A "Ringing Call For Incrementalism"

     Some excerpts from an address by former Social Security Commissioner Michael Astrue at a Social Security Advisory Board (SSAB) forum on March 8: 

I want to thank the SSAB for inviting me back to Washington.It has involved some sacrifice for me -- I’m going to miss the Early Bird Special this afternoon ... but I should be back in Boston for bingo tonight. ... 

Unlike in the past, we should not expect that this Congress will do a quiet and efficient reallocation of the Trust Funds to cover the OASDI [Old Age Survivors and Disability Insurance] deficit. We do not have a sufficient number of the Daniel Patrick Moynihans & Bob Doles, the Bill Archers & Barbara Kennellys, enough leaders to lead a civil, informed debate on a hard topic . What we must try to do now to is start a process of education and dialogue that could let us avoid another inflamed, last-minute public spectacle, like the fiscal cliffs and sequestration, driven by what Stephen Colbert calls truthiness rather than actual truth....

[I]n order to pay for sexier items, Congress had drained the SSA [Social Security Administration] administrative budget so badly over two decades that the inevitable occurred — backlogs increased not only for hearings, but also for the continuing disability reviews that are the agency’s main weapon against improper payments. Having said that, the level of actual fraud is still extremely low, probably some fraction of one percent of the people receiving benefits. C ritics of the agency have resorted to distoring data that relates to the perfection of documentation — not fraud, not even improper payments — in order to support overheated claims of massive fraud....

The number of people on the rolls is rising substantially, but that rise is a predictable consequence of the baby boomers reaching their disability -prone years, not the product of new rules or management. ...

By contracting with the Bureau of Labor Statistics to supplement the existing O*Net system, the agency has shaved tens of millions of dollars off the cost of replacing the DoT. It may be doable for an additional cost of 10-20 million dollars and periodic costs for updating ... 

I am very concerned , though, about the possibility of another well-packaged but ill- considered reform initiative driven by the OMB [Office of Management and Budget] institutional views, which relies on the fallacy that we can solve problems created by bureaucracy and complexity with ever-more complex bureaucracy and complexity. Like Ahab chasing Moby Dick, they reject all the evidence and experience to date and insist that they can harpoon a system that will be so much more accurate up-front that Congress will be impressed by the back-end savings and fund the added bureaucracy. 

This whale hunt failed with the Clinton Administration’s prototype initiative, and it failed more miserably with the Bush Administration’s DSI initiative. In fact, DSI almost brought the agency to its knees...

OMB should drop its harpoon, let that imaginary whale swim into the mist, and focus its attention on actions that could actually produce real program savings : two-year rather than one - year appropriations cycles; stronger support by the Appropriation Committees for the IT [Information Technology] carry-over fund; and CDR [Continuing Disability Review] funding formulas that would allow CBO [Congressional Budget Office] to score the program savings in a way that would shelter associated administrative costs. ...

I submit to you that the academics, the policy experts, and the advocates of all stripes have not demonstrated an overarching issue in the system that could be the foundation for sweeping reform. Most of the time Social Security disability does exactly what the American people want it to do, which is to provide a safety net for people whose medical problems dictate  that they legitimately cannot work for a year or more. I can tell you better than almost anyone that the system is far from perfect, but the problems result from many very different failings throughout a highly complex system, not one or two overarching issues. In my opinion, there is no magic bullet solution, only scores of detailed answers to very specific problems. ...

My ringing call for incrementalism is hardly sexy, but if you care about supplying a compassionate but cost-effective safety net for the disabled, you will need to have a laundry list of concrete reforms to offer Congress in the next year or so....

Let me “help” you with this list. ...

[B]udgeteers in state agencies have figured out that they can shift their program costs to the administrative budget of SSA by requiring a decision on disability from SSA before allowing people to collect benefits from TANF [Temporary Assistance to Needy Families] or some other state-funded program. .... It is time that Congress closed this loophole and made it explicitly illegal to condition receipt of any benefit upon an SSA disability determination if that benefit is partially subsidized by the federal government....

Another similar area for action is concurrent application for both unemployment and disability....

Congress can also help claimants help themselves by authorizing SSA to direct the state agencies to develop comprehensive, up-to-date websites in each state that include: 1) sources of assistance for free pharmaceuticals; 2) locations of DOL [Department of Labor] one -stop offices; 3) information about services available from the state vocational rehabilitation agency; 4) disease groups that offer supportive services; and 5) a primer about looking for work on the Internet and information about data bases that list available jobs, both locally and nationally.  ...

Congress also needs to give the Commissioner the mandate to begin over the next five years an orderly elimination of the reconsideration step that occurs in most, but not all, states ...

[A]bout half of the [hearing] backlog reduction came from more resources and about half came from increased productivity....

SSA accomplished much of this progress over the intransigent resistance of the Office of Personnel Management [OPM[ They steadfastly refused to reopen the [Administrative Law Judge hiring] list for over ten years — imagine what your hiring would look like if you could only hire off a list that was ten years old! I sat in one meeting where a senior OPM official told John Berry and me that there was no reason to consider new applicants until SSA hired from the last person left on the list. What does that statement say about OPM’s commitment to quality in public service? What makes it worse is that OPM is spending a lot of trust fund money doing very little.  ...

I believe the ALJ position is the only job left in the civil service that requires a test, and it is a test designed by people who have no understanding of the administrative process and no desire to learn. It has become a budget game to pad the OPM budget at the expense of the trust finds. For instance, not long before I left I learned third-hand that trust fund money is going to develop a new on-line testannounced this week will be administered by little cartoon figures on the screen. Little cartoon figures... 

Where are the oversight committees on this critical function? OPM’s work is excruciatingly slow, outrageously expensive, and of unacceptably poor quality —and it has been so since at least the Clinton Administration. OPM damages SSA’s efforts to supply timely, high-quality justice, and it is time for Congress to move OPM’s responsibilities in this area to a federal agency that understands administrative law — either the Department of Justice or the Administrative Conference of the United States. ... 

Congress needs to streamline its statutes on return to work. Congress has tended to have an unrealistic view as to how many recipients can return to work. Somewhere around 60% of the people on the rolls have no realistic expectation of returning to work — they have fatal diseases, like ALS or Huntington’s, that are certain to continue debilitating the person until he or she dies a premature death. Some people have horrific brain damage from car accidents or military service. For many of the 40% for whom a return to work would be difficult but perhaps possible at some point, the layers of new incredibly complex statutes to encourage work have become counter-productive....

When Congress gets serious about addressing the 2016 insolvency of the trust funds, there will be bad ideas floating around too. The one that has the most currency baffles me, which is another try at making hearings adversarial. I was stunned when I first answered questions before Congress on this proposal because none of its proponents knew that the agency had piloted this proposal in the 1980’s and that it failed miserably. It was expensive — probably several hundred million dollars to implement fully in today’s dollars — and it made no difference in outcomes while simultaneously undermining public confidence in the agency.  ...