Drunkard's Dream

The dangers of government aid for substance abusers

Not every bad government program strews corpses behind for people to find. But Bob Coté has stumbled upon a few that he lays at the feet of the Social Security Administration's Supplemental Security Income program. Coté runs Step 13, a Denver shelter for "street people," as he unsentimentally calls them. He reels off some names of the victims of a program he calls "killing people on the installment plan."

Through the innocent-sounding Supplemental Security Income program, the federal govern ment is "the country's largest supplier of alcohol and drugs to addicts," Coté charges. And that alcohol and those drugs often kill their users, as well as leaving them prey to a violent street culture that leaves many battered bodies for every dead one.

The program began in 1974 as a supplement to the 1956 Social Security Disability Insurance program, which gave disability relief money only to those who had paid in to the Social Security tax fund. SSI, unlike Social Security Disability Insurance, comes out of general Treasury funds, and you needn't have paid in money beforehand to cash in. You just have to be destitute and disabled, accord ing to government definition.

The deadly rub, say Coté and congressional critics, is that alcoholics and drug addicts meet that definition. This has led to greater and greater amounts of federal money going to an "aid" program that subsidizes potentially deadly habits, is expanding ever more rapidly (often through fraud), and shows no evidence of helping any of its disabled charges to mainstream. Attempts at congressional reform have begun, but they have not gone nearly far enough and could easily be stymied by bureau cratic and judicial activism.

Coté's Step 13 accepts no government money. He complains that a liquor store down the street gets the equivalent of his $210,000 yearly budget in SSI money from drunks. SSI demands that a third party receive and disburse the dole money for drug addicts and alcoholics (DA&A, in SSI lingo); unfortunately, in many cases that third party is a drug dealer, liquor store, or flophouse run ner. The first of the month, when the SSI checks come in, is eagerly awaited as "Christmas Day" by Denver's street people.

It's a day of mayhem and violence as well. Street criminals are well aware there are plenty of drunks wandering around then, pockets bulging with cash. "Someone's always sticking another one to get what's left," says Coté. "I know one guy, he gets beat up every month for his SSI check. He doesn't have his check any longer than four hours. He picks it up at a clinic, goes to the barin later stages of alcoholism it just takes one or two drinks to get 'em goingas soon as he goes to the bathroom, street pirates are all over the place, beat him up and take the rest. I ask him, 'Bob, how many times does this have to happen to you?'"

It can only keep happening for three more years. Maybe.

In response to press reports of abuses of the programconvicts getting on SSI in prison, unscrupulous translators coaching immigrants to fake disability, children encouraged by their parents to act crazy to climb aboard the gravy trainand testimony from people like Coté, Congress last year passed a reform bill imposing a 36-month limit on getting SSI cash just for being a drunk or drug addict. The bill also toughened, on paper, fraud controls and requires, again on paper, more reviews of past claimants to make sure they still belong on the rolls.

Congress is demanding 100,000 reviews a year from 1996­98, plus a review of everyone on the children's rolls who hits age 18standards the Social Security Administration has never been able to meet in the past. SSA spokesman Tom Marganau complains there is no increased funding for the reviews, which cost on average $1,000 per case. Whatever their upfront costs, the reviews prom ise big dividends down the line; SSA estimates $4.00 in lifetime savings for every dollar spent on case reviews.

The reviews are important not only to check on changed circumstances, but also to double -check on past fraud. In a paper done for the Cato Institute, Christopher Wright, publisher of Activists Online on the World Wide Web, has gathered many fraud reports, both from government watchdogs and the press.

Such cases include Cambodian interpreters in Southern California coaching recent immigrants on how to fake mental disability during interviews and providing them with bogus psychiatric testimony, and a clever New Yorker who pretended to be, alternately, a psychiatrist, neurologist, and attorney in order to funnel multiple SSI claims to himself. Some investigations and press reports suggest that the use of crooked translators and third-party helpers in getting SSI cash is widespread, but the government's own statistics on fraud have been stagnant since 1985"largely attributable to insufficient monitoring and enforcement," says Wright. The program's enormous growth since 1985 makes a steady fraud amount unlikely.

The main impetus for third-party fraud is the back payments you can get when you're accepted on SSI, dating to when you first applied. You can make big money helping people get on the rolls, fraudulently or not. Coté was enraged by a billboard across from his shelter placed by a law firm "poverty pimps"encouraging people to use the firm for help in getting on the SSI dole, for a percentage of the back benefits. These huge lump-sum giveaways, which can amount to tens of thousands of dollars, can lead, Coté says, to often-fatal drinking and drug binges. After the billboard appeared in a newspaper story on SSI, the sign was taken down. Here in Los Angeles, I regularly hear radio ads for a firm encouraging people to come to them for help in getting on SSI.

There's a big "but" in the new congressionally mandated 36-month limit for DA&As. If you can prove any other psychiatric or physical disabilityand often long-term drunks or drug addicts have made themselves sickyou can get back on the rolls under that category. Even now, there are plenty of substance abusers on the rolls for reasons other than their substance abuse, and the 36 -month limit doesn't apply to them. But the possibility of their using the dole money to support damaging habits still remains.

So last year's reforms don't go nearly far enough toward ending the federal subsidization of self-damaging habits. Congress is mulling further reforms this year that might do better. The initial House bill eliminates the DA&A category and gives drug treatment money to the states instead, kicks off most noncitizens, and toughens requirements for children getting on the rolls. A bill from the Senate Finance Committee going to the floor at press time also restricts payments to DA&A and noncitizen categories. Other possibilities to stem SSI growth include sending the whole program back to the states in block grants or establishing a flexible ceiling with adjustments only for inflation and population growth. It's too early to say what's going to happen right now. But with last year's action and this year's talk, the program is beginning to feel embattled.

For good reason. SSI has been ballooning beyond any expectations. Just from 1987­93, the number of under-65 SSI clients rose 65 percent, from 2.3 million to more than 3.8 million. And the percentage of DA&As has skyrocketed in the past decade. In 1984, there were only 4,021 such on SSI. In 1991, there were 33,869; and then in just two years the number more than doubled, to 78,730 in 1993; the 1994 estimate is 101,000. That's a small percentage of the total, but it's still a lot of drunks to support. (The bulk of the others on SSI are not traditional disabilities like blindness or lack of mobility, either; 57 percent on the SSI dole are there for mental disorders.) The rise in DA&As isn't hard to figure out from talking to Coté: SSI is a drunkard's dream if I ever did see one, and Coté talks contemptuously of SSI gatekeepers with "their masters in sociology coming up against guys with doctorates in streetology."

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