Banksy, Nola Girl with Umbrella

"The avoidance of taxes is the only intellectual pursuit which still carries some reward."

-John Maynard Keynes-

Last year, I spent a lot of time helping people prove they were disabled in order to collect about $950 a month in disability benefits. While my office did not take on cases without merit, there were certainly some disabled clients who walked a fine line between sometimes being able to work part-time at minimum wage jobs and being disabled profoundly enough to collect benefits.

Hidden Unemployment

Source: The Lovely Addict

In March, This American Life aired a piece called "Trends with Benefits" about the increasing cost of Social Security disability claims. Right now, 14 million people collect Social Security Disability Insurance or Supplemental Security Income.* Many economists argue that rising disability claims result from two trends: an aging workforce, and a changing economy. Because the rise in the number of claims is tied to the slowing of the economy, people have labeled the group of borderline disabled Americans who collect Social Security benefits the "Hidden Unemployed". 

What happens to vulnerable people in America? 
During the course of my work, I discovered two things: 

1. Part of the process of making a disability claim involves proving that one can no longer do the kind of work they have been trained to do. 
2. Most of our clients were unable to afford current housing and living costs, even with disability benefits.

The first fact means that the application process is easier for people who have only performed unskilled work. This group is also more vulnerable to work injuries and the effects of outsourcing. The second is just plain depressing, since disabled people often require assistive care and expensive accessible housing units. In 2009, the National Coalition for the Homeless reported that 13% of homeless people are physically disabled, and 26% suffer from chronic mental illnesses. Clearly, many disabled people are clinging to a hole-ridden safety net.

*SSDI is a conventional insurance program funded by payroll contributions. SSI on the other hand, is a social safety net program for people who have not worked enough to pay into the system. It is funded by general tax revenues.

The Life & Death of the American Social Security System

Source: Modern American Poetry, The Great Depression

During the social and economic upheavals of the Great Depression, American politicians finally recognized an opportunity to create an organized program which would provide ongoing substantive care for the elderly and disabled. The resulting creation of the Social Security Administration meant that the US government could reduce national poverty through a future-oriented insurance program. However, the system was not without its flaws; changing demographics, rising inflation, and lower tax revenues now threaten to deplete the trust fund that supports Social Security by 2033.

Source: The Simpsons

How to Help Old & Disabled People

If we don't change our current tax structure, Social Security is doomed to fail within the next century. Social service workers see themselves torn between reinforcing a system which barely works at all and pushing for larger reforms. However, the backlash to Mitt Romney's comment about the "47% of voters who are dependent on the government" shows that many people are learning to acknowledge the problems with our tax and safety net systems and attribute the cause to social and economic issues, not the failure of the disabled and working poor to take "personal responsibility".

"Laughter is the best medicine for when you cannot afford health insurance."

-Probably an American-

Have you seen this video?
Some key statistics regarding pre-Obamacare healthcare:

• Only about 28% of Americans get their insurance through government-funded programs.
• The US spends about 18% of its GDP on healthcare costs. Australia pays 9%.
• A month of the drug Lipitor in the US costs $124. In New Zealand it costs $7.
• America has higher rates of obesity, but less alcohol and tobacco use than most developed countries. 
• Tort reform (i.e., state laws passed to guard against frivolous malpractice lawsuits), have led to a .1% drop in health costs. Defensive medicine only accounts for 2% of our total health spending.

Healthcare is a unique part of the economy, and research suggests that it is a fairly inelastic market. Healthcare companies won't change enough because of competition; there's just not enough incentive to do so. Therefore, Obamacare will probably not lower healthcare costs to nearly the level of countries that provide socialized medical services.

Source: Invendo-Medical, Colonoscope

Up Yours
In an article focused on the price of American colonoscopies, Elisabeth Rosenthal of The New York Times examined the difference between American health companies and comparable but cheaper varieties of care in other countries. Competition actually played a role in raising the cost of a procedure in her case study. Rosenthal found:

"The high price paid for colonoscopies mostly results...from business plans seeking to maximize revenue; haggling between hospitals and insurers that have no relation to the actual costs of performing the procedure; and lobbying, marketing and turf battles among specialists that increase patient fees."

Rosenthal's example shows that healthcare is a capitalistic industry, and generally has no real drive to provide better or cheaper care. Business executives only need to ensure that every part of the system is profitable by constructing ways to maintain high profit levels for the companies, doctors, and administrative personnel who provide services. The threat to UPMC's tax exempt status demonstrates that even supposed charitable institutions are not immune from corporate influences.

In the future, everyone will die from typhoid and blood poisoning. Like Oregon Trail. 

Source: The Oregon Trail

True story: in 1911, the whiskey maker Jack Daniel died from blood poisoning he contracted after kicking a safe. Research shows that unless a new generation of antibiotics is developed in the next few decades, it's possible we'll all be felled by similarly preventable bacterial infections and diseases. The problem is that there is no market incentive for pharmaceutical industries to produce new antibiotics. Indeed, The Washington Post reported in 2012 that pharmaceutical companies are shutting down antibiotic labs. The reasons? Technical troubles, excessive regulation, and lack of profitability.

Life in not a race. It's a marathon.
Antibiotics, which cure diseases quickly and permanently, are less profitable than maintenance drugs like insulin, so companies aren't investing in new ones. Meanwhile, deadly superbugs are popping up in hospitals worldwide. As The Post reported, "it's a case of evolution outrunning capitalism."

In an article for Jacobin, Leigh Phillips argues that cases like this are proof that it is actually essential to socialize some parts of the medical industry; without political support for research, there will simply not be an incentive to develop new antibiotics...and many of us will eventually die from quaint diseases like cholera and dysentery.

Social Welfare and Health Policies
Social service workers have long been confined by immediate client needs to advocating on behalf of individual patients. By creating an opportunity for everyone to buy affordable health insurance, Obamacare allows us to broaden our efforts to include other policy reforms.

Although Obamacare has many faults, it represents a step in the direction of creating transparency within the health care industry, lowering prices for some patients, and preventing medical bankruptcies caused by paying for uninsured procedures. However, policy makers have to take a comprehensive approach to disentangling the messy dynamics of a profit-driven healthcare system. As the "superbug" articles demonstrate, complacency is dangerous.  

"Your silence will not protect you."

-Audre Lord-

Defining the capacity to change

Source: Baraka, Kecak Dance

Community organizing and direct social work practice have one obvious goal in common: inspiring people to change. The principles of organizing focuses on finding a "common self-interest". Likewise, direct practitioners draw out internal motivations in order to re-direct a person's behavior from destructive to constructive actions.

Psychological and Social Barriers
Apart from the unjust institutions which maintain the status quo, social workers must confront personal fears and cultural opposition to change. Cultural anthropologists suggest that narratives are key to understanding the motivational force driving individuals. In this respect, an agent of change may seem like a threat to one's personal identity, for:

Source: InfoNIAC

"when social workers ask people to change, we are also asking them to give something up -something which may be very important to them, even if it is only a memory or a way of understanding reality."

There may not be a deeper and more powerful motivation than self-preservation, but a social worker also usually only steps in when the negative impact of an individual on their environment (and vice versa) becomes clear. At this point, service providers, family members, and the criminal justice system may intervene in order to protect a person or community. The resulting confrontation means people will act defensively, but also gain insight into social and personal problems which they may need the help of others to change.

Ecological Theory and Maslow's Hierarchy of Needs
Bronfenbrenner's ecological systems theory features a model of how an individual interacts with their environment. His model is dependent on the idea of roles, norms, and compatibility. Supposedly, positive development occurs when expectations match across different settings.

Part of the social worker's role is to align internal motivations with the external expectations of "the system" in order to encourage prosocial behavior. However, the Code of Ethics also requires workers to advance the cause of social justice and respect individuality. In order to reconcile internal motivations with external forces, many social workers use resources as a way to incentive action and change. For example, advocates for Housing First programs argue that once disadvantaged individuals are housed, they become motivated to focus on personal development.

Source: The Character Therapist

Underlying this resource driven model of change is Maslow's Hierarchy of Needs, which is illustrated with a pyramid in which self-actualization is the pinnacle of motivational desire. However, an individual's personal development is first driven by the need to fulfill certain biological imperatives.

Understanding Bronfenbrenner's and Maslow's theories means using therapeutic skills to uncover the conflicts and gaps between a person's psychological needs and the often impersonal operations of power structures.

Alinsky's Rules for Radicals
In 1971, Saul Alinsky developed an oppositional model in which the "Have-Nots" band together to create a conflict group and seize resources. These 12 Rules for Radicals  underline the principles of modern community organizing, in which an oppressed group is defined by its opposition to structures that maintain conventional privilege. Alinsky's motivational guidelines require a slow process in which community organizers discover existing community resources, build relationships with individuals, and incite change.

Parables

Source: Clive Uptton, The Parable of the Sower

The ecological model is also driven by conflicts, since an individual's personal needs often differ from the resources and motivational tools the environment provides. Therefore, recognition of the need for change is essential to both Alinsky and Bronfenbrenner's models.

I'm an unforgivably big fan of science fiction, so allow me to attempt to get at the root of some connecting ideas about motivation central to both Bronfenbrenner's and Alinsky's models using Octavia Butler's dystopian novel The Parable of the Sower.

The heroine in Butler's book creates a new religion called Earthseed in response to a futuristic world in which social cohesion has completely broken down. In order to preserve her sense of self and community, she outlines the following ideas:

"All that you touch, you Change.
All that you Change, Changes you.
The only lasting truth is Change."

Similarly, a successful agent understands the interaction between person and environment and builds on people's intuitive sense of the need for change. Where there exists fertile ground, the agent can sow the seeds.

Examining Social Welfare in Post-Apocalypse America

Sometime in the 80's, a random deviant scrawled this message on the wall of an infamous housing cooperative in Berkeley: 

Only seven more shopping days till Armageddon.

Beneath the cynical joke about impending annihilation lies a prophetic perception of the current state of American class consciousness. Having outlasted multiple doomsdays predicted by various Mayan astrologers, would-be cosmologists, and Harold Camping, ego and materialism are still the only things holding us back from registering reality. Did I mention part of "registering reality" means confronting some very real and research-based predictions of future calamity?

"May you live in interesting times."

-Chinese Proverb-

Source: Beyond Revolution, Occupy Oakland 2011

On September 12th, Technology Review reported that 45% of American jobs will likely be automated within the next 20 years. In May, the Social Security Administration confirmed its projection that the Old-Age and Survivors Insurance, and Disability Insurance (OASDI) Trust Funds will become depleted in 2033, and the Disability Insurance (DI) Trust Fund will run out in 2016. Currently, 1 out of every 15 Americans lives in deep poverty (less than $11,510 for a family of four). The United States can no longer pretend to be a solid tower of prosperity...and a record $16 trillion in debt means we can't afford to, either.

Maybe most of us already gleaned this information from the news, our phones, and our Facebooks. What are we doing about it?

The Call
In the aptly titled article "It's the Inequality, Stupid", Mother Jones charted data collected in several

Source: Mother Jones, "How Rich are the Super Rich?

recent studies, including research from 2007 revealing that the top 1% of income earners in the US control 34.6% of the nation's wealth. One chart created by professors at Harvard and Duke compared what most Americans believe the income distribution to be to reality, and then to how the majority want it to look. The study revealed the sheer power of denial and obfuscated media messages. However, by 2008 the growing gap in wealth had manifested in conspicuous signs of economic weakness like rising unemployment, the collapse of the housing market, and astounding levels of private debt.

...and the Response
Eventually, in 2011, outrage at the corporate abuse that created the Great Recession generated the impetus for the organization of the Occupy Wall Street encampment and the subsequent construction of hundreds of Occupy tent cities in places around the world. Public and institutional opposition to the movement led to the violent destruction of many of the camps by late 2012, and most of the rest disbanded because of poor organization and fracturing.

Occupy was criticized for lacking a clear and unified message. Significantly, the movement was driven as much by abstract notions as a solid understanding of the economic dynamics behind the growing separation between the "99 percent" and the "1 percent". The ideological slogans associated with Occupy include: "Democracy by Consensus", "Decolonization Now", and "Debt is Slavery", and these sharp catchphrases target the political and economic structures underlying American institutions, including representative democracy and capitalism.


Deconstructed Spaces
In American Ethnologist, Jeffrey Juris argued that, "social media contributed to an emerging logic of aggregation in the more recent #Occupy movements—one that involve[d] the assembling of masses of individuals from diverse backgrounds within physical spaces." Attempts at unifying or defining the movement's immediate goals often resulted in backlash from the bulk of the occupiers, who saw Occupy as an experiment in social freedom and equality. As such, the dream of Occupy was to build an alternative and non-hierarchical system which would eliminate racism, classism, sexism, and the need for representative governance. Ambitious goals.

Source: Benjamin Smith, The Quotes Project 

Occupy was a true countercultural movement, not just an economic protest, and it tried to deconstruct basic social structures in order to promote simplified, utopian spaces. Many conservatives (somewhat understandably) misunderstood the movement as a disorganized and amoral gathering of antisocial derelicts. As Walter from The Big Lebowski famously pronounced, "nihilists? Say what you like about the tenents of National Socialism, dude, at least it's an ethos."

Although organizational failures and public backlash resulted in the dispersion of the bulk of the dispirited occupiers, many Americans are now firmly aware of the undeniable existence of widespread poverty and inequality.

Motivating Social Change in Cynical Times

Source: Mabel Hill,
Illustration for "Chicken Little" 

The legacy of Occupy includes a lot of anti-consumerist sentiment and some resentful disenfranchisement. Social service professionals and liberal policy makers are currently trying to build on the lessons learned during a countercultural movement that was rather opposed to strategic political and social organization.

In particular, social workers face the paradoxical professional responsibility of fostering social change while preserving overall cohesion in a disenchanted society. Many are tasked with the job of providing palliative care to the newly impoverished, disabled, and underemployed. Others are trying to adjust to changes in healthcare policy, welfare reform, and funding deficits.

In times like these, it is extremely important to reflect on our origins and goals. What does it mean to advance the cause of social justice during an era of unprecedented change? How can we conceptualize an ethical system when it seems most established ideologies are beginning to fail? Perhaps the only way to re-examine our priorities is by seeking to understand the warnings and predictions economic theorists, folk tellers, and historians have already provided.