[zer8k]

> I feel like the biggest thing the US could do is remove means-testing from our disability aid programs.

The problem isn't the means testing the problem is it's applied with broad strokes like all well meaning but inevitably awful government work. First, everyone pays into disability. So everyone should be able to get their share when necessary. Second, means testing includes things like housing, retirement accounts (which will be penalized severely if accessed), assets, and other things than just raw cash available. Just having a half decent computer is enough to make you fail means testing. So people who are on disability are almost universally forced to be poor. Don't try to hide your assets either. Shifting money/assets/etc to a family memory will still disqualify you.

In a practical sense we also need to prevent the exploitation of disability programs. For example, self-inflicted disability (morbid obesity for example) should be subject to a different test of means than birth defects. If you're only disabled because you eat too much and can't be bothered to exercise I question whether you're actually disabled. Every "class" of disability is not equal and so we shouldn't treat them exactly the same. But, like all things, because the government runs it disabilities must be treated this way and as a result everyone suffers.

[citruscomputing]

Something my therapist pointed out to me is that obesity is directly linked to childhood and intergenerational trauma; calling it self-inflicted is not accurate. Even if we're focused on healthy eating, food deserts exist. No man is an island, &c.

Also, to cite an HN darling[0], obesity is, at the very least, a lot stranger and more complicated than CICO.

> we also need to prevent the exploitation of disability programs

What if we _encouraged_ the "exploitation" of disability programs? What if everyone who wanted or needed it got help, regardless of whether someone thinks they "deserve" it? What if people didn't have to worry about failing to re-prove they still need help? I would rather that myself & my disabled friends live in that world.

[0]: https://slimemoldtimemold.com/tag/a-chemical-hunger/

[scarby2]

> Something my therapist pointed out to me is that obesity is directly linked to childhood and intergenerational trauma; calling it self-inflicted is not accurate. Even if we're focused on healthy eating, food deserts exist. No man is an island, &c.

The idea that obesity is self inflicted runs contrary to our current understanding not just of psychology but of physiology. Most people don't have a constant struggle to maintain a healthy weight generally people with obesity even if they lose weight have to work extremely hard to not regain that weight and most fail.

[Supermancho]

> The idea that obesity is self inflicted runs contrary to our current understanding not just of psychology but of physiology.

Eating your feelings (emotional eating) is commonplace. I'm saying it's a uniform cause, but common enough to pass the bar of "contrary to current understanding of psychology".

[scarby2]

i'm late replying but i'd argue that emotional eating isn't entirely self inflicted. It's partially biological (our bodies naturally crave higher calorie foods during times of stress), partially down to learned behaviours that you may not be able to break without outside help.

[wizofaus]

> What if everyone who wanted or needed it got help

That's always the ideal surely. But there are at least some cases where simply providing people with material necessities and access to medical care etc. doesn't always feel like it's really helping them - I have one such friend, and while I genuinely sympathise with his very real mental illnesses, it's hard not to think sometimes the fact there's no expectation he will ever need to provide for himself at all might be part of what's stopping him turning his life around.

[zer8k]

> calling it self-inflicted is not accurate

Controlling the motion of your hand to your mouth is entirely within the powers of even amoeba. No one forced you to eat yourself to death.

It's strange how we are so tolerant of the obese but alcoholics who climb into a bottle because of PTSD are considered derelicts. "Healthy at any size" has been the most effective form of long term population control.

[cogman10]

> For example, self-inflicted disability (morbid obesity for example) should be subject to a different test of means than birth defects.

I don't really agree with this.

First, I don't see "abuse" of the system being a major problem that needs to be defended against. If someone wants to destroy their future health by Homering, let 'em. They aren't extending their life by eating themselves to death.

But even if that's the concern, I'm pretty sure we could circumvent a lot of those issues simply by subsidizing disability causing conditions (such as building/maintaining public gyms). We can prevent people from getting there in the first place which would greatly reduce the problem of "abuse".

Strong means tests are expensive to run and ultimately will filter out people that actually need assistance. If we are going to apply a social filter, I'd rather side with letting those that don't deserve it in than keeping those that deserve it out.

This is born out with homelessness studies. Applying sobriety or religious tests before sheltering the homeless ultimately keeps people homeless. Housing first, on the other hand, has a tendency to make people sober.

[macintux]

The dreaded “welfare queen” trope has cost so many lives, so much misery. We’d rather countless needy people suffer than dare give someone else more than he/she is due.

[cogman10]

Yup. I support expensive social programs with minimal means testing. I'd rather give every kid a school lunch on my tax dime than have kids go hungry because their parents weren't poor enough to get a free meal. The wealthy kids parents are already subsidizing meals so why not let them have a free meal as well?

It's silly to bill people twice for the same product to make sure the underserved aren't accidently helped.

[zer8k]

> First, I don't see "abuse" of the system being a major problem that needs to be defended against. If someone wants to destroy their future health by Homering, let 'em. They aren't extending their life by eating themselves to death.

Absolutely. No one should have to pay for it, though.

[SoftTalker]

> everyone pays into disability. So everyone should be able to get their share when necessary

That's not how insurance works. Everyone pays with the expectation that few will need it.

Everyone gets disabled to one degree or another as one gets older.

So what we have is a Ponzi scheme, where early participants get benefits but the majority get screwed.

> Every "class" of disability is not equal and so we shouldn't treat them exactly the same

Agree 100%. You should be expected to take care of yourself if you can.

[notamy]

> If you're only disabled because you eat too much and can't be bothered to exercise I question whether you're actually disabled.

Okay... how do you then prove this? Is preexisting medical issues considered legitimate? What about medication changes? What about [insert any of many possible causes]? What if you have one of those causes but are missing one piece of paperwork to prove it? What if what if what if? I worry that trying to put legitimacy tests on disability just leads to "you're not disabled enough to deserve health" the way it does now.

[mgkimsal]

> If you're only disabled because you eat too much and can't be bothered to exercise I question whether you're actually disabled.

Perhaps there's a distinction between chronic/permanent disabilities and transient disabilities? If I'm obese to the point where I can't walk, I am, indeed, disabled, but don't necessarily have to be for the next 20 years. Diet/exercise/surgery/etc could all reduce the obesity, but in the immediate 'now', I'm disabled and need assistance.

[jstarfish]

There's a reason you have to requalify every three years.

[mgkimsal]

Well there you go. I’m not intimately versed in the specifics. Thanks for clarifying.

[AnthonyMouse]

> Every "class" of disability is not equal and so we shouldn't treat them exactly the same.

You're making the argument for this dystopia:

https://www.tnellen.com/cybereng/harrison.html

The point of government assistance isn't to make everyone the same, it's to provide a baseline. Someone in such a poor state that they can't work at all still gets a roof over their head.

Someone else can use the money to go to college or start a business, and society has an interest in promoting that because it yields returns. There is even an argument for investing more in people with more potential.

But in both cases the government is terrible at doing the evaluation as a result of politics and bureaucracy, so the right answer is for everyone to get the same.