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Do SSI Requirements Force Parents to Medicate Their Children? Part One

As we have previously discussed in this blog, Supplemental Security Income (SSI) benefits can often be a lifeline for families struggling to make ends meet. When compared to other public benefit programs, SSI usually comes out on top. For example, an average parent with two children can expect approximately $600 per month from welfare checks. If just one of those two children receives SSI, monthly payments can double. Yet some health advocates and government officials are worried that parents are taking it too far, placing their children on medication they don't need solely to be approved for SSI benefits.

SSI for disabled children was created in 1972, when Congress began work on a Supplemental Security Income program for disabled and blind adults and the elderly. At the last minute, lawmakers added disabled children to the list, with the intent that the financial benefits provided would help make up income lost by indigent parents due to the extra care required by a child with a severe physical or congenital disability such as cerebral palsy or muscular dystrophy.

Until a 1990 U.S. Supreme Court decision proclaiming that the eligibility rules were too strict, SSI served only a small number of the most seriously disabled children. However, after the landmark ruling, the floodgates opened. In the mid-1990s, Congress reacted to the increase. Legislators raised the standards for children with mental disability disorders, stating that a child had to "exhibit a medically determinable disability with marked and severe limitations".

Yet despite the new eligibility requirements, the number of children who qualified for SSI under behavioral, mental and learning disorders more than tripled between 1997 and 2008, from 180,000 to over 550,000. Many believe that families quickly learned to place their child on a medication in order to prove that they had such a disability, leading to the severe overmedication of children.

According to MIT economics professor David Autor, the strict SSI requirements may be causing more harm than good. "This is a very valuable resource for families, but you're providing incentives for them to produce a diagnosis for their children to be part of this program, and there's also incentives to medicate them," he said. "This is a substantial public policy problem."

Source: The Boston Globe, "A legacy of unintended side effects", Patricia Wen, 12 December 2010

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