Articles from prior issues of The Advocate

November/December, 1995

Better, Faster, Cheaper Decisions?
But For WHO?
by Bill Dunn, Texas DDS

IN A SPEECH AT THE NADE conference in Portland, Maine in 10/95, SSA Associate Commissioner Susan Daniels emphasized that the American public demands changes in the disability program. Her three buzz words were BETTER, FASTER and CHEAPER. When talking about BETTER, she emphasized the need to make the right decision the first time. She was asked if that meant we should allow more claims. She denied this but then was asked to define the “right” decision. She noted it was the last decision made and she quickly added that not all people denied at the initial level appeal their decision. However, this totally ignores the fact that virtually everyone who applies thinks the “right” decision is an allowance and the majority of applicants continue to file appeals until they are allowed or run out of appeals. It ignores the fact that no one appeals a fully favorable allowance. Thus, if you want to follow the definition of Ms. Daniel’s for making the “right” decision (the last decision made), it would seem necessary to either allow more cases or do a better job of explaining why they will not be allowed. SSA feels that the Pre Denial Hearing called for by Redesign will do a better job of explaining denials. Most DDS employees feel that the Redesign process will not do this. There is basically no way to satisfy most people unless you give them what they want--an allowance.

When talking about FASTER, she gave numerous examples of how the American public demands faster service now, and gets it through such things as microwaves and ATMs. As an illustration, she described how people get irate when they wait in a line at McDonald’s and it is finally their turn at the counter, they are told they will have to wait 10 minutes for their fries. Now I know this does occur. However, I have also seen people wait for up to an hour just to be seated at the finer restaurants in town. Should one of them complain about how long it will take to be served their meal after ordering, chances are the chef may even come out and irately explain why it takes so long to prepare the quality of meal he is preparing. He would NOT rush his preparation to satisfy the customer and that customer would be advised to revise his expectations. Instead of building a McDonald’s level program, why isn’t SSA explaining to its customers why it is not possible? The American public can deal with a longer time before a decision is made if they understand why it is necessary. They will have a much harder time accepting a longer time if they are told they can expect a “final” decision in a short time. When talking about CHEAPER, Ms. Daniels explained that the American public wants more service at lower cost. She stated that the SSA disability program uses up half the SSA budget to serve 12% of its customers. However, she never explained how the redesigned process can achieve this goal of more service at a lower cost. She never addressed how SSA will afford the increased allowance rate that we see it generating. She never addressed the massive start up and switch over costs that SSA is even now incurring from this program. In fact, after listening carefully to her speak, I don’t have a clue as to how redesign will save SSA a dime.

My 18 year old daughter wants me to buy her a car. She wants a BETTER one. In fact, a brand new one would be just perfect for her. She wants it FASTER. In fact, today would be just fine. And she wants it CHEAPER. In fact, she doesn’t want to spend a dime. Now I could get her this car, BETTER, FASTER and CHEAPER or can explain to her why I’m not. If I did get it, I am pretty sure that I would score well on any survey completed by her (I am also pretty sure that I would score poorly in any survey completed by my creditors). If I do not buy her this, then it is incumbent on me to explain very clearly why. Even if I explain it very well, I don’t think that I would score well on any survey completed by her although my creditors would be greatly relieved. SSA is in the same position with the disability program as I am with my daughter’s car but it appears to be responding differently than I did. Instead of explaining why better, faster, cheaper is not the best choice, it is promising this to claimants and their advocates. There is a basic conflict between the promises they are making. It is not possible to build a system which is both better (“right” decision first time) and cheaper. When the American public (SSA’s creditors) realizes this, SSA will be in big trouble. SSA should be serving the entire nation by explaining why BETTER, FASTER, and CHEAPER is not possible.