http://apps.npr.org/unfit-for-work/
Starting
with the Bush I recession in 1990, the numbers of Americans on
disability rolls has surged. The Great Recession has further accelerated
the trend. Now disability spending > (food stamps + welfare
combined), with 14M Americans participating (9% of the labor force).
Of course some people are truly disabled and need public assistance
to survive, but many others suffer from the same "ailments" that working
people have. I am not saying that these people are lazy "takers", and
in fact there is a higher prevalence in southern Red states (and of
course is correlated with education levels and local economic
conditions). And that is kind of the point - due to structural changes
in the US economy and labor force, tens of millions of Americans are now
effectively unhirable in the 21st Century. Often they come from
blue-collar non-desk jobs that are more physical, so it is likely that
they have various pains and elements. So it is easy for a physician to
approve many of them for disability. But the problem is that once they
are approved and on the rolls, there is next to zero incentive for them
to find a job and go through the effort of retraining. It's not like
welfare and unemployment with a finite time span of benefits. And
speaking of welfare - that is a driver too. "Reforms" under Clinton and
Newt effectively shifted people on welfare to other programs such as
disability, so it didn't really save the country much money or motivate
the labor force. Probably America would get more bang for its buck if it
invested in worker transition and retraining programs rather than just
hide/relegate these people to the disability space (the US spends about
$260B/year on the 2 major disability programs). I am not advocating
kicking legitimate people off these programs, but I think it behooves us
to at least perform a cost and impact analysis, and propose
improvements/alternatives. Disability is just a band-aid to mask our
larger labor and health care problems.
There is even a cottage industry now ("disability industrial
complex") to advise and help people to get approved for disability -
similar to the folks who help kids get into college or help immigrants
get their green cards (one firm took in $70M in fees in 2012 alone). And
some families may now see their kids as "cash cows" too, by enrolling
them and collecting additional benefits. The number of kids on
disability has grown 4X since 1990. Clearly medicine has improved since
then, and doctors are better able to diagnose disabilities, but it is
pretty much impossible to attribute that huge rise to actual increases
in disability diagnoses and incidence.