I know a number of people who have disabilities, ranging from fairly mild to fairly severe. Most of them have some amount of interaction with social services of one sort or another, whether in the US or elsewhere. And everywhere, there is a single constant theme:
The entire system seems predicated on the notion that people with disabilities do not face more difficulties in doing things than other people would. And I am pretty sure this is a really bad idea and does not make very much sense at all.
In general, social services seem to rely heavily on maintenance of paperwork, and failure to maintain paperwork means you don’t get services. But the paperwork is fairly hard to maintain. It involves requirements that you keep and provide copies of various evidence, that you process paperwork and hand it in in a timely fashion, and so on.
One of my friends recently got shifted from medication which was having a bad side effect to different medication. Which hospitalized him. It was about two months before he was pretty recovered, at which point he could at least conceptually handle tasks other than trying to survive individual days. So he checked his mail, and he had overdue paperwork which means that his food stamps are now gone until he does new paperwork which will then have to go through a long bureaucratic procedure.
Now, if you’re not disabled, it may seem strange to you that merely being hospitalized would prevent someone from keeping up with their paperwork. It will almost certainly seem strange to you that having been hospitalized a month ago would leave someone unable to keep up. But the fact is, disabled people really do run out of spoons. And then the system punishes them for not having been well enough to keep up with things.
I’m not sure how to solve this, but a first pass would be to simply declare that, if someone has any disability, no matter what it is, whether cognitive or physical, the duty of keeping up with the paperwork is not theirs to manage. Paperwork should be handled by the bureaucrats who so want the paperwork kept up with. You need bank records? Get a standard form you can fill out exactly once, ever, which authorizes the bureaucrats to pull copies of bank records for purposes of updating the paperwork.
And this might increase costs, but honestly, compared to the paperwork storms that ensue when people get their paperwork screwed up, I am not sure at all that this would even be more work overall for the bureaucrats. I think it would save them a lot of work. They wouldn’t have to go through forms filled out by literal-minded autistics and “correct” all the places where someone answered the question on the form rather than the question intended. They wouldn’t have to do three rounds of back-and-forth to find out why some questions were left blank.
So far as I can tell, the current system is rooted mostly in a combination of things, but comes down to the common perception that disabled people are just being “lazy” when they don’t keep up with things.
The US system in particular creates additional problems with its focus on trying to prove that people aren’t really disabled. I know more than one disabled person who has turned down short-term paying work because if you ever get paying work, that can be used as evidence that you must not really be disabled. Even if there is no more work. Even if you lost the job because you actually couldn’t do it. So if you work now, you may end up not working later and also unable to get any kind of support services.
What if, having determined that someone was disabled in a way that does not usually magically clear up over time, we just kept that information forever? What if we allowed them to get jobs without losing their “disabled” status? Yeah, doubtless there would be someone somewhere collecting disability money and also working. But the chances aren’t bad at all that they would be earning less working than they would be if they weren’t disabled, and furthermore, if they’re working they’re paying taxes, which is sort of a nice improvement over the current situation, where they don’t work because working could lead to them starving a few months later.
I think people tend to underestimate the impact of the paperwork for a number of reasons. One is that the paperwork is a lot harder for many disabled people than it is for other people. But there’s a more subtle one. Say we conclude that a given amount of paperwork should consume, say, four hours a week. That doesn’t sound too bad; it’s only 10% of a full-time job. But if your functional cap on productive effort isn’t 40 hours a week, but 20 hours a week, that just turned into 20% of your time, instead of 10%. And if the paperwork takes you twice as long to do as it takes other people, it’s 40% of your time. Now consider all the lovely research we’ve got on how stress affects people’s ability to do things. And consider whether “you will probably end up not eating if you do not do all these complicated poorly-defined tasks correctly, and will not know until it is too late if you’ve screwed one up” might create stress. What happens? That “reasonable” 10% of your time is now consuming at least half of your available effort, and what you have left is a lot less than half of what effort you would have had available otherwise.
Mostly, this comes down to the general observation that if you’re going to try to save money on a system, you should consider carefully whether what you propose to do will actually reduce costs at all, and you should also consider what your goals were, and whether you will also reduce your achievement of those goals.