costs and insurance

Regarding Disability: No Easy Answers

John McManamy Health Guide October 14, 2012
  • NAMI’s website reports that “bipolar is the most expensive mental health care diagnosis,” both for patients and their health insurance plans. Citing various research studies, NAMI notes that: Bipolar is the sixth leading cause of disability worldwide, that the lifetime cost per person ranges from $12,000 (for a single manic episode) to $625,000 (for nonresponsive and chronic conditions), and that indirect costs such as lost productivity make up a substantial portion of the economic burden.

     

    Just do the math: You are pulling down $90,000 a year (plus comprehensive medical coverage) in your office job. Make it $70,000 after taxes.  Crash! - bipolar. Now you are collecting $9,000 a year (plus free medical) on Disability. I’m getting a $61,000 pay cut here.

     

    But maybe you are part of the half of the country that earns below $26,000 a year (with abysmal medical). Make it $23,000 after taxes. And maybe you qualify for more generous Disability. Make it $20,000 (plus the free medical). The math is starting to look a whole lot different.

     

    It’s a crazy world we are living in, one that encourages people with our illness NOT to work, but that’s the way it is. Government entitlements have been the object of intense debate this election season, but the real issue is that the American Dream is slipping away from many of us. For far too many, “working poor” - living on the edge from one crisis to the next - is the best we can aspire to in this economy. Under these circumstances, going on Disability starts to present itself as a rational economic choice.

     

    There were 8.6 million workers in the US receiving disability payments at the end of 2011, an increase of nearly 20 percent when the recession began. Of these, according to the Social Security Administration, 1.3 million (15 percent, one in six) had mood disorders. Mood disorders, unlike many other disabling conditions, tend to strike us in the prime of life. Suddenly, we can’t perform on our jobs. And because mood disorders do not exactly go away, getting back to work and staying there remains problematic.

     

    There is another twist to the Disability issue: Those on Disability are not officially counted as unemployed. According to a June, 2011 article on CNN Money

     

    The program is disguising just how bad unemployment really is. If those 1.2 million new post-recession beneficiaries were still counted as unemployed, the national unemployment rate would be nearly a full percentage point higher than it currently is.

     

    Translation: For either political party, high unemployment figures reflect badly on their economic stewardship. Shunting us onto Disability eases their embarrassment. Out of sight, out of mind. 

     

    Unfortunately, very few on Disability ever return to work (only 0.4% of workers in the program re-enter the labor force each year, according to the CNN Money article). There are many reasons for this, but I will focus on just one:

     

    Here we are with a chronic illness where we are depressed way more than we are manic. One way of describing depression is “loss of hope.” We apply for Disability, which is a virtual acknowledgement that we will be living out the rest of our lives in poverty. No more aspiring to the American Dream, to a better life. “Abandon all hope, ye who enter here.”

  •  

    Trust me, this can’t be good for us. But what are the alternatives? No easy answers, here ...