In news that shouldn't surprise anyone, politicians sometimes enact laws that have negative consequences. Levitt and Dubner are at it again in this week's New York Times Magazine analyzing three distinct laws and how they actually hurt the parties they are intended to help.
They begin by discussing the American Disabilities Act and how it actually seems to hurt the disabled in many circumstances:
A few months ago, a prospective patient called the office of Andrew
Brooks, a top-ranked orthopedic surgeon in Los Angeles. She was having
serious knee trouble, and she was also deaf. She wanted to know if her
deafness posed a problem for Brooks. He had his assistant relay a
message: no, of course not; he could easily discuss her situation using
knee models, anatomical charts and written notes.
The woman later
called again to say she would rather have a sign-language interpreter.
Fine, Brooks said, and asked his assistant to make the arrangements. As
it turned out, an interpreter would cost $120 an hour, with a two-hour
minimum, and the expense wasn’t covered by insurance. Brooks didn’t
think it made sense for him to pay. That would mean laying out $240 to
conduct an exam for which the woman’s insurance company would pay him
$58 — a loss of more than $180 even before accounting for taxes and
overhead.
So Brooks suggested to the patient that they make do
without the interpreter. That’s when she told him that the Americans
With Disabilities Act (A.D.A.) allowed a patient to choose the mode of
interpretation, at the physician’s expense. Brooks, flabbergasted,
researched the law and found that he was indeed obliged to do as the
patient asked — unless, that is, he wanted to invite a lawsuit that he
would probably lose.
If he ultimately operated on the woman’s
knee, Brooks would be paid roughly $1,200. But he would also then need
to see her for eight follow-up visits, presumably with the $240
interpreter each time. By the end of the patient’s treatment, Brooks
would be solidly in the red.
He went ahead and examined the
woman, paying the interpreter out of his pocket. As it turned out, she
didn’t need surgery; her knee could be treated through physical
therapy. This was a fortunate outcome for everyone involved — except,
perhaps, for the physical therapist who would have to pay the
interpreter’s bills.
Brooks told several colleagues and doctor friends about his deaf
patient. “They all said, ‘If I ever get a call from someone like that,
I’ll never see her,’ ” he says. This led him to wonder if the A.D.A.
had a dark side. “It’s got to be widely pervasive and probably not
talked about, because doctors are just getting squeezed further and
further. This kind of patient will end up getting passed on and passed
on, getting the runaround, not understanding why she’s not getting good
care.
And "surprisingly", the ADA led to a drop in the employment of disabled workers:
Their conclusion was rather startling and makes Andrew Brooks’s hunch
ring true. Acemoglu and Angrist found that when the A.D.A. was enacted
in 1992, it led to a sharp drop in the employment of disabled
workers. How could this be? Employers, concerned that they wouldn’t be
able to discipline or fire disabled workers who happened to be
incompetent, apparently avoided hiring them in the first place.
This has been going on for a long time. Read the entire piece.
