Disabling security

Dec. 13 is the fifth anniversary of the death of a 4-year-old, Rebecca Riley. She died on the floor of her parents' Massachusetts bedroom. She was one more victim of governmental compassion.

Eight million Americans now receive SSI, Supplemental Security Income, because the Social Security Administration deems them unable to hold a job now or at some point in the future. Washington will typically give each person so classified about $700 per month. Rebecca Riley's parents received about $30,000 because administrators had deemed them and their two older children "disabled" because of "mood swings" and attention deficits.

Last year, after extended legal wrangling, jurors found the parents guilty of murdering Rebecca by giving her a fatal overdose of a drug taken for bipolar disorders. Their goal, prosecutors said, was to increase their income by having their 4-year-old also diagnosed as disabled. To do that they had to make sure that she ingested lots of powerful medicine garnered by way of a prescription-wielding doctor.

Rebecca Riley's death was an extreme circumstance, but many of the 1 million children who garner SSI income for their parents are also on drugs that many of them do not need. Even the Boston Globe, which usually cheerleads for more governmental welfare, has seen something wrong. The Globe editorialized this past May that "the damage done to children who are misclassified as mentally ill is incalculable: Some linger in special ed classes when they are capable of accelerated work; others come to believe themselves to be impaired when no such impairment exists."

Some SSI recipients need help-sometimes much more help than they receive. But many do not, and their subsidies signify a new national development. In the past, Americans rich and poor were known for having a can-do, never-give-up attitude. Now, the poor benefit from saying cannot do and never-start-up. In the past, Americans were sometimes known for bragging: We tried to seem better than we are. Now we have incentives to seem worse than we are.

When Congress in 1972 made disabled children eligible for SSI payments, the goal was to help poor parents who lost wages by taking time off from work to care for children with muscular dystrophy or cerebral palsy. Politicians spoke of families having additional expenses such as wheelchairs or taxi rides to hospitals.

Fair enough-but psychologists asked, why not us? They argued that depression can be as disabling as a bad physical ailment. True enough, but while medical exams reveal physical cancers, psychological ones are often judgment calls-which means that some money-seekers can game the system when they want the money that a diagnosis can generate.

Rebecca Riley's parents and hundreds of thousands of others learned how to do just that. Some learned by word-of-mouth, but others gained tutelage from "eligibility service providers" hired by hospitals and health insurers eager to pay their bills by getting poor patients onto SSI. When Washington decreed that at least 10 percent of preschoolers in Head Start programs needed to be disabled, that also created an incentive to have more children so classified.

How much gaming goes on? Last year Boston Globe reporter Patricia Wen did a terrific job of accumulating specific detail. She interviewed Geneva Fielding, 34, a single mom for 18 years with three sons, who opposed putting a child on psychotropic drugs, but concluded, "To get the check ... you've got to medicate the child." Wen tracked down a mother whose 2-year-old is now on SSI after being diagnosed with speech delay and potential signs of autism: "It's an easier and better form of welfare. You get more money, and they don't check up on you."

That mom was receiving $600 per month from SSI because she had obtained a diagnosis of depression. The bankable diagnosis she received for her toddler meant $700 more and an apartment upgrade. "I can move out," she happily told Wen, even as she described the cost to her spirit: "SSI sucks you in. Most people get lazy."

That entrance into a corrupt system, even with awareness of the personal damage, is poignantly frequent among some of the teenagers on SSI. One 15-year-old told reporter Wen she wanted to work, but if she did "they'll take money away from my mom. She needs it. I don't want my mom's money to go down." A young man said he wanted to work but "I'm afraid to lose the check. It's attached to me." (No wonder both of them are depressed.)

Wen met many who think of getting a job but then visualize being laid off: They compare that uncertainty to the eternal security they think a government check affords them. She also observed that unmarried fathers have learned news they can use: Authorities can garnish work wages for child support but not SSI checks.

Wen concluded, "The sense of dependence on SSI checks, for children and for their families, can creep up slowly." She quoted a psychologist's view that "children who grow up on SSI often cannot see themselves ever living outside the system. ... They develop an identity as being disabled." In the movie Forrest Gump, Forrest has below-average intelligence but his mother is always telling him, "You're not stupid." Today, mothers tell children of average intelligence, "You are stupid."

Two kinds of poverty

The liberal Boston Globe was not ready editorially to declare the SSI program entirely a fundamentally misshapen mess. Instead, it asked for SSI reforms in eligibility standards and payment structures. That's fine. It asked for more social workers to re-evaluate cases. Maybe. But more radical changes may be needed: Why not differentiate among SSI recipients so that each is more likely to receive "help" that actually helps? As with poverty-fighting generally, why not distinguish between lifestyle problems and catastrophe problems?

Lifestyle poverty comes about when people don't do four things: Stay sober, stay in school at least through high school graduation, stay out of bed in situations likely to lead to pregnancy or abortion, and stay with a job even if it lacks thrills. When people don't follow these basics, the result is often alcoholism and addiction, single parenting, and lack of the skills or perseverance needed to get and hold a job.

Lifestyle poverty arises out of messy lives, and sending a government check does nothing to clean up the mess. That's different from catastrophe poverty: A plant closes, a person is injured, or-right now-a person is laid off when recession begins and doesn't get new opportunities, as economic blight drags on year after year.

Catastrophe poverty is not like lifestyle poverty. Those who suffer through catastrophe poverty are often work-oriented. They have not fallen into joblessness: Situations beyond their control have pushed them into it. They may need financial help to bridge the gap until they are ready and able to work again, but their values do not need realignment.

With lifestyle poverty, though, a government check can hurt rather than help, because it may just further a non-work psychology. Those sunk into lifestyle poverty need challenging, personal, and spiritual help, rather than cold, enabling, entitling, by-the-numbers bureaucratic aid. We should not treat them the way we treat pet dogs: In the morning put some food and water in their bowls, and in the evening take them out for walks.

Given the logic of Social Security, SSI is a logical supplement to it. But when Congress grandly created the program 40 years ago, leaders did not recognize that it would become a moral hazard for those sunken into lifestyle poverty, because SSI might push them to act worse than they otherwise would. Administrators looked at disabilities without asking how the disabilities had occurred and whether money would make them worse.

Many adults have been hurt or killed by government compassion for self-generated problems. Walk around with Denver homeless shelter manager Bob Cote and see places where alcoholics who received SSI because they were alcoholics had cashed their government checks, gone on binges, and then frozen to death. Rebecca Riley's death reminded us that children also become victims.

But the Boston Globe articles about SSI did have a couple of encouraging paragraphs amid all the gloom. One told of Eliseo Ramirez, a 15-year-old who "virtually begged his mother not to apply for SSI benefits for him, even after a state social worker ... predicted quick approval of benefits. ... Eliseo said he has seen troubled classmates qualify for SSI, then lose their ambition to get part-time jobs or strive for better things in their lives. Some, he said, have drifted into the underworld of drug dealing because they didn't want any above-board income.

Ramirez said he is turning his life around and wants to earn his own way in life: 'I don't want to depend on the check.'