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PubMed1981

Aged widows and OASDI: age at and economic status before and after receipt of benefits.

This article, which is based on panel data from the Retirement History Study, analyzes the economic status of widows in late middle age. Its objectives are threefold: (1) To describe the income, labor-force, and demographic characteristics of widows 2 to 3 years before they become eligible for old-age benefits under the old-age, survivors, and disability insurance (OASDI) program; (2) to examine the age at which they elect benefits and the characteristics associated with that decision; and (3) to compare their economic status before and after they begin collecting benefits. The findings show that employment during the pre-OASDI period greatly influenced a widow's benefit-timing decision. Among workers, the decision was related to earnings, occupation, job tenure, extent of employment, income from assets, pension coverage, monthly benefit amount, and work limitations. Earnings and monthly benefit amount were important pivotal variables. Although the majority of widows experienced a reduction in their standard of living after moving into beneficiary status, a sizable minority--made up mainly of the most economically disadvantaged--experienced and improvement.

Age Factors↗
PubMed1981

Federal civil service adult survivor annuitants and Social Security, December 1975.

This article reviews the recent experience of adult survivor annuitants under the Federal civil service retirement program. Data are presented for such persons in terms of their status in December 1975 as primary beneficiaries, secondary beneficiaries, or nonbeneficiaries under the Old-Age, Survivors, and Disability Insurance (OASDI) program. Analysis reveals that 63 percent of the survivor annuitants were dual beneficiaries-that is, they received an OASDI benefit as well as an annuity payment. About half the remaining annuitants were permanently insured under the OASDI program, so it can be anticipated that at least four-fifth of the Federal civil service survivor annuitants ultimately will also receive an OASDI benefit. The survivor annuity replaced 27 percent of a decreased spouse's Federal civil service salary at the median. The median replacement rate of annuity plus OASDI benefit was 48 percent of civil service salary.

Aged↗
PubMed1994

The influence of Social Security benefits and SSI payments on the poverty status of children.

This is the first of two articles that will examine the effect that the Old-Age, Survivors, and Disability Insurance (OASDI--Social Security) and the Supplemental Security Income (SSI) programs have in maintaining the income of poor and near poor families with children at a level that is at least equal to the poverty threshold. The articles also will evaluate the extent to which these programs augment the income of those families that receive benefits but who still remain below the poverty line, and look at the interaction between the OASDI and SSI programs and other income transfer programs, such as Aid to Families with Dependent Children (AFDC) and the Food Stamp program. The primary data source for this article is the second wave of the 1990 panel of the Survey of Income and Program Participation (SIPP). The principal findings are as follows: (1) During May 1990, OASDI and SSI benefit payments sustained the income of 1.1 million children above the poverty level; (2) these programs alleviated the effects of poverty for an additional 1.3 million children in families whose income remained below the poverty level; and (3) a significant proportion of those families that received OASDI and SSI benefits received additional assistance from other means-tested programs. This article looks only at survey data. The second article will consider survey data matched with SSA administrative records.

Adolescent↗
PubMed1994

The socioeconomic impact of rehabilitation.

Rehabilitation of patients with end-stage renal disease (ESRD) should encompass all aspects of the patient's well-being and include vocational, physical, and medical therapies. This would be best achieved by careful management of the patient before the start of dialysis, as well as by provision of adequate dialysis in the most appropriate setting for the individual patient's needs. Before starting dialysis, blood pressure should be well controlled, nutrition maintained, and human recombinant erythropoetin (epoetin) used as necessary to prevent the development of anemia. In patients who are employed, efforts should be made to maintain employment, and vocational counseling should be provided to unemployed patients who are capable of work. Physical well-being should be maintained by encouraging participation in an exercise program. Social, financial, and other counseling should be provided as necessary, together with patient education regarding treatment, including modalities and other aspects of care. The social impact of these efforts primarily will be on the patient's quality of life, and secondarily, on family members and friends. Quality of life depends on many factors, including modality of treatment and adequacy of dialysis. Economic impact also depends on many factors. Providing optimal care before starting dialysis, including the use of epoetin where appropriate, will increase the cost both for drugs and staff. For patients who are able to continue working or can be successfully retrained, these costs will be offset to some degree in the future by taxes paid by the patient and by the patient not participating in the Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1994

The role of the nephrologist in patient rehabilitation.

The justification for the enactment of the End-Stage Renal Disease (ESRD) Program in 1972 was to provide the lifesaving potential of dialysis and transplant to patients with terminal renal failure. Implied as a return on cost was that many of those whose lives were prolonged would contribute to society through work and taxes. It is not surprising at a time of growing concern about health-care costs that vocational rehabilitation for patients undergoing dialysis and transplant has again come to the attention of Congress and others. The nephrologist, the leader of the health-care team caring for patients on dialysis and outpatients with transplants, plays a crucial role if an increasing number of patients are to be rehabilitated. The attitudes of the nephrologist can establish the belief in staff and suitable patients for or against the possibility of attending school, retraining, or working. Identification of medical problems as impediments to rehabilitation and their resolution, where possible, is an essential function of the nephrologist and other team members. Any process that seems at first glance to be difficult requires an evangelist if success is to come. The nephrologist must be the primary motivator. There are a number of extrinsic barriers to rehabilitative success including employer health insurance, disability regulations, and attitudes toward people with disabilities. The nephrologist, as a respected figure and patient advocate, must be willing to deal aggressively with these barriers whenever the occasion arises.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1994

Social Security and the emigration of immigrants.

Each year the Social Security Administration forecasts the financial status of the Old-Age, Survivors, and Disability Insurance (OASDI) programs by projecting trends in key variables such as the labor-force participation and earnings of the U. S. population. In the difficult task of projecting the long-term financial status of Social Security, assumptions are made concerning the relationship of immigrants to Social Security. An important aspect of that relationship is the emigration of immigrants. This article describes the general assumptions related to the level and timing of emigration that underlie projections of Social Security's financial status and examines how closely these assumptions fit research findings based on a variety of data sources. Previous trends in emigration and factors that may affect current and future levels of emigration are described. The article also presents theoretical expectations and empirical evidence concerning the timing of emigration.

Adult↗
PubMed1993

Human immunodeficiency virus transmission between surgeons and patients in orthopaedic surgery.

Surgeons are at risk for contracting human immunodeficiency virus (HIV) from patients. The risk of HIV transmission between patient and surgeon and the potential strategies to reduce the risk of HIV transmission are important. Continuous occupational exposure makes the risk of HIV transmission greater for surgeons than patients. Although the risk of seroconversion after a single exposure is relatively low, the risk for surgeons is more appropriately expressed as a cumulative lifetime risk. The estimated cumulative risk of HIV seroconversion for surgeons may be as high as 1 to 4%. Currently available strategies to prevent HIV transmission require knowledge of the mechanisms of exposure. Adequate barriers, such as double-gloving, waterproof outerwear, and face protection, should be worn for most, if not all, orthopaedic procedures. Additional specific strategies, however, are required to minimize sharp injuries. Surgeons should report any significant exposure to the occupational health department of their institution. Hospitals should have appropriate guidelines and procedures for counseling exposed surgeons, HIV testing of source patients, consideration of zidovudine prophylaxis, and disability insurance policies for surgeons who are occupationally infected with HIV.

Gloves, Surgical↗
PubMed1993

The HIV-infected house officer: residency training issues.

Efforts to fully integrate physicians infected with the human immunodeficiency virus (HIV) into residency programs have been complicated by concerns of the potential risks of viral transmission from physician to patient. Despite numerous studies, this potential risk has not been quantified. This article addresses the issue of HIV-infected interns and residents, classifying HIV as a potential disability. The suggested recommendations emphasize routine monitoring and evaluation of professional competence and compliance with proper infection control procedures, as delineated by the Centers for Disease Control and Prevention. The need for hospitalwide guidelines and adequate health and disability insurance are also discussed.

Female↗
PubMed1995

The influence of OASDI and SSI payments on the poverty status of families with children.

This is the second of two articles on the effects of Old-Age Disability Insurance (OASDI) and Supplemental Security Income (SSI) payments on the poverty status of children. Based primarily on a data file from the 1990 SIPP matched with Social Security Administration (SSA) administrative records, the principal findings in the article are that: (1) the families of children who were entitled to survivors benefits, and in particular those families in which the surviving parent was remarried, were much less likely to have income below the poverty threshold than other families with children who received OASDI benefits; (2) families with a child eligible for SSI payments, and headed by a single adult, received considerably less income from earnings, and had less income overall, than other families with children that received SSI payments; and (3) the primary reason that some families who received OASDI and SSI benefits remained in poverty was the absence of any employed family member.

Adolescent↗
PubMed1977

Aid to families with dependent children: an overview, October 1977.

In 1977, reorganization of the Department of Health, Education, and Welfare brought together in the Social Security Administration three major income-maintenance system--old age, survivors, and disability insurance; supplemental security income; and aid to families with dependent children. These are distinct and separate programs differing in purpose and in methods of financing and administration but often serving different members of the same household. The Federal-State program for aid to families with dependent children program (AFDC) is a grant-in-aid program and in many ways reflects the local policies in the 54 States and jurisdictions in both administration and levels of payments. This article outlines its national structure and variations in the program and describes how this cash assistance program operates to provide income for more than 11.2 million needy recipients in 3.6 million families, including almost 8 million children. In May 1977, program payments totaled about $840 million a month.

Aid to Families with Dependent Children↗
PubMed2004

[Genetic screening of patients with familial hypercholesterolemia and insurability for life insurance policies and disability cover policies].

In the Netherlands, people with familial hypercholesterolaemia (FH) have been actively screened since 1994 by means of DNA analysis. Recently, the Stichting Opsporing Erfelijke Hypercholesterolemie (Foundation for the Detection of Familial Hypercholesterolaemia) initiated a large scale-screening programme aimed at finding all 40,000 people. The Dutch ministry of Health, Welfare and Sport is providing the financial support. Genetic screening has social implications and raises questions on insurability. The Dutch Medical Examination Act prohibits insurers from posing questions about untreatable, serious inheritable conditions for insured sums under a certain value: for life-insurance policies < [symbol: see text] 150,000 and for disability-cover policies < [symbol: see text] 30,000 in the 1st year and < [symbol: see text] 20,000 in the 2nd year and following years. The Health Council of the Netherlands has defined FH as a serious disease, but one which responds well to treatment. Therefore insurers can request information for the purpose of an accurate risk classification. Insurance contracts can be accepted at normal rates if the target value of LDL-cholesterol < 4 mmol/l and additional risk factors such as smoking and an abnormal BMI are absent; the risk is determined by the phenotype and clinical factors and not by the genotype.

DNA Mutational Analysis↗
PubMed1985

Relationship between the retirement, disability, and unemployment insurance programs: the U.S. experience.

This article was prepared initially for an international conference of social security program administrators and researchers. They examined the reasons for, and implications of, a recent trend in several European countries toward making it easier to qualify for retirement or disability benefits as a way of alleviating long-term unemployment. The article notes that the United States has not followed this trend. Instead, this country has continued to use temporary extensions of unemployment insurance benefits as a way to help the long-term unemployed during recessionary periods. Since the mid-1970's, the emphasis in retirement and disability insurance programs has been to strengthen the financial integrity of these programs rather than to expand eligibility. Described here are the progression of extended benefit provisions of unemployment insurance through the most recent recession, the historical development of early retirement features in the social security program, and the more recent attention that has been paid to the financing issues that have played a central role in legislation during the late 1970's and early 1980's. Unemployment experience and trends toward early retirement are examined, along with the role of public and private employee pension plans that supplement social security retirement benefits. Preliminary data from the Social Security Administration's New Beneficiary Survey show the prevalence of such pension coverage for recent retirees and the extent to which these pension benefits were claimed before normal retirement age.

Adolescent↗