One problem is that physicians are being employed to make medical decisions affecting people who are not their patients. Another problem is that politics has demolished state welfare programs that would ordinarily serve to support those who cannot work, and the only reasonable alternative to those facing homelessness and starvation is to apply for federal benefits, of which the only benefit commonly available may be Social Security disability.
The politicians have already decided the people in question do not matter, and they would like to kill them off as quickly and quietly as possible, preferably in such a way that blame is not attachable to them. They have been temporarily frustrated by the fact that their targets have found some other means to acquire the means to survive. The physician that denies the disability claim by default is thus serving a political interest, not a medical or humanitarian one. They are not being paid to advance the health interests of the community, but to protect the coffers of the states from those who may have a lawful claim on the money in them, in a manner that is technically conformant with the letter of the law.
The people dying while their disability denials are reviewed? That stems directly from the same political assumptions that mandate work requirements for welfare recipients. "Why should we give them money, if they're just going to die soon anyway, and they will never be able to pay it back?" It's the same premise businesses use to fire workers that are temporarily unproductive. "If you aren't making me money continuously, and especially right now, I have no further interest in you, so get out."
So if you have stage IV metastatic cancer, and are unable to walk, stand, or sit, and may have enough pain and/or pain-management medication to make concentration difficult, then I guess you had better make sure you fill out your complex bureaucratic forms correctly, as just one of the many things you have to juggle now in order to not die. You also have to trust that everyone else involved, none of whom have any direct stake in your outcome, will also fill out their forms correctly.
You can temporarily alleviate the symptom, but you cannot cure the disease without addressing its root cause: people who lack empathy for the infirm and the insolvent have acquired a large amount of power over both the government bureaucracy and the healthcare business.
Thus I suspect that the only phrase the review physician really needed to make a disability determination--"diagnosis: inoperable stage IV metastatic cancer"--was intentionally omitted from the review materials, because it was the only way to plausibly deny the application. A vital missing record can plausibly be explained as accidental, if you intentionally make the bureaucratic process onerous enough. Absent that vital datum, the whole dossier of review materials was absolutely useless. There is no point in employing an impartial administrative physician at all, if the medical record is incomplete. In that light, paying someone $0.5M every year for "garbage in, garbage out" processing is a lot more than the healthcare value provided to the patients. But paying someone $0.5M to paint a veneer of respectability, professional expertise, and due process over a system that would otherwise be paying out many millions in disability benefits is a lot less than the political value provided to the system. It's a lot cheaper to pay out $0.5M and let those sick people die, than to pay out those millions to keep them all alive just a little longer, at $800 apiece, every month until they kick off.
So the corrupt physicians working admin jobs under contract to the state aren't really at fault. Vote for government representation that believes "provide for the general welfare" is more of a mandate than an introductory rationale. Pay more to buy products from companies whom you know to be honorable with respect to their treatment of their workers. Try to treat people that you encounter in your job like people, rather than tasks or obstacles. You can't meaningfully change the outcome until you change the culture that produced it.
> Thus I suspect that the only phrase the review physician really needed to make a disability determination--"diagnosis: inoperable stage IV metastatic cancer"--was intentionally omitted from the review materials, because it was the only way to plausibly deny the application. A vital missing record can plausibly be explained as accidental, if you intentionally make the bureaucratic process onerous enough. Absent that vital datum, the whole dossier of review materials was absolutely useless.
This is the key insight I took away as well. I have not applied for SSDI (nor made determinations for it); however, if the physician reviewing the records is not provided the information nor provided an opportunity to question to patient directly, you will of course have "garbage in, garbage out".
This is a systemic issue, and the system at fault is the local government.
"Those who are badly off must go there." "Many can't go there; and many would rather die." "If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population."
The politicians have already decided the people in question do not matter, and they would like to kill them off as quickly and quietly as possible, preferably in such a way that blame is not attachable to them. They have been temporarily frustrated by the fact that their targets have found some other means to acquire the means to survive. The physician that denies the disability claim by default is thus serving a political interest, not a medical or humanitarian one. They are not being paid to advance the health interests of the community, but to protect the coffers of the states from those who may have a lawful claim on the money in them, in a manner that is technically conformant with the letter of the law.
The people dying while their disability denials are reviewed? That stems directly from the same political assumptions that mandate work requirements for welfare recipients. "Why should we give them money, if they're just going to die soon anyway, and they will never be able to pay it back?" It's the same premise businesses use to fire workers that are temporarily unproductive. "If you aren't making me money continuously, and especially right now, I have no further interest in you, so get out."
So if you have stage IV metastatic cancer, and are unable to walk, stand, or sit, and may have enough pain and/or pain-management medication to make concentration difficult, then I guess you had better make sure you fill out your complex bureaucratic forms correctly, as just one of the many things you have to juggle now in order to not die. You also have to trust that everyone else involved, none of whom have any direct stake in your outcome, will also fill out their forms correctly.
You can temporarily alleviate the symptom, but you cannot cure the disease without addressing its root cause: people who lack empathy for the infirm and the insolvent have acquired a large amount of power over both the government bureaucracy and the healthcare business.
Thus I suspect that the only phrase the review physician really needed to make a disability determination--"diagnosis: inoperable stage IV metastatic cancer"--was intentionally omitted from the review materials, because it was the only way to plausibly deny the application. A vital missing record can plausibly be explained as accidental, if you intentionally make the bureaucratic process onerous enough. Absent that vital datum, the whole dossier of review materials was absolutely useless. There is no point in employing an impartial administrative physician at all, if the medical record is incomplete. In that light, paying someone $0.5M every year for "garbage in, garbage out" processing is a lot more than the healthcare value provided to the patients. But paying someone $0.5M to paint a veneer of respectability, professional expertise, and due process over a system that would otherwise be paying out many millions in disability benefits is a lot less than the political value provided to the system. It's a lot cheaper to pay out $0.5M and let those sick people die, than to pay out those millions to keep them all alive just a little longer, at $800 apiece, every month until they kick off.
So the corrupt physicians working admin jobs under contract to the state aren't really at fault. Vote for government representation that believes "provide for the general welfare" is more of a mandate than an introductory rationale. Pay more to buy products from companies whom you know to be honorable with respect to their treatment of their workers. Try to treat people that you encounter in your job like people, rather than tasks or obstacles. You can't meaningfully change the outcome until you change the culture that produced it.