Quadagno J
Pepper Institute on Aging and Public Policy, Florida State University, Tallahassee 32306, USA.
Clin Orthop Relat Res. 1997 Mar(336):11-7. doi: 10.1097/00003086-199703000-00003.
Between 1989 and 1994, Disability Insurance and Supplemental Security Income, the 2 federal programs that provide disability benefits, expanded rapidly. The largest growth has been among recipients with mental disorders in the Disability Insurance program and among children with learning disabilities in the Supplemental Security Income program. The expansion was partly due to changes in eligibility rules and partly to other factors including outreach efforts by the Social Security Administration and a lack of funds to review and terminate cases. Factors that keep many of the disabled from seeking work include a fear of being unable to obtain health insurance, which is provided to beneficiaries under Disability Insurance and Social Security Insurance, and the fear of being unable to obtain and keep stable employment. Although children's Supplemental Security Income benefits have reduced poverty in families with disabled children, there is some evidence that parents are encouraging their children to behave poorly so they can qualify. Replacing present welfare and disability programs with national health insurance and a guaranteed annual income would eliminate the work disincentives, but such dramatic restructuring is unlikely in the context of present political debates.
1989年至1994年间，提供残疾福利的两项联邦计划——伤残保险和补充保障收入迅速扩张。增长幅度最大的是伤残保险计划中的精神障碍受益者以及补充保障收入计划中的学习障碍儿童。这种扩张部分归因于资格规定的变化，部分归因于其他因素，包括社会保障管理局的宣传努力以及缺乏审查和终止案例的资金。使许多残疾人不愿找工作的因素包括担心无法获得医疗保险（伤残保险和社会保障保险会向受益人提供医疗保险），以及担心无法获得并保住稳定工作。尽管儿童补充保障收入福利减少了残疾儿童家庭的贫困状况，但有证据表明，父母在鼓励孩子表现不佳，以便他们能符合资格。用国民健康保险和有保障的年收入取代现行的福利和残疾计划将消除对工作的抑制因素，但在当前政治辩论的背景下，这种剧烈的结构调整不太可能实现。
