SSAB On Health Care Costs

The Social Security Advisory Board (SSAB) has issued a report with the title The Unsustainable Cost of Health Care. The basic premise of the report, that health care costs are increasing at an unsustainable rate, is beyond debate. What is odd is that the report fails to discuss in any meaningful way the possibility of the so-called "public option," a government run insurance program that competes with private insurers, as a solution or part of a solution for this problem. The possibility of a single payer system is not even hinted at. There may well be no public option in the final plan passed by Congress and signed by the President, but this is certainly on the table. Instead of evaluating the public option as a possible fix for the problem the report states that one reason for increasing health care costs is that too many people have health care insurance! The report says flatly that reducing the ranks of the uninsured would lead to a greater problem with health care costs. The report seems to offer a compilation of plans backed by Republicans as the only possible solutions for the problems identified.

I do not understand why Democrats on the SSAB would sign on to this document.

It is my opinion that the SSAB as presently constituted is a waste of money. This report is certainly a waste of money. Why do Democrats in Congress keep funding SSAB?

Update: One poster noted that the SSAB was set up by statute. That is true but statutory bodies can be defunded. Without an appropriation, SSAB dies. It has happened to other agencies in the past. One that I recall well was the Administrative Conference of the United States (ACUS). ACUS still exists as a statutory body, but it offended Republicans and was defunded in 1995. For that matter, maybe ACUS should be revived.

Another Year With A Continuing Resolution?

When Congress is unable to complete work on an appropriations bill by the beginning of a fiscal year (FY) -- October 1 -- it passes what is called a continuing resolution that allows the agencies involved to continue spending at the same rate until an appropriations bill is passed.

Take a look at the status of the appropriations bills for FY 2010 which begins in 16 days. Social Security is covered by the Labor-HHS bill. It does not seem likely that all of these bills will be passed by the end of the month. Continuing resolutions hamstring agencies. They make planning difficult.

How Far Will This Go?

From The Hill:

Rep. Carolyn McCarthy (D-N.Y.) introduced legislation this week that would provide seniors and others who receive Social Security payments a one-time $150 payment to make up for the loss of the COLA [Cost Of Living Adjustment]. The bill has 14 Democratic cosponsors.

First Meeting Of Social Security Board Happened On This Date In 1935

Picture from left to right are Arthur J. Altmeyer, John G. Winant (Chairman), and Vincent M. Miles.

"Emergency Clause" For Disability Determination

The budget crises that are causing many states to partially furlough their employees, including disability determination employees who make initial and reconsideration determinations and whose salaries are paid by Social Security, has led to the issuance of a new item in Social Security's Program Operations Manual Series (POMS) concerning the "emergency clause." The "emergency clause" is what Social Security is calling an agreement with a state to transfer some of that state's disability determination workload to Social Security for adjudication at the Office of Central Operations (OCO), Program Service Center - Disability Processing Branch (PSC-DPB), or Disability Quality Branch (DQB).

Unfortunately, Social Security has only very limited ability to help any state, so this may mean little. It may also make it more difficult for OCO, the PSCs and the DQBs to process their regular workloads. I am sure that Social Security realizes that this is borrowing from Peter to pay Paul, but they must feel that they have no choice.

Does This Mean Anything?

From a press release:

A poll taken by [a law firm] asked the question, "Do you feel the Social Security Administration will handle your Social Security disability claim fairly?"

The response was astounding. Eighty three (83) percent of the responses to the yes/no question were No; they do not trust the Social Security Administration to handle their claim fairly. At the time of this release 389 people had responded. When such a huge majority of people do not trust the government to handle their disability claim, it simply cannot be ignored.

Another GAO Report

From Social Security Disability: Additional Performance Measures and Better Cost Estimates Could Help Improve SSA's Efforts to Eliminate Its Hearing Backlog, a report issued by the Government Accountability Office (GAO):

SSA’s Plan should help the agency reduce its hearings-level backlog, but the likelihood that SSA will eliminate the backlog within its projected time-frame depends on the extent to which SSA’s assumptions for improved administrative law judge (ALJ) hiring, availability, and productivity are achieved in practice. Both SSA and GAO believe that the agency has about a 78 percent chance of eliminating the backlog, that is, reducing the number of hearings-level pending claims below 466,000 claims, by the end of fiscal year 2013—SSA’s target date—if those assumptions are fully realized. However, SSA’s assumptions project higher levels of performance achieved than recent experience—from fiscal year 2008 to April 2009. ALJ productivity improvements are especially important to SSA’s reaching its goal. The likelihood that SSA will eliminate the backlog by its target date changes under different scenarios for achieving its ALJ hiring, availability, and productivity goals. If SSA achieves its average ALJ productivity, but not its ALJ hiring and availability goals, GAO estimated that SSA’s chances are reduced from about 78 percent to about 53 percent. Conversely, if SSA achieves its goals for ALJ hiring and availability, but not for average productivity, its chances are about 34 percent. If SSA is unable to achieve any of its ALJ workforce and performance goals, the likelihood of the agency eliminating the hearings-level backlog by its target date drops to about 14 percent.

GAO is foolish enough to think that the chances of reducing the backlogs can be reduced to percentages and that Social Security's projections of productivity gains have a relationship to reality. It has seemed clear to me for many years that Social Security figures out how much budget it can expect to get and how many people it can hire and then works backwards to figure out how much productivity it needs to project to meet some abstract backlog goal.

Fee Payment Stats

Social Security has posted these updated statistics on payments of fees to attorneys and others for representing Social Security claimants:

Fee Payments
Month/Year	Volume	Amount
Jan-09	28,423	$101,128,880.69
Feb-09	31,352	$112,791,207.17
Mar-09	29,199	$104,155,187.96
Apr-09	30,963	$110,133,425.19
May-09	36,603	$126,725,262.45
June-09	31,799	$113,962,564.84
July-09	34,802	$124,621,068.71
August-09	28,218	$100,279,282.51

ODAR Processing Time Report

The National Organization of Social Security Claimants Representatives (NOSSCR) has obtained the report reproduced here on backlogs at Social Security's Office of Disability Adjudication and Review (ODAR -- I still hate this name and abbreviation). Click on each thumbnail to see it full size.

Here are some historical numbers to help put this in perspective.

• January 25, 2007 -- 508 days
• May 25, 2007 -- 523 days
• July 28, 2007 -- 528 days
• August 31, 2007 -- 523 days
• November 30, 2007 -- 500 days
• February 29, 2008 -- 511 days
• May 30, 2008 -- 523 days
• June 27, 2008 -- 529 days
• July 31, 2008 -- 530 days
  
• September 3, 2008 -- 532 days
• November 5, 2008 -- 476 days
  
• December 3, 2008 -- 480 days
• March 8, 2009 -- 499 days
• April 24, 2009 -- 505 days
• June 3, 2009 -- 505 days
• June 29, 2009 -- 495 days
• July 31, 2009 -- 494 days
  

Backlogs Soar At Initial Level

Courtesy of the National Organization of Social Security Claimants Representatives (NOSSCR) here are stats on Disability Determination Service backlogs. Click on the thumbnail to see it full size.

The picture is ugly, even eye popping. The national backlog of cases at the initial level is up 37.7% over a year ago. Every state but two has increased backlogs.

As Social Security makes a very slow start on reducing the backlog of cases awaiting a hearing, another bigger backlog opens up at the initial level. Very discouraging.