled due to severe epilepsy and blindness, look really bad and at risk of losing her benefits because people assume *everyone* on aid is like that.

Vote up Vote down Report this comment Score: 12 (26 votes cast)
TLP sees worth in nothing.<... (Below threshold)

September 8, 2011 6:13 PM | Posted by Anonymous: | Reply

TLP sees worth in nothing.

Vote up Vote down Report this comment Score: 0 (10 votes cast)
shut the fuck up... (Below threshold)

September 8, 2011 6:41 PM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

shut the fuck up

Vote up Vote down Report this comment Score: -16 (22 votes cast)
The Comedian from Watch... (Below threshold)

September 8, 2011 7:07 PM | Posted by Rorschach: | Reply

The Comedian from Watchmen always reminds me of Alone/The Last Psychiatrist.

You know what happens to the Comedian, eventually...

Vote up Vote down Report this comment Score: -5 (11 votes cast)
Lonely can explain/defend h... (Below threshold)

September 8, 2011 7:21 PM | Posted, in reply to anon's comment, by Perry : | Reply

Lonely can explain/defend himself without me, so I'll confine myself to my interpretation of his post by raising three points in response to yours, knowing that I could be dead wrong:

1. Narcissism via TLP (aka Lonely) appears to be a prime diagnosis for what distinguishes our time from others', both individually and more or less across the culture at large. It is pervasive to the extent that tree dwellers have trouble seeing the forest. Or to go aquatic, fish can't leave the water in self-examination. We're immersed, as I interpret his thinking, so we have to try really hard to recognize it in ourselves in order to be able to see it at work around us. So it may be a scapegoat to you, but I don't believe it is to him. That's too easy.

2. It is a form of Ponzi scheme, if people think they are getting something for nothing. Something cannot come from nothing. I've been wondering lately if our money printing isn't some kind of ruse. The system works until someone says, "No, that money you're printing is worthless. I won't buy your bonds anymore." At that point the system collapses like a house of cards. The major players are so deep into the game that so far they keep playing along. But something unforeseen, perhaps a little glitch somewhere, like Toto pulling the curtain back on the Wizard of Oz, could expose the weakness. We've all heard people in Washington use the "kick the can down the road" image. They know the truth, but the aim is to keep the boat floating, not to safe harbor, but until the chopper plucks them out to safe harbor.

3. About sticking to what he knows. He can't and won't. He extrapolates and ventures into other areas precisely because so few other do. Most specialists stick to the safety of their expertise, resulting in the cul de sac of little or no interdisciplinary dialog. We talk around, over and under each other, but don't dare venture out of our cubicle. So the right people don't speak to each other. He may not have PhD's in twelve unrelated fields, but he knows one well and obviously reads without ceasing to try to grasp what he can of the rest. He sees through a lens, yes, but he at least knows he's seeing through a lens. Some people, especially maybe the lonely ones, feel like someone has to try.

I'm glad you said what you did. I hope I haven't really screwed up on what Lonely is up to.

Vote up Vote down Report this comment Score: 17 (29 votes cast)
Dilbert has brought up simi... (Below threshold)

September 8, 2011 7:55 PM | Posted by BeamMeUpScotty: | Reply

Dilbert has brought up similar points before...

http://dilbert.com/strips/comic/1992-08-02/

I am curious about caption on the chart. Are you asserting high productivity causes narcissism?

Vote up Vote down Report this comment Score: 5 (5 votes cast)
As a social worker, I am of... (Below threshold)

September 8, 2011 8:16 PM | Posted by Natalie Hill: | Reply

As a social worker, I am often asked to fill out SSI applications (because the psychiatrists don't have time for that kind of thing). It's actually quite a bind, most of the time. I think work has enormous benefits for mental health (and occasionally tell a client *I* would be paralyzed by depression if I didn't work), and also think many of my clients are capable of working. However, as this post points out, just because they can work, doesn't mean 1) there are jobs available to people without a high school diploma, or 2) that employers would put up with the assumption that one only should do what one feels like doing. A total lack of income (rather than the $700 a month, give or take) leaves them unable to fill their prescriptions, pay the electric bill, or get enough food or clothing to get buy - and while working may be beneficial to mental health, abject poverty is absolutely a detriment to mental health. So, it is a policy quagmire for the country, and a professional moral dilemma on an ongoing basis. - Natalie (practicewisdom.blogspot.com)

Vote up Vote down Report this comment Score: 12 (16 votes cast)
Wait..... what?... (Below threshold)

September 8, 2011 9:40 PM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

Wait..... what?

Vote up Vote down Report this comment Score: -3 (5 votes cast)
"The system works until som... (Below threshold)

September 9, 2011 12:10 AM | Posted, in reply to Perry 's comment, by Anonymous: | Reply

"The system works until someone says, 'No, that money you're printing is worthless. I won't buy your bonds anymore.'"

But that money is still used to pay your taxes, so until people decide they're not going to pay taxes, either: we're fine.

Vote up Vote down Report this comment Score: 5 (7 votes cast)
Uhhhh, yeah, the sanctimoni... (Below threshold)

September 9, 2011 12:53 AM | Posted by asphalt : | Reply

Uhhhh, yeah, the sanctimonious use of tired nomenclature such as "Ponzi scheme"... Could you please offer an alternative pension/retirement model for us, the unnarcissistic yet unwashed masses, that's got more scheme than Ponzi?
You're obviously brilliant (certainly vis-à-vis perrygoodhair): the Ponzi bit was so very anticlimactic, so unsexy. Come on...
And, no offense, but you're (also) missing an umlaut at the top.

Vote up Vote down Report this comment Score: -7 (19 votes cast)
I'm not against paying stup... (Below threshold)

September 9, 2011 1:05 AM | Posted by Anonymous: | Reply

I'm not against paying stupid ugly people to not rob or loot, however, the catch should be that you only get your $700 check if you get a tubal ligation/vasectomy.

Sure, the government will pay you for life not to fuck up and steal and kill people, but the trade off for this pension is taht you must never, ever breed ever.

Rather than pretending to be crazy, SSDI should be availabile for any ignorant low iq genetic waste bucket who wants it... you just need to sterilize yourself first.

I would totally support this law and I can only imagine the reason it is not in effect now is because any politician who tried it would be accused of racism, simply for the fact most people fitting this profile are not white.

Sorry if more not white people are losers compared to white people, even if it is true. Losers are losers regardless of color there are plenty of white people this pathetic, I have some in my own family. It only so happens that relatively more of them are not white.

But whatever, I am all for easy access to SSDI, just sign a release for a vasectomy/tubal ligation and get it done.

Imagine how much better society would be in like, 2 or 3 generations? It would be a fucking utopia in america. All problems would be solved when the stupid ugly and ignorant would be given a pension to sterilize themselves. Crime rates would drop. Dumb crack babies would decrease. I've solved all of our countries problems boom done.

PS, as a registered nurse, I can tell you $700/month is slightly less than what an average CNA makes. Sad isn't it? The CNAs at my facility make a little more than $10/hr. That is PATHETIC.
Keisha was right to opt for SSDI. The CNA's I work with are making, taking home, not much more than that. Maybe a little over 1k per month. But Keisha can easily make the extra money by selling cosmetics like avon or spending more time with her children and not paying for child care.

The problem is corporations are pretty much stealing labor, so in truth, unless you have a degree that is worth something , there is absolutely no money to be made, the government handouts are a smarter option.

Vote up Vote down Report this comment Score: -14 (50 votes cast)
Translation: I am a capital... (Below threshold)

September 9, 2011 1:22 AM | Posted, in reply to anon's comment, by Anonymous: | Reply

Translation: I am a capitalist and a libertarian and a right winger and a stereotypical idiot, therefore your views on society/economy piss me off and ruin my dream that, quote :"we're not broke unless we decide to be, and if we leave future generations standing in the rubble it will be because we decide to do so."

Ha. Ha. Ha.

Right wingers are such jokes, the poor ones anyway, and I can tell by your naive optimism and desire for power ("I DECIDE TO BE BROKE!!1111") that your income is clearly on the wrong end of the tax bracket.

What is it with young male right wingers and their obvious desire for power? It is almost physically painful to watch them , they look and sound as if any minute they are a shade from a break down after realizing just how shitty it all really is and how powerless and weak and out of control they actually are.

Vote up Vote down Report this comment Score: -15 (27 votes cast)
1) $10/hr is about $1600/mo... (Below threshold)

September 9, 2011 1:25 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

1) $10/hr is about $1600/month, and well below losing a substantial amount in taxes. That's not including overtime.

2) $700/mo. varies depending on where you live. That amount in LA wouldn't pay rent. In Iowa, it easily gets you a three bedroom apartment. You can't look at the number without looking at the context.

3) If you want nightmares, start asking yourself, "Why is the apartment in Des Moines 1/3 the cost of the same apartment in LA?"

Vote up Vote down Report this comment Score: 10 (12 votes cast)
Also: "The problem is corpo... (Below threshold)

September 9, 2011 1:31 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

Also: "The problem is corporations are pretty much stealing labor, so in truth, unless you have a degree that is worth something , there is absolutely no money to be made, the government handouts are a smarter option."

Wow, way to completely destroy your own initiative. Maybe it's living in the tech world, or that half my friends have started companies even if they aren't technology companies (restaurants, design), but: You don't need a degree to make money. In fact, thinking you need a degree to make money is the same system that feeds 'unemployables' $700/mo. It's the same logic, the same system.

Break out. Start a company. Do something meaningful. Add SOMETHING to this world. But STOP thinking, "People need a useful degree." With rare exception: No. No, they don't.

Vote up Vote down Report this comment Score: 10 (20 votes cast)
Actually, $10/hr leads to $... (Below threshold)

September 9, 2011 1:51 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

Actually, $10/hr leads to $1500 a month. At my facility, they pay you only up to your scheduled shift, but they will NOT pay you if you are even 6 minutes before clock in. So that means, for example, if they understaff the floor so that everyone has too many patients, including CNAs, and they don't leave until 30 or 60 minutes after shift, they are still only getting payed up until shift end. Meanwhile, if they clock in 6 minutes late, they are docked 15 minutes of pay.
Almost NO ONE at my job gets payed a full 37.5 hour work week, even though our company intentionally understaffs the units with nursing and CNAs so we always have to stay over shift. They are greedy scumbags. So yes, $1500/month before taxes is an OPTIMISTIC figure for a CNA.

FICA is about 15% of pay at this bracket, which means her actual take home, after FICA, is only 1275. This does NOT include the state taxes or other taxes.


Then, consider, the expenses of working ITSELF.
You have to pay for transportation to work, which means a car, gas, train tickets, and/or bus tickets.
You have to pay child care for children, as most of these women who are low income have childen and are not married.
You often have to pay more money for meals due to working often, you have to pay for clothes for your job, such as uniform fees.

At my job, they are actually stealing money from the CNAs pay check to pay for crappy uniforms (no doubt someones uncle owns a uniform business).


Yes, Keisha made the RIGHT decision, but being white and male and probably middle class you have never worked with or interacted with someone low income like this so you really do believe it is smarter to work at an unskilled labor job than it is to say I'M BIPOLAR NOW GIVE ME MY MONEY.

If Keisha gets payed $700/month to do absolutely nothing, she has 37.5 hrs left to make money in other ways. She doesn't pay child care, or transport expenses, and never has to buy clothes really either other than a 2 dollar pair of stretch pants and a xxxL T-shirt that advertises a 40oz alcoholic beverage.

Vote up Vote down Report this comment Score: 19 (27 votes cast)
This is a stereotypical shi... (Below threshold)

September 9, 2011 1:57 AM | Posted by Anonymous: | Reply

This is a stereotypical shitty nursing home company FYI.

Things (pay/compensation) for CNAs are better in many hospital systems, making it an obviously better choice than SSDI... but it is very difficult for a CNA to get a job in the hospital. Your average hospital patient is ambulatory and needs minimal assist with ADLs , so obviously hospitals need fewer CNAs (but relatively more RNs for medical care). In the hospital, CNAs mostly take vitals, blood sugars, weights, set up basins and trays for patients, etc. They aren't "poop machines" most patients receiving treatments in the hospital are alert/oriented, not incontinent.

The overwhelming majority of CNA work is in goverment/medicare funded nursing homes, populated by end stage dementia patients, run by greedy low ethics companies. So yes, the picture I painted above is rather typical of CNA work.

Vote up Vote down Report this comment Score: 6 (10 votes cast)
How's that delusional power... (Below threshold)

September 9, 2011 2:01 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

How's that delusional power working out for you?

PS: I am employed and even though my job does suck, I am not hurting financially and it is mostly my own fault, I have really not tried to get other work. I am a RN.

Yes, you are right little boy, we can all be entrepreneurs, wish I wish upon a star and reach for it, big powerful invincible ME! Working is for the weak, and it's the worker's own fault when labor conditions are poor. Yes little boy, good corporate brainwashing you regurg line by line. Blame the lazy worker, fight the unionization, it's his / her own fault when he or she is undercompensated and exploited , go ahead and meld your ego with the power structure, maybe one day it will be true.

Vote up Vote down Report this comment Score: 8 (30 votes cast)
Funny how many assumptions ... (Below threshold)

September 9, 2011 3:13 AM | Posted, in reply to Anonymous's comment, by anon: | Reply

Funny how many assumptions you make. You might learn something by finding out their truth values (or not, but since it will only take me two minutes to tell you...)

Capitalist-I don't even know how to answer this.

Libertarian-No

Right Winger-I'm usually accused of being on the opposite end of the spectrum from this. I'm probably on the mid-far left by current American standards, closer to the middle by the standards of 15 years ago.

"income is clearly on the wrong end of the tax bracket"-I'm substantially above the median income, which depending on your point of view could be considered the wrong end of the bracket.

Young-Depends on your definition. Well beyond college age, but south of 40 thankfully.

Male-Finally one that is unambiguously correct.

Powerless-Aren't we all?

The above is just for the education of the poster I'm replying to. People ought to be informed when their assumptions are completely invalid. Of course, none of this matters. We're here posting on a blog of a person who chooses to be anonymous. Probably a lot of that is to avoid personal/professional ramifications, but I like to think (hope) that at least part of it is because it DOESN'T FUCKING MATTER. Who people *are* is less important than what they *say and do*. Arguments are correct regardless of the characteristics of the people making them. This isn't an economics blog, so I'm not going to go into an extensive defense of the solvency of social security or the US federal government in general, but the reality is there isn't much support for the doom and gloom predictions contained at the end of posts like this one (which isn't to say that the insight about the true workings of programs like SSI isn't spot on, just that there isn't really any reason to believe the current system is unsustainable.)


Vote up Vote down Report this comment Score: -1 (9 votes cast)
I'd assume that someone on ... (Below threshold)

September 9, 2011 5:38 AM | Posted, in reply to Anonymous's comment, by Dave Pinsen: | Reply

I'd assume that someone on SSI wouldn't be paying market rent. You'd be surprised how little Section 8 recipients pay out of pocket for rent.

Vote up Vote down Report this comment Score: 2 (4 votes cast)
How likely is she to have k... (Below threshold)

September 9, 2011 8:45 AM | Posted by Russell: | Reply

How likely is she to have kids if she's on all this medication. I'm assuming that if she gets pregnant the psychiatrist will cut her off of all the medication she's become addicted to. Is this realistic? Does SSI have a depression effect on birth rates for the unemployable?

Vote up Vote down Report this comment Score: -1 (1 votes cast)
I don't know if you ... (Below threshold)

September 9, 2011 7:26 PM | Posted by Social Worker: | Reply


I don't know if you are aware of this fact, but I work with CalWorks. When a homeless family recieves section 8, their children inherit that section 8 voucher FOREVER.
Generation after generation recieve section 8 vouchers, after the parent(s) is awarded and dead.
Talk about an AWARD! No so much for tax payers.

Vote up Vote down Report this comment Score: 3 (5 votes cast)
"I would totally support th... (Below threshold)

September 9, 2011 8:48 PM | Posted, in reply to Anonymous's comment, by if the shoe fits: | Reply

"I would totally support this law and I can only imagine the reason it is not in effect now is because any politician who tried it would be accused of racism, simply for the fact most people fitting this profile are not white."

you lose--the vast majority of all welfare benefits, be they ssi, ssdi, food stamps, medicaid, or what have you are paid to white people. white people who live in the rural parts of this country, who like to say things like "keep your socialism out of my government benefits check." and "i'm no racist, but losers are mostly not white." with absolutely no irony intended.

hey, alone--next time you borrow michelle bachman's brain to write one of your rants, you might want to google whether your "facts" weren't just pulled out of your ass or not. SSI and SSDI benefits are taxed. the average benefit for SSDI is over a $1000/month. and the majority of its recipients are over the age of 40, male, and white.

does kiesha exist? how the fuck do i know? but it does seem a little convenient that the "lazy, moocher" who calls herself "retired," from the story, is a young, inner city, unwed woman, who not only is able bodied, but is trained no less, in a [DEVRY] career [that probably cost her as much as my law degree] who has never worked, and has an "evocative" name...and not someone named john from russell springs, ky (which is much more likely statistically). (and given that any amount one owes on their unpaid student loans is deducted from their their benefits, even if it results in complete loss of said benefits...something about kiesha smells like horseshit)

so how narcissistic is that the horror stories about "the system" we tell our selves always feature people who don't look, think, or live like us? the boogey man always is some inner city keisha kruegar...

as part of gen x, i was indoctrinated into the "there won't be any social security" for us. i believed it, till i did what i always do--i crunched the numbers. the claim was pure bullshit that had a very specific motive--to activate our scarcity reflex. and it apparently found fertile ground in some...it might not be there for my generation or those that follow, but it won't be because the program was designed for only my grandparents and my parents.

social security does not impact the budget--what impacts the budget are the iou's that have been slipped into the trust fund, as it has been raided, time and time again, to cover budget short falls--short falls from house harkonnen levels of militarism --not from the niggardly amount of "riot-preventing" benefits parsed out as grudgingly as the gruel in a dickensian work house: "please sir, can i have some more?"

the social security system was beautifully designed and is completely self-sufficient. and the hack to account for the baby boomers was already made, way back in 1981. the hack to get it to last indefinitely is oh so simple too...just lift the payroll cap tax, do away with the feudal bias between income from work and income from property, so that all income is taxed equally regardless of where it comes from, and make it a federal crime to apply the funds in the trust fund to anything other than payment of benefits...that's it. it won't happen, but not because of the narcissism of the 95%, but because of the narcissism of the 5%.

so, i agree that narcissism is to blame for why it may very well disappear in my life time, but to create a false equivalency that everyone's narcissism is equally to blame is lazy. you're smarter than that and doing so hurts your street cred. the scarcity reflex turns us all in too narcissists...out of fear...and the fear of scarcity has been played up since the 1970s, purposefully. and this accounts for the concurrent rise in levels of narcissism in our culture that exploded in the 1980s--which is also when the scarcity terror was amped up to 11.

you like "exposing" the secret (yet obvious to your enlightened eyes), narrative, underlying everything. but you need to work on understanding the subtext. in the end, you are just making the situation worse, because you don't or won't see the whole picture due to your biases. you are part and parcel of what is driving the narcissism epidemic.

Vote up Vote down Report this comment Score: 13 (29 votes cast)
Keisha should develop some ... (Below threshold)

September 10, 2011 1:09 AM | Posted by Nurm: | Reply

Keisha should develop some chronic pain and get a nice big script for oxycontin - now we're talking income.

Vote up Vote down Report this comment Score: 7 (7 votes cast)
Thoughts on the dismal scie... (Below threshold)

September 10, 2011 11:02 AM | Posted by Henri Montando : | Reply

Thoughts on the dismal science

For at least 40 of my 64 years, I have tried to understand financial and economic matters. I have found that, if any understanding is possible here, the long view works better than the short view.

In what follows, I shall sketch out the pillars of the house of cards my understanding has constructed. Maybe some of it applies to Dr. Balt’s comments. Maybe not.

The long view informs us that for roughly 10,000 years of human history, most people (99.9% give or take) lived at a subsistence level. Subsistence does not mean survival. Subsistence means that most people could acquire enough to live, with a small surplus left over. Famine was not imminent for everyone, but given a year’s drought or a bad harvest, and it would quickly appear.

This pattern did not change until the industrial revolution, beginning, say, around 1840. This is about the time when the graph of income versus percentage of population went from being a straight line to being a steadily increasing function. By the 1970s, more people were middle class than were poor. (But the total of people who were either poor or desperately poor was still around 60%.)

To summarize. The First Epoch, from about 8000 BCE until 1840, the time of subsistence living. The Second Epoch, from 1840 until roughly the mid-1970s, the age of the middle class.

In the long view, the most significant change during the Second Epoch was that the pool of available labor became larger than the pool of available jobs.

We are now in the Third Epoch.

The ‘Baby Boomer’ generation, of which I am a member, has lived through the transition from the Second Epoch to the Third Epoch. In the most straight forward economic terms, here is what that means for a person living in the United States during that time. My father was a computer systems engineer for NCR. He could never explain to me what he did, because the role of computer systems engineer did not yet exist. By doing what he did when he did it, in the 1960s he earned about $50,000 a year. A standard house cost about $15,000. Gas was 22 cents a gallon. Minimum wage was $2.25 an hour. I attended a first-rate private liberal arts college where the tuition was $3000 a year.
In 1974, pretty much the last year this was possible, I bought a two story, three bed room house in an upper middle class neighborhood in Baltimore for $26,000. Within blocks lived two Nobel Laureates.

Forward to 2011. The Baltimore house is going for $800,000. Gas is $4.00 a gallon. Tuition at the college I attended is $42,500 a year. Minimum wage is $7.25 an hour.

These figures, which are not atypical, demonstrate unprecedented changes in income versus cost of living. In a little less than four decades, college tuition has risen 1400%. Housing costs have gone up 3100%. Gasoline has increased 1800%. Wages, on the other hand, have gone up 322%.

The average increase in the three areas I have mentioned comes to 20 times. If income had kept pace with expenses, and if I were earning an amount equivalent to what my father earned in the 1960s, I would be making over one million dollars a year. I earn approximately 1/10 of that - (which still puts me in the 99.34th percentile worldwide, because 30% of humans are desperately poor, with incomes less than $1.00 a day.)

In the First Epoch, most people’s incomes were at steady-state subsistence. A very few had assets at the level of nations. In other words, in dynastical Egypt, 99.999% of the people lived at the subsistence level, and the ruling family of a few score or several hundred possessed more than 99% of the assets. This was more or less the pattern everywhere, so radical shifts in wealth occurred at the level of the few ruling elites, when one king would conquer another king and get all his treasure.

During the Second Epoch, kingships began their last hurrah. Vast accumulation of wealth was due to massive exploitation of labor and the environment, particularly the latter.

One of the biggest changes at the beginning of the Third Epoch occurred when asset production was due more to financial dealings than industrial production. This trend was consolidated in the mid-1970s, partly through the rationalization of the debt market. This meant that, for the first time ever, the global economy grew more from the financial side (debts and derivatives) than from the manufacturing side. This accelerated the boom-bust cycle that had been part of capitalism since the inception of stock markets in Holland in the 1690s.

The United States has had ten major stock market crashes in the last 100 years (major defined as loss of 40% or more of value). Since stock markets began, there has been a major crash in some stock market, somewhere in the world on the average of every six months.
At the same time, particularly in the countries that had led the rush to industrialization, the labor pool continued to grow and the job pool to shrink.

Let’s continue with the long view, this time looking at labor practices.

In the First Epoch, the labor pool was small relative to a huge job pool. Basically, everyone had to work. Wealth accumulated slowly, and redistribution occurred due to warfare, plague and, occasionally, technological change (e.g. the iron plough). Agriculture was the main industry and it was a bottomless sink for labor surplus.

During the Second Epoch, the biggest change came as the demand for agricultural labor dwindled. In the US, before the Second World War, agriculture still absorbed any surplus labor. Today, of course, that is not the case.

During the Third Epoch, the labor pool continues to grow as populations grow, but the job pool continues to dwindle. Technology is often spoken of as “labor saving” but the meaning of that phrase is not what it was originally. When one person using a machine can do the work of one hundred working “manually”, labor is indeed saved, but the job pool in that local sector has shrunk by 99%. In the US, there is no labor sink that can or will ever again absorb the surplus of workers.

People point out “Well, there are always plenty of minimum wage jobs.” That is true, but… most require a high school diploma, which increasingly, Americans growing up now do not acquire. If you accept the standard that 30% of income should go to housing costs (mortgage or rents) then there is no county in the US where a person with a single minimum wage job earns enough to meet the 30% standard.

The cut-to-the chase way of analyzing Dr. Balt’s argument might be as follows. There are only so many categories into which a social population can be divided. For example, a first cut could be Employed/Unemployed. Within Unemployed there are Child, Student, Properly Retired (i.e. in an age-appropriate way), Incarcerated, Disabled, Homeless. Dr. Balt thinks that among the Unemployed Disabled there is a (substantial?) number who could really work or should really work because they are not really disabled. He wants the people in this category to move to the Employed category by, of all things, getting a job. He is not keen on the fact that his patient claimed a category not yet mentioned. Let’s call it Retired-by- Choice.

A dismal scientist might argue that Dr. Balt’s patient may be onto something. Let’s suppose the government offered a subsidy for people to retire before their appropriate age. Call this option the Retired-by-Choice option. Make the payments for this option enough to live a reasonable life (and call that Subsistence). In California, Subsistence for a single person would probably be about $30,000 a year. The dismal scientists crunching the numbers on this proposal would probably point out that this option would cost less per capita than Incarceration or Disability.

Vote up Vote down Report this comment Score: 38 (42 votes cast)
^^ Do you mind not jerking ... (Below threshold)

September 10, 2011 3:12 PM | Posted by E Sharp: | Reply

^^ Do you mind not jerking off in public?

Vote up Vote down Report this comment Score: -14 (20 votes cast)
It was obvious to me having... (Below threshold)

September 10, 2011 4:45 PM | Posted, in reply to Henri Montando 's comment, by Children: | Reply

It was obvious to me having children would be a stupid idea, based on what you're saying and what I saw in 1980, so why would I want to support people who have children anyway?
Having children seems cruel based on your post. Maybe children who have parents that do not have a few million to pass down to subsidize their lifetimes should hate/kill their parents? This ebe and flow seems futile to me, so what’s the answer?

Vote up Vote down Report this comment Score: 2 (2 votes cast)
I'm in favor of offe... (Below threshold)

September 10, 2011 9:46 PM | Posted, in reply to Anonymous's comment, by TheDavid: | Reply


I'm in favor of offering free sterilization to SSI/SSDI recipients not because we're "genetically unfit" or non-white (I'm white by America's strictest standards) but because if we're unable to work we're unable to do the work of correctly raising a kid.

As are most of the people who've been having kids for a hundred generations, which is why I think we should offer free sterilization to everybody. Children should be the exception, not the rule, because reproduction is a privilege, not a right.

There are too many people on Earth, most of them coming from idiots, fanatics and loonies. Regardless of genetics, kids raised by people who should never have had kids will be fucked up somehow, and the rest of Society will pay for it.

I had a vasectomy because I was never up to the burden of raising kids. Regardless of genetics, although I do happen to come from a line of weirdos. Given that I'm on SSI because I'm damned inept at providing for myself that's a no-brainer. I admit it, I'm fucked in the head: if you won't have the guts to take me out and shoot me you can at least let me live indoors so I can stay out of everybody's way.

As to what's wrong with me, regardless of canonical labels I'm a disagreeable fruitcake: I have no friends and my family doesn't want much to do with me because no matter how hard I try I still take too damn much effort to deal with. If nobody wants to have supper with me you can imagine what having to put up with me for 40 hours a week would be like.

And I'm smart enough to know I have no business with as kid. Most people who don't don't know it.

Like I said, reproduction should be a privilege, not a right. If that means you'll have to pick your own tomatoes and clean your own toilets that's just too bad for you.


Vote up Vote down Report this comment Score: 9 (15 votes cast)
The David: Maybe you have a... (Below threshold)

September 11, 2011 12:32 AM | Posted by information addict: | Reply

The David: Maybe you have adhd or a learning disability...many people on social assistance as we call it in Canada, have an (invisible)LD.

Vote up Vote down Report this comment Score: 2 (2 votes cast)
Ron Paul 2012... (Below threshold)

September 11, 2011 12:45 AM | Posted by dan: | Reply

Ron Paul 2012

Vote up Vote down Report this comment Score: -3 (7 votes cast)
I totally agree with you. ... (Below threshold)

September 11, 2011 3:32 PM | Posted, in reply to Cat's comment, by Savage Henry: | Reply

I totally agree with you. There is much in medicine and government spending like that. Look at fibromyalgia, for example. I work in an emergency department, and I hate taking care of "fibro" patients the most. I'd rather take care of a drunk homeless guy - it's more honest.

It's not because I disbelieve fibromyalgia. There's probably something there - legitimate suffering and illness taking place. Those patients are not the ones I see. Legit fibro patients are managing their malady with diet, excercise, and maybe a dash of Lyrica and Tramadol for when things get bad.

The fibrofolks I take care of at 0300 on a Tuesday are depressed, overweight housewives with cluster B problems and hopeless addiction to narcotics. We know them by their endless and illogical list of drug allergies. Anaphalaxis to tylenol (but not percocet!), synthroid, ibuprofen, toradol, all SSRI's, latex, tape, Benadryl, and Medrol - in the same person - can't be that common. I see it listed a couple times a month, though.

What's the answer, though? How do you tell these idiots to kick rocks when their clinging desperately to the liferaft of their diagnosis? Take away fibromyalgia, and you'll be punishing the 10% of people who actually have something wrong.

Our answer so far is to just dope up the fakers - 2-4mg Dilaudid IVP q6h - and "Push it fast 'cause I like how it makes me feel."

Vote up Vote down Report this comment Score: 6 (8 votes cast)
I totally agree with you. ... (Below threshold)

September 11, 2011 3:34 PM | Posted, in reply to Cat's comment, by Savage Henry: | Reply

I totally agree with you. There is much in medicine and government spending like that. Look at fibromyalgia, for example. I work in an emergency department, and I hate taking care of "fibro" patients the most. I'd rather take care of a drunk homeless guy - it's more honest.

It's not because I disbelieve fibromyalgia. There's probably something there - legitimate suffering and illness taking place. Those patients are not the ones I see. Legit fibro patients are managing their malady with diet, excercise, and maybe a dash of Lyrica and Tramadol for when things get bad.

The fibrofolks I take care of at 0300 on a Tuesday are depressed, overweight housewives with cluster B problems and hopeless addiction to narcotics. We know them by their endless and illogical list of drug allergies. Anaphalaxis to tylenol (but not percocet!), synthroid, ibuprofen, toradol, all SSRI's, latex, tape, Benadryl, and Medrol - in the same person - can't be that common. I see it listed a couple times a month, though.

What's the answer, though? How do you tell these idiots to kick rocks when their clinging desperately to the liferaft of their diagnosis? Take away fibromyalgia, and you'll be punishing the 10% of people who actually have something wrong.

Our answer so far is to just dope up the fakers - 2-4mg Dilaudid IVP q6h - and "Push it fast 'cause I like how it makes me feel."

Vote up Vote down Report this comment Score: 0 (4 votes cast)
The voices twell me ... (Below threshold)

September 11, 2011 9:35 PM | Posted by TheDavid: | Reply


The voices twell me being a fucking fruitcake is what makes me special.

Vote up Vote down Report this comment Score: 0 (2 votes cast)
Although in a sense you're ... (Below threshold)

September 12, 2011 11:34 PM | Posted by Toto: | Reply

Although in a sense you're feeding your own sense of narcissism by maintaining this blog, I agree with many of the things you say (and that justifies this blogs existence, of course, due to my own narcissism). I don't suppose anyone can escape from the vicious reality of their context.

In any case, thank you for sharing.

Vote up Vote down Report this comment Score: 0 (2 votes cast)
@Savage HenryAs a ... (Below threshold)

September 13, 2011 7:01 AM | Posted, in reply to Savage Henry's comment, by Anonymous: | Reply

@Savage Henry

As a nurse (the "everyone on SSDI should be sterilized ranter"), I concur with your assessment of chronic pain sufferers.
A MASSIVE list of allergies is a huge sign that the person is drug seeking,anxious and depressed cluster B drama case. Especially if the allergy is tylenol. NO ONE has a tylenol allergy except narc seeking addicts.

When one is a professional patient, one learns tricks like "if I am allergic to OTC mild pain relievers they have no choice but to dilauded up my life".

They also feign chest pain and suicidality.

Yea, all you can do is dope them up. There is no other way of handling a drug seeker because the rules state a patient's pain is exactly what they say it is, and doctors give what they want (within reason) because they want the $$$.

Vote up Vote down Report this comment Score: 2 (2 votes cast)
The answer is pain doctors.... (Below threshold)

September 14, 2011 4:43 PM | Posted, in reply to Anonymous's comment, by children: | Reply

The answer is pain doctors. If you keep giving them what they want in hospital, they come back. If you are not, then they go to the pain doctor. If you give psych meds for a month or two, why would they hook up services with a clinic/psychiatrist? All services need to be on a computer to track. If they are not going to the doctor, sorry, you can not use the hospital as a "drop in".
Plus, caps on visits. Far to manny cluster B's are given MORe services when they act out- they will always act out- unless they suffer from doing so. FCS and FCCS are a good example.
I do agree, give them thier drugs and shoo them away so really hurt people can see the doctor. Then there is always NO, and if they suicide out of manipulation, so be it. It is a tough stance, but character counts. We all suffer when we give in.

Vote up Vote down Report this comment Score: -1 (1 votes cast)
Children, what you're sayin... (Below threshold)

September 15, 2011 1:35 AM | Posted, in reply to children's comment, by Savage Henry: | Reply

Children, what you're saying makes sense.

Unfortunately, you're not accounting for things like EMTALA, lawyers, Press-Gainey, online reviews, hospital administrators, and the one that all of us providers worry about - what if one of these people actually is sick?

Even lying, manipulative, wastes-of-good-carbon get appendicitis and ectopic pregnancies once in awhile.

A doc who misses that will likely lose his/her job. Do it twice, and the doc is unemployable and will lose his/her house, cars, spouse, kids' education funds, etc. But they'll still have that $150,000 student loan to pay...

Also, pain management doctors actually hold their patients accountable for their med usage. They require things like urinalysis, prescription monitoring, and even random pill counts. Blow one of those, and the patient has violated their pain contract and is dismissed from the practice.

Of course, these patients will never tell you that. My head will explode the first time I hear,"Well, I violated my pain contract and I'm withdrawing really bad right now. Can you help?"

Hell, if I survive the shock, I'll beg/bully the doc into giving the patient some benzos to help the withdrawal (probably wouldn't have to - the docs would love a chance at helping an honest addict) and I'll move heaven and earth to get the pt into some form of rehab.

But I ain't holding my breath. Instead I'll keep hearing stuff like,"Oh, my pain doc is out of town/a lying bastard/an asshole who doesn't care/incompetent."

Yours in End-Stage Fibromyalgia Management,

SH

Vote up Vote down Report this comment Score: 5 (7 votes cast)
@if the shoe fits--that was... (Below threshold)

September 19, 2011 12:54 AM | Posted, in reply to if the shoe fits's comment, by Swanhilde: | Reply

@if the shoe fits--that was a hell of a smackdown--I thoroughly enjoyed it. Thank you for telling it like it is re: social security and SSDI! I'm working on my Ph.D. in public policy and one of my research interests is welfare/poverty-reduction policy. Findings from the literature support (overwhelmingly and consistently) that most Americans are misinformed about these programs. It's not just that people don't know who receives these benefits, or how much the gov't spends on these programs, or what people have to do in order to get the benefits, or how generous the benefits really are (for example, TANF cash benefits for a woman and 2 children is the state of Alabama is $179/month--or at least it was in 2009, according to the HHS data I'm looking at right now). The fascinating thing is that people truly THINK their beliefs are accurate, when in fact they are demonstrably false. Like that poster who claims that "generation after generation" inherits Section 8 housing vouchers. Amazing.

Vote up Vote down Report this comment Score: 2 (6 votes cast)
"The fascinating thing is t... (Below threshold)

October 10, 2011 8:50 AM | Posted by Anonymous: | Reply

"The fascinating thing is that people truly THINK their beliefs are accurate, when in fact they are demonstrably false."

It's fascinating that people believe that people think their beliefs are accurate? That's the dumbest thing I've read in months...

Vote up Vote down Report this comment Score: 3 (3 votes cast)
Congratulations. You have p... (Below threshold)

October 28, 2011 11:06 PM | Posted by Vi nam: | Reply

Congratulations. You have proven that the point of this article is lost on those who can't remember back to the first and second pages.

As Ms. Gottlieb intimates, it's not choice that's the problem, but like everything it's excess. There is nothing wrong with reward systems... in moderation.

They teach a child the value of goals or drive. Believe it or not, even a 5-year old knows that a choice means assuming responsibility. The question this article asks is: do the children know that they're the ones assuming the responsibility, or the adults stepping in?

Obviously letting children pick what they want to eat without any preconditions is a recipe for disaster SOMEWHERE down the road. That should be your primary takeaway from this article.

Nevertheless, I can only conclude that you were more concerned coming up with a hyperbolic witticism rather than a valid response. Good job.

Vote up Vote down Report this comment Score: 0 (0 votes cast)
I'm not surprised you're de... (Below threshold)

October 28, 2011 11:10 PM | Posted by How to grow hair faster: | Reply

I'm not surprised you're defending him for not reading the article because you didn't either. The problem is rarely what choices are offered, but more often how and where. As with anything, you don't foster responsibility by assuming complete control over your kid's life. To take that away from this article would be a gross distortion of what it was trying to get across.

And for the record, I did grow up in a household where I picked my cereal, but it was always of a healthy variety. Why? Because those were the only options I had at the time? I am still a fit individual.

The fact that kids away with being fat is because of all these new age psychologist types said it's okay to be fat. After your reply, I wouldn't be surprised if you weren't just another one of them.

Vote up Vote down Report this comment Score: -2 (2 votes cast)
Other criticisms of the art... (Below threshold)

December 27, 2011 10:12 AM | Posted by Galted: | Reply

Other criticisms of the article aside, it perfectly describes the conundrum of those deemed "unemployable." It's not fun scraping by on PwD (as it is called up here); I'm utterly sick of it, I hate it, hate it, hate it! I'd love to work, but it's hard to find an employer who is willing to deal with a bipolar/boderline/FAS employee with hardcore social phobia. I've been through more jobs in the last ten years than I can even remember now. Even McDonalds, ugh. Very depressing.

Vote up Vote down Report this comment Score: 2 (2 votes cast)
As someone who has been dia... (Below threshold)

January 19, 2012 8:56 PM | Posted by Fibro-diagnosed: | Reply

As someone who has been diagnosed with fibromyalgia, I can say it's the biggest con game diagnosis ever. I have legitimate pain, but until about five months ago, not a single doctor could tell me what the pain was about. It took an excellent physical therapist who believed me when I said I had unbearable thoracic back pain and who sent me to an back specialist who specializes in injections to finally get some relief.

The first round of injections knocked the pain out completely. I'm going back for round two combined with intensive physical therapy to retrain my body after 10 years of intense body/back pain. It turns out that I have nerve damage in my thoracic spine from an accident. You can't see that on an MRI or an x-ray, but I live with the pain every single day.

I went to a pain specialist about five years ago. I wanted to get a TENS unit to try to control the back spasms and other pain. I said "I do not want drugs. No drugs." He tried to prescribe drugs. I told him I would rather destroy my liver taking 4-5 ibuprofins at a time than taking narcotics.

I agree that a lot of fibro-diagnosed people abuse the system, but some of us are just trying to regain our bodies. I feel like I lost 10 years of my life to incompetence in the medical field. And don't get me started on the psychiatrists who tried to tell me I was depressed and that my depression was causing the pain. How about I was in pain and that was causing depression?

Most doctors lack imagination, or they're looking for the quickest fix. It's easier to sign off on someone's SSI application than it is to find the real reason he or she is suffering. I had several doctors suggest I go for SSI during this 10 years of hell. They wanted me to go away because figuring out the pain was too much work.

Vote up Vote down Report this comment Score: 2 (2 votes cast)
My problem with this point ... (Below threshold)

January 26, 2012 12:52 PM | Posted by anononononno: | Reply

My problem with this point of view is the idea that some powerful person or group of men came to the conclusion that it's either put a large section of the population on welfare and drugs or else it's "burn LA, burn." I understand that the left wants to farm voters, they don't care about them, except for their vote, just dope em up and drive them to the polls once a year, but otherwise pretend to provide them with services like shitty teaching by shitty teachers who earn more than they deserve but hey it's a union. Contrary to the LA-burning thesis is the destruction of the black family and black work ethic because before the war on poverty, these same people were productive, decent members of society. So, if that were the case, when did the LA burning idea have to become the deal with the devil it supposedly is. Furthermore, maybe the productive members in society would have liked to be in the room at that discussion. "Oh, the great unwashed will riot if we don't pay them to work, and to become a permanent underclass, democrat party voting block, living lives that are an anathema to the rest of us who actually work? Fuck, em. Let em riot, we're armed too, bitches." Finally, note that US immigration policy is now importing more and more of the Sudan and Somalia and dumping them straight into dependency here. That's slow motion genocide of the US population who were here before Ted K changed the rules. That's bad faith and they call people who point that out as being the bad guys. But to the original point, who does the author think actually made these decisions and on what basis?

Vote up Vote down Report this comment Score: 0 (4 votes cast)
This site has been the bigg... (Below threshold)

February 18, 2012 12:36 PM | Posted by craig: | Reply

This site has been the biggest waste of time since I last went to church...blah blah.....B.S.

Vote up Vote down Report this comment Score: -3 (3 votes cast)
I know! I'm so sick I'm ba... (Below threshold)

March 25, 2013 6:44 AM | Posted, in reply to Cat's comment, by anon: | Reply

I know! I'm so sick I'm barely able to make it out of bed, and yet people still give me flack for not working and relying on disability. I really have an issue with the tone of the linked article; he seems to think we've all taken the easy way out. Whoever reviews my case must think so too; I tried to pick up a couple part time jobs this year, and as a result had my benefits cut. Just because I managed to drag myself to work and fake it for a couple hours a week doesn't mean I'm well! I hate having to spend all my time in bed and with nothing to do. People who can work don't know how lucky they are.

Vote up Vote down Report this comment Score: 0 (0 votes cast)

Post a Comment


Live Comment Preview

April 23, 2014 02:38 AM | Posted by Anonymous: