[camgunz]

I posted about it in a different little branch: https://news.ycombinator.com/item?id=43903848

TL;DR: the average disability recipient age has hovered ~50 (stddev 1.54 years) since 1960. The theory of "baby boomers are a huge generation, they got old and US health care sucks ass" is far more parsimonious than your theory of individual accountability, which has to explain why every generation suddenly becomes fraudulent/immoral/unaccountable at the exact same point in their lives.

[mech9879876]

Aggregating statistics regarding age has very little explanatory value in regards to fraud and is a non sequitir. I would not be surprised if the average age of a convicted insurance fraudster has remained relatively constant over time either.

The example in linked materials of 1 in 4 adults in Hale County receiving disability payments is a clear example of a situation where individuals and healthcare providers have both contributed to widescale fraud. This is an obvious case where moral hazard is present and you continue to deny it.

[camgunz]

This is my claim: the narrative that these programs incentivize and facilitate freeloading is false. Let's use your example: NPR's exploration of Hale County [0], which I'm not sure you've read/listened to.

The first interview [1] is exactly what I've written: baby boomers got older and more disabled, and economic conditions pushed people into disability. Quote: "consider this: Since the economy began its slow, slow recovery in late 2009, we've been averaging about 150,000 new jobs created per month. But in that same period, almost 250,000 people have been applying for disability every month." What do you want these people to do, manifest new jobs?

The second interview [2] outlines how the definition of disability has expanded over the years and the way the legal profession has exploited that to increase the number and success rate of disability claims. Again, not freeloading.

The third interview [3] describes how welfare-to-work legislation put a higher burden of the welfare onto states, so it's actually in their financial benefit to move people off of welfare and onto Social Security disability--so much so in fact that they pay people to do it. Quote: "PCG estimates it'll save Missouri about $80 million with all the people that will be getting onto disability and off of welfare".

Interviews 4 [4] and 5 [5] describe how people and families get trapped in these systems where if they do too well they'll experience extreme financial hardship. Quote: "a lot of the letters that we got from people responding to the stories were people saying, I'm one of those 14 million people on disability and I want to work. But I get health insurance on disability and what job am I going to find that accommodates my disability, it also gives me health insurance."

If your model of this problem is "there's a bunch of people too lazy to work who are freeloading on the public dole" you will be unsuccessful at solving it, because your model is wrong.

[0]: https://www.npr.org/series/196621208/unfit-for-work-the-star...

[1]: https://www.npr.org/2013/03/22/175072446/millions-of-america...

[2]: https://www.npr.org/2013/03/26/175396983/expanded-definition...

[3]: https://www.npr.org/2013/03/27/175502085/moving-people-from-...

[4]: https://www.npr.org/2013/03/28/175619112/kids-may-stay-on-di...

[5]: https://www.npr.org/2013/03/29/175722025/americans-on-disabi...

[mech9879876]

Your method of argument relies on lumping all persons into one category. The annoying detail about designing public policy is that policy changes happen on the margin, and it is the marginal cases where moral hazard presents itself first. If you continue to boundlessly extend your empathy for everyone that walks into their doctor's office to anybody that says they have back pain, you will clearly have fraud. And Hale County is clearly a case where this fraud is broadly present. You have presented your argument in the best way to try to lump the fraudsters in with the rest of the empathy-deserving recipients.

When Hale County has 1 in 4 adults on disability, it is beyond evident that the system is not working as intended. Yes, it is distinctly clear that some of those adults should be getting jobs. Your question "What do you want these people to do, manifest new jobs?" implies that this must be some unthinkably cruel thing to believe.

>If your model of this problem is "there's a bunch of people too lazy to work who are freeloading on the public dole" you will be unsuccessful at solving it, because your model is wrong.

Even if freeloading is unsolvable, the moral hazard exists. My primary claim prior to this comment has been limited to the fact that the moral hazard is present. Your argumentative strategy to claim that because the problem isn't solvable, it must not exist, strikes me as dishonest.

[camgunz]

I'm gonna do the point by point thing here, not because I think you really deserve it, but because I want you to really think about the arguments you're making. Will it work? I don't know. Do I know of a better way to do it? I wish I did. OK here we go.

> Your method of argument relies on lumping all persons into one category.

I literally broke people up into different generations, people who can work, people who can't, children, people who are lawyers, policymakers, government workers or contractors moving people from welfare to disability. I really think you not only didn't read the NPR stuff, you didn't read what I wrote either.

> The annoying detail about designing public policy is that policy changes happen on the margin, and it is the marginal cases where moral hazard presents itself first.

You've no evidence for this. It's also not true; see for example the financial collapse of 2008. Also people who cry "moral hazard!" (this is you) don't think this, because their chief villains are subsidies and bailouts which explicitly create moral hazard. Also people who cry "social programs create moral hazard!" (this is also you) don't think this, because they see this as the fundamental dynamic of aid programs.

> If you continue to boundlessly extend your empathy for everyone that walks into their doctor's office to anybody that says they have back pain, you will clearly have fraud.

You've also no evidence for this. There's counter evidence though. Did you know a small fraction of disability claims are approved? You do now! Turns out we're not "extending [our] empathy for everyone that walks into their doctor's office".

> And Hale County is clearly a case where this fraud is broadly present.

This isn't my claim. My claim is (again): the narrative that these programs incentivize and facilitate freeloading is false. If there's no job literally in America that you can have, I don't think going on Social Security Disability is freeloading. I'd love to engage on the quote I posted ("Since the economy began its slow, slow recovery in late 2009, we've been averaging about 150,000 new jobs created per month. But in that same period, almost 250,000 people have been applying for disability every month.") but you've not responded to it at all, probably because it's devastating to your argument.

> You have presented your argument in the best way to try to lump the fraudsters in with the rest of the empathy-deserving recipients.

I do think these people (like all people) deserve empathy, but again that's not my claim. I'm making the claim I am because if you disagree with it, you'll ratfuck (or shutdown entirely) these programs such that they don't actually help people. When I talk about all the dynamics around aid programs, it's because I want people to understand the dynamics around aid programs, not to sneak freeloaders in through the back door. Elsewhere I posted "The overall point here is that if we let criminals and a very small number of freeloaders sour us on these programs, we literally let kids go hungry; we literally let them die of preventable illnesses; etc. etc. It is absolutely bonkers to me that we are making this tradeoff." Do you disagree? It's hard for me to imagine a rational person disagreeing.

> When Hale County has 1 in 4 adults on disability, it is beyond evident that the system is not working as intended.

Agree! The whole NPR series explains it. You should read it!

> Yes, it is distinctly clear that some of those adults should be getting jobs.

Again:

- For most of those people there aren't jobs

- There might be jobs but they're shit jobs that don't cover their bills or health insurance

- They actually in many cases _do have jobs_

Again, you should definitely read the NPR series you're citing over and over again (lol).

> Even if freeloading is unsolvable, the moral hazard exists.

Correct. Now:

- design an aid program without moral hazard or

- decide moral hazard is OK or

- decide it's OK for kids to literally die entirely of preventable causes

[mech9879876]

My main intention in my argument was to convince you that moral hazard exists in current social welfare programs. Judging by your statements, you were already aware of this, but rely on discussion points that deny it exists. Starting off an argument with such a clearly untrue line of discussion sets up pretty poor grounds for an honest talk.

That's all I intend for this. There's room for agreement on some other points, but I doubt it would be a productive conversation when you deny the existence of the downside tradeoffs of your preferred policies.

[hgomersall]

It existing is a necessary and desirable part of any rational system. If it didn't exist that system would either be too complicated as to not help those that need it and/or cost more to implement than is saved by eliminating the fraud. The correct amount of fraud is non zero: https://www.bitsaboutmoney.com/archive/optimal-amount-of-fra...

[camgunz]

Maybe let's go back to this thing you wrote:

> It seems apparent to me that your attitude toward individual level accountability is one that denies agency of the individual and ascribes their moral failures as a result of societal-level problems. After all, there is no moral hazard when individuals have no moral agency to begin with.

Yeah! I do think people are 99% defined by the systems and scenarios they exist in, whether that's a government, a school system, a culture/society, a family, etc. You can see this all over, but my favorite example is when people from deeply misogynistic cultures move to Western countries, within a few years their views moderate. It's hard to find a more deeply held moral belief than the fundamental roles and identities of men and women, but it changes and quite easily.

Or with the Hale County example, I'm not at all surprised that as the economy failed that community they noped out of it. Reading through the NPR stuff, you'll get a good feeling for how they rationalize it (I don't think Hale County is especially beset by freeloaders) and their dissatisfaction with it. A world where people are strictly adhering to codes of morality isn't one I've ever experienced.

I'm not saying people never do moral or ethical things, and I don't think you can fully understand the world if you don't include morality/ethics in your thinking. But in the aggregate, this isn't how things work.