Aug 22, 2008

Paper And Productivity

I reviewed an emergency room report recently. The patient was seen due to hyperglycemia. She is a diabetic and her blood sugar had gotten too high. This is a routine sort of emergency room visit. The report on the ER visit ran to 36 pages. Ten years ago, maybe even five years ago, the report would have been about three to five pages. I strongly doubt that her treatment was any different than it would have been five or ten years ago, but the hospital generated a lot more paper. This is routine in most medical settings today. Medical care generates far much more paper than it used to.

It takes more time these days to review an average Social Security disability claimant's file than it used to, because the average claimant's file is thicker than it used to be. This has an effect upon productivity. People in the field may not talk about this or even notice it because it has happened slowly over the years, but it is important.

I mention this because it is a reality that seems not to penetrate to the higher reaches of the Social Security Administration. Above a certain level one never reviews an actual claim file.

Commenting On Old Posts

Efforts have been made to use the commenting feature of this blog to promote pornography websites. Comments were posted about old items as part of an underhanded search engine optimization effort. I have deleted these posts and set the blog to require my approval before comments are posted on anything more than three days old.

Aug 21, 2008

Social Security -- The Movie

I have a hard time believing this will get many viewers, but I.O.U.S.A., a movie, is being released today. A blurb describes it as being … an alternately amusing and alarming primer on America's off-the-charts fiscal irresponsibility ...

The Comptroller General, Patrick Creadon, is featured in the movie according to the International Movide Data Base. I guess he is trying to go down the same path as Al Gore.

Apparently, Social Security must be discussed prominently in the movie, since the National Academy of Social Insurance is offering to make "experts" available to discuss the movie with reporters.

Atlanta Journal-Constitution Editorial And Commissioner Responds

The Atlanta Journal-Constitution is running an editorial on Social Security's backlog situation. The article tells us that the current level of service at Social Security is "unacceptable" and notes that "The reason for the backlog is not in dispute —- not enough workers to process the claims, and not enough administrative law judges to hear appeals of denials."

The editorial makes the common naive mistake of asking for "streamlining." In my opinion, Social Security is suffering from an excess of efforts to "streamline." These efforts, which have become more and more desperate and even ridiculous have had the perverse effect of making things worse because they have not worked (other than to cut corners, reducing the quality of the decision-making process) and because they have diverted attention and resources from the real problem of lack of staff.

The editorial also suggests that there is something awful about long term disability (LTD) insurers having offsets in their policies for Social Security disability benefits. Think about it a bit. Without that offset, how expensive would LTD be? Without being able to offset Social Security disability benefits, LTD would be so expensive that almost no one would be covered. The LTD available now is quite imperfect, but it is far better than nothing.

Michael Astrue, Commissioner of Social Security, was given an opportunity to respond. His response was adapted from a statement he made to a Congressional committee. It is not clear whether this was Astrue's choice or the newspaper's choice. There is nothing new in it.

A Unitary Theory Of What Went Wrong At Social Security -- And Beyond

From The Wrecking Crew: How Conservatives Rule by Thomas Frank:
Conservatism ... seems actively to want an inferior product [government service]. Believing effective government to be somewhere between impossible and undesirable, conservatism takes steps to ensure its impotence. The result is predictable enough: another sour truckload of the mother's milk of conservatism, cynicism toward government.

Waiting In Milwaukee

From the Milwaukee Journal-Sentinel:
David Hintz had waited nearly three-and-a-half years for this.

At the end of July, the Social Security Administration called his attorney to schedule a hearing. A judge would finally determine if the 39-year-old man from Custer was eligible for disability payments.

For years, Hintz and his wife had lived off her parents. Blood clots in his lungs, an injured leg and a plethora of daily pain medication and blood thinners had kept Hintz out of the work force since 2004. He hoped the call from Social Security signaled the end to a long road.

Instead, the red tape only got longer and more tangled.

When Hintz's attorney reported that his client had moved from Custer to South Milwaukee last year, the Social Security worker said the case had to be sent back to Milwaukee.

Aug 20, 2008

Stephanie Tubbs Jones Dies

Massive Shredding Of Charter Hospital Medical Records

Charter Hospitals, which had been the nation's largest chain of psychiatric hospitals, went bankrupt. At one time Charter operated 90 hospitals around the country. Some of the hospitals were sold and continued in business under other names, but many closed for good. I have recently learned that most, if not all, of the medical records generated by the Charter Hospitals that closed for good have been shredded. There was no money to pay for continued storage of the medical records. Apparently, the state governments in the states in which Charter had operated were offered the records, but most, if not all of them declined to accept the records.

This is awful, just dreadful. There should be laws to prevent this from happening. This can affect the outcome of Social Security disability cases.