The Obligation to be Healthy

I think a lot of it has to do with choices. Some health issues we have little control over. But that is not true with all health issues. Many issues are a result of people's choices.

Now - people are free to make whatever choices they wish, but that doesn't mean they are responsible choices. People are free to smoke 2 packs a day, but that doesn't mean it's not frustrating when they need assistance to treat the lung cancer they gave themselves. ya know?

This state is rife with disability and idk why. I do know that the neighbors are all going to pain clinics and when they come back they stay high for the better part of the month. I was told (by them) they have always been on disability and have never had a job. I have watched them fall out in the street and been so wasted they couldnt get up themselves. These are big strong men who mow their lawns, climb up on their roof and work all day. If they can climb on a roof and work for 8 hours they can get a job and pay for their things. It just makes me mad because I see some people *****ally need it and couldnt get a free meal from the state.

If they've never had a job, they shouldn't be getting Medicare (unless they are over 65 but it sounds like they are not that old).  To get Medicare, you must either be 65 OR receiving SSDI (Social Security Disability Insurance).  Eligibility for SSDI is based on how much you've worked and earned before becoming disabled.

I understand that it makes people mad to see people getting disability and other benefits when it looks like they don't really need them.  I don't want people to get benefits that they don't really need, either.  It's not fair.

But I have found that a lot of people don't fully understand how different types of benefits work and they may mistakenly think people are getting benefits that they aren't getting, like thinking people are getting Medicare when they don't qualify for Medicare or thinking Medicare is giving them money that they are using for drugs when Medicare doesn't give anyone money, Medicare is much like any health insurance plan.

I have also found that many people assume other people are not disabled based on what they see, but they may not have all the facts.  I don't know anything about your neighbors and I have no idea if they are disabled or not.  Maybe they aren't, maybe they are faking it and getting benefits they aren't really entitled to. 

But someone that didn't know me well might mistakenly assume I was not disabled.  I could mow my lawn.  It would be a bit difficult with my back problems, but until a couple years ago, I could have gotten up on my roof for eight hours.  Not every day, but I assume your neighbors aren't up on the roof every day for eight hours, right?  I mean, how many days can it take to fix a roof?  If being able to mow a lawn and spend eight hours on a roof means one is not disabled, I would not be receiving SSDI.  But I don't recall those being issues Social Security asked about when determining eligibility.  They looked at how many hours I could consistently work per week, at how many times I'd been hospitalized, at how many hours of work I typically missed per week due to my conditions, at what kinds of accommodations I needed on the job and what job duties I had difficulty completing, at how my disability interferes with my ability to do things like take my medication regularly and take care of myself, and so on.  My neighbors wouldn't be able to answer all those questions about me, though, so they might assume I'm not really disabled, even though I am.

All very valid points.  When I did my counseling internship, however, at LEAST half of my clients were people who were raised in a culture of "working the system" and were only seeking "counseling" in order to try to convince someone to fill out the SSDI papers for them.  When I flat out told two of them that I would not be able to honestly say that I believed they were disabled by mental health issues if I filled out the papers I had received, they asked for a new counselor.  When I assured them that the agency would be happy to transfer them to a new counselor, but wanhted them to know that agency policy required that I provide the new counselor with an overview of the client's case and progress (which would include a discussion of the blank SSDI paperwork), they mysteriously left the agency (and sought "counseling" elsewhere, no doubt). 

Several of my other clients had already been approved for disability and bragged about the fact that it was free money and they could (and did) still work for cash under the table. I, on the other hand, nearly had a nervous breakdown (literally) trying to keep from losing my job (once my vacation and sick time were gone) after enduring two signficant traumas (and the unexpected death of my brother) in a two-year period.  I took a demotion and a significany pay cut just to keep my job (even after I felt compelled to tell my boss what had happened) since I was the only one to pay the bills... and even then, I almost was fired twice because of attendance issues, problems focusing and making mistakes, "zoning out" at work, etc.  I never would have been able to get (or keep another job).  Disability would have been my only option, and it would ahve been legitimate.  So seeing those clients (several years later) abusing the system made my blood boil.

I had only one client who was legitimately on disability for mental health issues and had one client who SHOULD have been on it for physical reasons (a severely deformed spine that made it hard for her to walk, bend, or even sit for very long) but kept getting denied.

I guess what I am trying to say is that I have no problem with people who legitimately cannot work, but it makes me extremely angry that so many people are abusing the system (and that so little is done to try to cut off benefits to those who are abusing it), especially knowing how much I struggled to keep MY job.  I still suffer from PTSD so I know, both personally and professionally, that there are situations where no matter how much someone WANTS to be healthier, it sometimes simply isn't possible.  I have no problem with my tax dollars helping people with legitimate disabilities and I know that the only thing that makes them different  from me is the disability, but I resent those who perpetuate a culture of SSDI abuse.

I guess my position would be similar when it comes to physical health.  It is an extremne example, but I don't think I/we should be forced to help cover the medical costs of someone that woman who is intentionally trying to get up to 1000 pounds.  (How you avoid that, however, is a logistical nightmare.)

Lora

See, I suspect most health care providers are like you and won't fill out the SSDI papers for someone that isn't really disabled.  And even if someone convinced their therapist to do that for them, they would also need to convince their psychiatrist to do so.  And in many cases, though not all, Social Security requires applicants to be evaluated by a physician of their choosing, so they would also have to convince that doc that they were disabled.  And some people probably are able to do that, but I'm not sure many are.

Also, if you are on SSDI, Social Security reviews your case periodically to make sure you still qualify.  How often they review it depends on whether they think your condition is likely to improve, might improve, or is unlikely to improve.  I've been on SSDI for almost nine years now and my case has been reviewed twice so far and I expect to be reviewed again soon.  So in order to stay on SSDI, a person would have to convince their treatment providers to fill out paperwork verifying that they are still unable to work.

Unfortunately, at the agency I was at, the psychiatrists almost never consulted with the therapists and these clients knew quite well -- via both the Internet and friends/family -- what symptoms to report in order to support their chosen mental health issue and to get medication.  Some of them sold the medications they were prescribed. Appointments with the psychiatrist were 15 minutes in length and bloodwork was not routinely done.  Medication was adjusted based solely on client report regarding symptom severity and improvement.  You don't have to be a very good actor/actress to say the right things for 15 minutes every few months.  None of my clients mentioned having to see any physician other than their own PCP (who generally simply referred them to the agency for cou selling and to see out psychiatrist).

For several of the clients I saw, the review period was 5-7 years. That's a hell of a lot of taxpayer money being collected fraudulently.   Based on talking to therapists who had been at the agency for some time, many clients continued seeing the same therapist that filled out their initial paperwork and came in just often enough to be kept "active".  Some of them were unfortunate enough to have their original therapists (who were often older in both age and experience and were clearly "burned out") leave the agency and get assigned to a new therapist who was less willing to go along with the charade. 

Lora

I missed the original discussion. Call me a socialist if you will, but I think that all humans have a responsibility to each other. That means (to me) that you help yourself as much as you can, but when you need help, everyone steps in to help.

Does the world work that way? No, and I can imagine some of you shuddering at my naivete. But all we really have in this world is each other. I don't begrudge people who need food stamps or other forms of governmental help. I also don't have an opinion on people being fat, except occasionally I will see someone struggling with their weight and wishI could help them. But I don't have a litmus test for how healthy anyone has to be. I also don't place a higher value on someone who has greater earning capacity.

Long ago, I decided that everyone has something beautiful, unique, and valuable that no one else has, and I look for it. For some, it's readily apparent. For others, it's harder to find. But I dislike the arguments that it's okay to be fat as long as you're healthy. I prefer to think that we are all okay, whether we are fat or not, healthy or not. We are all chugging along as works in progress. And it's perfectly okay to accept that someone has a chronic health condition that may not get better despite all their efforts.

 I think there is a huge difference between helping people who want to help themselves and helping those who think they are owed the world and don't try to help themselves.  I deal with this every day.  I don't begrudge anyone anything, and firmly believe we need these programs, but they are getting abused by a LOT of people, and that is wrong.

We need a massive overhaul in the system so people who need the help get it.  But there are a lot of loopholes and ways to get around everything.  and people lie a lot to get what they want.

If there is an obligation to be "healthy" there are a lot of people in trouble including most of the people in my family.

I have four children each has a disability. If you gave me a magic pill tomorrow to "fix" them or make them "healthy" I'd flu**** down the toilet. I love them for who they are and how they are even if some people here think they are a "drain on society", that one gets SSI and medicaid (you know those "entitlement" things that allow her as a young adult to move out on her own and learn to live in her own apartment independently).

We have come so far as a society but we have so much further to go.

"Maybe I would prefer to accept myself as I am and learn to live with my conditions."  Kelly that is the healthiest thing I've read in a long time. Now if we could get society and media to understand that we might take a couple of more steps forward.

Please tell me I am reading this wrong....

"I have four children each has a disability. If you gave me a magic pill tomorrow to "fix" them or make them "healthy" I'd flu**** down the toilet."

I know that the "magic pill" you are referring to is not a reality however I can't believe that any mother of a disabled child would not give everything in her power to have her children not be disabled no matter how wonderful their child is. I too am the mother of a disabled child. My son was born 4 months premature, had multiple medical problems that required multiple hospitalizations. He is developmentally delayed and Autistic. He is the joy of our family however if I could do anything in my power to not have him deal with the daily struggles in his life I would in a heartbeat. I totally commend you and admire that you have 4 children that have struggles however I have to admit this statement really bothered me.