Articles about bureaucracy preventing people from using social services?
January 17, 2019 5:28 PM Subscribe
A thing I've thought about during my years in social services is the way many, important systems like social security disability benefits are set up in a way that makes them almost unusable and indeed unusable to people who aren't fully functional in one way or another. Is this something that has been written about?
I've had any number of clients who stopped getting social security benefits because the system itself is an impenetrable bureaucratic fortress. (At times it seems almost like this is by design, so that people will give up and not use up funds. ) I'm just wanting to see if this is something anybody else thinks, or if I am merely a loon. In the former instance, I am wanting to read the reasoning of a clearer head than mine.
I've had any number of clients who stopped getting social security benefits because the system itself is an impenetrable bureaucratic fortress. (At times it seems almost like this is by design, so that people will give up and not use up funds. ) I'm just wanting to see if this is something anybody else thinks, or if I am merely a loon. In the former instance, I am wanting to read the reasoning of a clearer head than mine.
It's not quite what you're looking for, but this article about a new medical team for people experiencing homelessness was just published in my local paper. Both the article and the project are based on your premise - there are hoops to jump through to get medical care, some people are not in a position to jump through hoops, and removing hoops is one way to improve access to healthcare. (And FWIW, I have started looking for volunteer opportunities that involve navigating bureaucracies and paperwork, on the same general principle.)
posted by mersen at 6:30 PM on January 17, 2019
posted by mersen at 6:30 PM on January 17, 2019
Automating Inequality: How High-Tech Tools Profile, Police, and Punish the Poor by Virginia Eubanks is a book where each chapter outlines a different example of this. It's quite good. Tough read just because the stories are often bleak. I talk a lot on my digital divide talks about how "economies of scale" quickly become "economies of hassle" when you get bad tech in the mix.
posted by jessamyn at 8:21 PM on January 17, 2019 [6 favorites]
posted by jessamyn at 8:21 PM on January 17, 2019 [6 favorites]
You're definitely not the only person to feel that way.
Not a book, but the critically acclaimed 1997 black comedy Gridlock'd tells the story of two heroin addicts (Tupac Shakur & Tim Roth) desperately trying to navigate government red-tape to gain access to drug rehab after watching a friend (Thandie Newton) overdose.
Writer/Director Vondie Curtis-Hall said of it:
Not a book, but the critically acclaimed 1997 black comedy Gridlock'd tells the story of two heroin addicts (Tupac Shakur & Tim Roth) desperately trying to navigate government red-tape to gain access to drug rehab after watching a friend (Thandie Newton) overdose.
Writer/Director Vondie Curtis-Hall said of it:
"It's largely autobiographical, with a lot of it coming from the time when I was a teenager in Detroit, playing guitar and singing in bands. Everybody was doing drugs. That was the way we thought we could play faster guitar, write better songs ... One day my best friend, the bassist, and I were sitting around and decided that maybe we could actually play better if we weren't stoned all the time. Next day, we went to try and get into rehab. We were doing a bit of everything and were both sixteen, living with our folks, so we couldn't give our address in case they got to know about what we were doing. So we ended up wandering around from place to place, no one giving us any help. I remembered that when it came to writing my first movie."posted by Secret Sparrow at 10:22 PM on January 17, 2019 [1 favorite]
I have to admit I have not read more than a few pages of this book (have been meaning to for 3+ years) but in my brief skimming of David Graeber's The Utopia Of Rules, Graeber appears to argue that when bureaucratic processes are designed, they are imagined in a (completely non-existent) "utopia" where everyone is always going to fill out the form correctly, and due to this misconception, bureaucracy makes life hell for humans who make mistakes (as humans do), or don't fit the intended circumstances. I'm sure he makes a whole lot of other interesting arguments and his work may resonate with you.
posted by rogerroger at 10:24 PM on January 17, 2019 [4 favorites]
posted by rogerroger at 10:24 PM on January 17, 2019 [4 favorites]
This is definitely an area of academic research, with several different literatures. For example, Armando Lara Millan wrote his PhD dissertation on how state services (hospitals, jails, etc) often redistribute poverty among agencies instead of ever resolving it. He's now an assistant professor in sociology at Berkeley.
posted by migrantology at 7:34 AM on January 18, 2019
posted by migrantology at 7:34 AM on January 18, 2019
One term sociologists & legal scholars have used for this is "bureaucratic disentitlement."
posted by schwinggg! at 7:48 AM on January 18, 2019 [4 favorites]
posted by schwinggg! at 7:48 AM on January 18, 2019 [4 favorites]
The book Scarcity: Why Having Too Little Means So Much by Sendhil Mullainathan and Eldar Shafir touches on this topic. It has been awhile since I read it, and I don't recall it being the major issue but the authors do talk about the cognitive resources to accomplish a variety of things and how scarcity, temporary or permanent, affects people and can make it basically impossible for people to adhere to various regulations and requirements. But it was not written in a way that blames the people forced to cope with scarcity.
Another example, which is probably more on the nose, comes from Arkansas. The governor's "work requirements" demand that certain Medicaid beneficiaries fill out paperwork on a monthly basis or have their health insurance taken away. The program was implemented in a way that made it nearly impossible for people to meet the requirements.
A new report out this week from the Kaiser Family Foundation examined the issue in a series of focus groups with beneficiaries and interviews with safety net health care and food assistance providers. The study found that many enrollees were unaware of the new requirements or confused about the details of what was required; those who were aware found it difficult to navigate the process of setting up the account required for the reporting. Many of those interviewed were already working or looking for work because of normal economic pressures, but none said that they had gotten jobs because of the requirements.
The state initially required electronic reporting via a web portal, which was widely reported to be glitchy, confusing, and difficult to use. It was offline every day from 9 p.m. to 7 a.m. The Arkansas Nonprofit News Network and others have reported on people who sought help from the state's Department of Human Services, only to be flummoxed by a bureaucratic trainwreck. Amid a flurry of criticism, the Hutchinson administration finally caved and began allowing telephone reporting, beginning last Thursday, though that is cold comfort to those who already lost coverage.
For residents who need access to affordable health care, the program has been terrible; more than 17,000 state residents have lost Medicaid benefits. Of course, that makes the program a huge success for the assholes who think poor people should die.
I don't think there is outright proof, at least not yet, that the system was planned to dramatically reduce the number of Arkansas residents on Medicaid. But honestly, if the people in charge do not care about the people subjected to the rules, the outcome will be similar. If you have to report electronically and do not own a computer and/or there is no mobile interface or a sucky one or you do not have access to a smartphone, or you work during the hours the web portal is offline, you are guaranteed to lose your benefits because the system is impossible for you to use.
BTW, there are more links in the article about the train wreck that is Arkansas' work requirements, which have been discussed periodically in some of the US politics megathreads.
posted by Bella Donna at 8:06 AM on January 18, 2019 [1 favorite]
Another example, which is probably more on the nose, comes from Arkansas. The governor's "work requirements" demand that certain Medicaid beneficiaries fill out paperwork on a monthly basis or have their health insurance taken away. The program was implemented in a way that made it nearly impossible for people to meet the requirements.
A new report out this week from the Kaiser Family Foundation examined the issue in a series of focus groups with beneficiaries and interviews with safety net health care and food assistance providers. The study found that many enrollees were unaware of the new requirements or confused about the details of what was required; those who were aware found it difficult to navigate the process of setting up the account required for the reporting. Many of those interviewed were already working or looking for work because of normal economic pressures, but none said that they had gotten jobs because of the requirements.
The state initially required electronic reporting via a web portal, which was widely reported to be glitchy, confusing, and difficult to use. It was offline every day from 9 p.m. to 7 a.m. The Arkansas Nonprofit News Network and others have reported on people who sought help from the state's Department of Human Services, only to be flummoxed by a bureaucratic trainwreck. Amid a flurry of criticism, the Hutchinson administration finally caved and began allowing telephone reporting, beginning last Thursday, though that is cold comfort to those who already lost coverage.
For residents who need access to affordable health care, the program has been terrible; more than 17,000 state residents have lost Medicaid benefits. Of course, that makes the program a huge success for the assholes who think poor people should die.
I don't think there is outright proof, at least not yet, that the system was planned to dramatically reduce the number of Arkansas residents on Medicaid. But honestly, if the people in charge do not care about the people subjected to the rules, the outcome will be similar. If you have to report electronically and do not own a computer and/or there is no mobile interface or a sucky one or you do not have access to a smartphone, or you work during the hours the web portal is offline, you are guaranteed to lose your benefits because the system is impossible for you to use.
BTW, there are more links in the article about the train wreck that is Arkansas' work requirements, which have been discussed periodically in some of the US politics megathreads.
posted by Bella Donna at 8:06 AM on January 18, 2019 [1 favorite]
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posted by Little Dawn at 6:13 PM on January 17, 2019 [1 favorite]