490: Trends With Benefits - This American Life
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00:00 00:00 Transcript Share This American Life Life Partners How to Listen Episodes Recommended About Overview Staff Announcements Fellowships Jobs Music Make Radio On The Road FAQ Submissions Merch Contact Us Our Other Shows Merch Follow Us Life Partners Subscribe to our newsletter Full episode Toggle Audio and Transcript Sync Transcript | Episode #490 | March 22, 2013 490: Trends With Benefits Note: This American Life is produced for the ear and designed to be heard.
00:00 00:00 文字记录 分享此 美国生活 生活伙伴 如何收听 剧集 推荐 关于 概述 员工公告 奖学金 工作 音乐 在路上制作电台 常见问题解答 提交 商品 联系我们 我们的其他节目 商品 关注我们 生活伙伴 订阅我们的时事通讯 整集 切换音频和文字记录同步 文字记录 | 内容第 490 集 | 2013 年 3 月 22 日 490：趋势与好处 注：This American Life 是为耳朵而生，旨在让人们听到。
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如果可以的话，我们强烈建议您收听音频，其中包括页面上没有的情感和重点。
Transcripts are generated using a combination of speech recognition software and human transcribers, and may contain errors.
文字记录是使用语音识别软件和人工转录员结合生成的，可能包含错误。
Please check the corresponding audio before quoting in print.
请在印刷版引用前检查相应的音频。
Prologue Ira Glass OK, here's a weird fact that one of the reporters that we work with around here stumbled upon.
序言 Ira Glass 好吧，这是一个奇怪的事实，是我们在这里工作的一位记者偶然发现的。
There are these little pockets all over the country where like 20%, 25% of the people in a given county are on disability.
全国各地都有这样的小地方，某个县大约有 20%、25% 的人患有残疾。
They get government checks for disability.
他们获得政府的残疾检查。
For example, Hale County, Alabama.
例如，阿拉巴马州黑尔县。
Nearly one in four working age people are not working, because they're disabled.
近四分之一的工作年龄人口没有工作，因为他们患有残疾。
One in four.
四分之一。
What is going on there?
那里发生了什么事？
Well, last fall, this reporter, Chana Joffe-Walt, who's with Planet Money, she went to Hale county to try to figure out what was going on there.
去年秋天，Planet Money 的记者查娜·乔菲-沃尔特 (Chana Joffe-Walt) 前往黑尔县，试图了解那里发生的事情。
And her experience there was the beginning of a six-month-long obsession with our nation's disability programs.
她在那里的经历开始了她对我们国家残疾人计划长达六个月的痴迷。
Hey there, Chana.
嘿，查娜。
Hello.
你好。
Ira Glass So these are government checks going out every month to a fourth of the population of this county.
Ira Glass 因此，这些是政府每月向该县四分之一的人口发放的支票。
Of this county and other counties.
本县及其他县。
There are other counties and towns like this.
类似情况的县、镇还有很多。
And the disability programs that are run by Social Security, if you could prove to the Social Security Administration that your disability prevents you from holding down a job, the government will pay you money.
而社会保障管理的残疾人计划，如果你能向社会保障管理局证明你的残疾使你无法保住工作，政府就会付钱给你。
The average people get is about $1,000 a month.
人们平均每月领取约1,000美元。
And the government also covers your health care.
政府还承保您的医疗保健。
They cover your health care benefits, yeah.
是的，它们涵盖您的医疗保健福利。
I didn't realize that.
我没有意识到这一点。
Chana Joffe-Walt Yeah, and in Hale County, people have all kinds of theories why this might be.
Chana Joffe-Walt 是的，在黑尔县，人们有各种各样的理论来解释为什么会这样。
Why one in four adults are on disability.
为什么四分之一的成年人患有残疾。
And are freeloaders on the list?
贪图便宜的人也在名单上吗？
Is that it?
是这样吗？
Freeloaders, fakers, people who are faking disability was always the number one theory.
贪图便宜者、骗子、假装残疾的人始终是第一理论。
Oh I don't know.
哦，我不知道。
Don't get talking to me on that.
别跟我谈论这个。
But hey, there's people on disability in this town that I can write a list out is able as much to work as I am.
但是，嘿，这个镇上有一些残疾人，我可以写一份清单，他们和我一样可以工作。
It's going to ruin the country.
会毁了国家的。
This is John Jay.
这是约翰·杰伊。
He's a fit guy in his 70s.
他是一个70多岁的健康人。
I met him in Greensboro, the county seat in Hale County.
我在霍尔县县城格林斯伯勒遇见了他。
And John Jay is the head of the utilities board in Greensboro.
约翰·杰伊是格林斯博罗公用事业委员会的负责人。
He used to be the mayor.
他曾经是市长。
He sits on the board of a local bank.
他是当地一家银行的董事会成员。
Basically, a guy who is used to people listening to him.
基本上，他是一个习惯了别人听他讲话的人。
And he has some theories he wanted to share.
他有一些想要分享的理论。
Is it OK with you that I'm recording?
我录音你同意吗？
I'm doing a story for the radio.
我正在为电台做一个故事。
You just have anything you want, I say.
我说，你只要想要什么就可以了。
Because I'll tell anybody to the world.
因为我会告诉全世界的任何人。
I'll get out there in front of the thing.
我会在那个东西前面出去。
But doctors, oh, whoa, my shoulder hurts and my knee hurts, doctor.
但是医生，哦，哇，我的肩膀疼，我的膝盖疼，医生。
I just can't work no more.
我只是不能再工作了。
Can you get me on disability?
你能帮我解决残疾问题吗？
And they keep going back and back, and they'll put him on disability.
他们不断地来来回回，他们会让他残疾。
And then nobody comes checks them.
然后没有人来检查它们。
OK, so fakers is one theory.
好的，造假者是一种理论。
Chana Joffe-Walt So fakers is one theory.
Chana Joffe-Walt 所以造假者是一种理论。
But there were actually lots of theories.
但实际上有很多理论。
I sat in on dozens of conversations like this where people were just trying to explain the high numbers to themselves.
我参加了数十次这样的对话，人们只是试图向自己解释如此高的数字。
For instance, a group of ministers I met in a coffee shop were sitting around wondering if it was because of the food.
例如，我在一家咖啡店遇到的一群部长围坐在一起，想知道这是否是因为食物的原因。
It's very hard to find healthy food in Hale County.
在黑尔县很难找到健康食品。
There's lots of obesity.
肥胖的情况很多。
I heard there's something in the water in Hale County.
我听说黑尔县的水里有东西。
I sat with one couple on beach chairs on their porch, and the wife, [INAUDIBLE] said, it could be because people here just live life full force.
我和一对夫妇坐在门廊的沙滩椅上，妻子[听不清]说，这可能是因为这里的人们生活得很充实。
But as she was talking, her husband, Cecil, was shaking his head
但当她说话时，她的丈夫塞西尔却在摇头
Like I said, we was always hard playing, hardworking.
就像我说的，我们总是努力踢球，努力工作。
I don't know what that's got to do with the thing.
我不知道这和这件事有什么关系。
Well, we did things to our bodies that we shouldn't have done.
好吧，我们对自己的身体做了一些不应该做的事情。
Drinking, smoking.
喝酒、抽烟。
You think people in Hale County just drank and smoked, nobody else did?
你认为黑尔县的人只是喝酒抽烟，其他地方没有人这样做吗？
No, but my age group.
不，但我的年龄段。
Cecil Then what's the difference?
塞西尔 那么有什么区别呢？
So I drank and smoked too.
所以我也喝酒、抽烟。
Female Speaker Yeah.
女议长 是啊。
I was just saying how we lived.
我只是说我们是如何生活的。
That's--
那是——
Same everywhere else.
其他地方都一样。
Chana Joffe-Walt People do smoke in Hale County.
查纳·乔夫-沃尔特 (Chana Joffe-Walt) 黑尔县的人们吸烟。
There is lots of obesity in Hale County.
黑尔县有很多肥胖者。
I think there are definitely people who are faking a disability.
我认为肯定有人在假装残疾。
But the reality is much more complicated.
但现实要复杂得多。
One in four people in Hale County are disabled because of this much bigger story happening in our country overall.
黑尔县四分之一的人是残疾人，因为这个更大的故事正在我们国家发生。
And that's why six months later you're still talking about disability programs.
这就是为什么六个月后你仍然在谈论残疾计划。
It is.
这是。
Because I feel like what I figured out is that these numbers and the growth of disability programs overall tells a story about the economy that's very different from the one we usually hear.
因为我觉得我发现这些数字和残疾人计划的增长总体上讲述了一个与我们通常听到的非常不同的经济故事。
Run me through the numbers.
让我了解一下这些数字。
Chana Joffe-Walt OK, so the growth numbers are pretty staggering.
Chana Joffe-Walt 好的，所以增长数字相当惊人。
Some of this is the Baby Boomer generation.
其中一些是婴儿潮一代。
As they age, more and more of them qualify as disabled.
随着年龄的增长，越来越多的人符合残疾人资格。
Because, basically when any generation gets older, they get more disabled.
因为，基本上，当任何一代人变老时，他们都会变得更加残疾。
Exactly.
确切地。
But Baby Boomers is a big generation.
但婴儿潮一代是一代人。
Still, it doesn't explain all the growth.
尽管如此，它并不能解释所有的增长。
Today there are 14 million Americans receiving payments for a disability.
如今，有 1400 万美国人领取残疾补助金。
Fast.
快速地。
The number of workers on disability has basically been doubling every 15 years.
残疾工人的数量基本上每15年翻一番。
And part of what's surprising about that is that it's happened despite all these other factors that you'd think would have exactly the opposite effect.
令人惊讶的部分原因在于，尽管存在所有其他你认为会产生完全相反效果的因素，但它还是发生了。
That would take people off of disability.
这将使人们摆脱残疾。
Right.
正确的。
And that would drive the numbers down.
这会导致数字下降。
For instance, the Americans with Disabilities Act.
例如，《美国残疾人法案》。
Remember, that's supposed to ban discrimination against people with disabilities.
请记住，这应该禁止对残疾人的歧视。
So you would think, in theory, that more disabled people would be working because of that.
所以你会认为，从理论上讲，更多的残疾人会因此而工作。
But during this period, the numbers grew?
但在这期间，人数却增长了？
But during that period, the numbers grew.
但在那段时期，数字有所增长。
In the 1990s, unemployment declined, crime declined, welfare was down, the economy was doing great.
20 世纪 90 年代，失业率下降，犯罪率下降，福利下降，经济表现良好。
And the numbers still grew?
而且数字还在增长？
Chana Joffe-Walt And the numbers grew during the 1990s.
Chana Joffe-Walt 这个数字在 20 世纪 90 年代有所增长。
And there are so many more services available to people who have disabilities.
而且还有更多服务可供残疾人士使用。
We have perfected artificial hips and knees to help people walk.
我们已经完善了人工臀部和膝盖来帮助人们行走。
And we have better hearing aids to help people hear.
我们有更好的助听器来帮助人们听到声音。
And computer programs that read for blind people from their computers.
以及为盲人从计算机上读取内容的计算机程序。
And as all this is coming in, the disability numbers still grow.
随着这一切的发生，残疾人数仍在增加。
The disability numbers have still been growing and growing and growing.
残疾人数仍在不断增加。
And we have barely paid attention to this.
而我们却几乎没有注意到这一点。
The number of disabled workers is not reported alongside unemployment data or welfare numbers or jobs numbers.
残疾工人人数没有与失业数据、福利数字或就业数据一起报告。
Oh, that's right.
哦，是这样。
You never hear these numbers on the news.
你永远不会在新闻中听到这些数字。
Never.
绝不。
So it's basically 14 million people who do not show up in any of the places that we look to to explain how things are going, to tell us how our economy is doing.
因此，基本上有 1400 万人没有出现在我们希望解释事情进展情况、告诉我们经济状况的任何地方。
And the jobs numbers, that's the thing that we pay a lot of attention to right now.
就业数据是我们现在非常关注的事情。
The monthly disability numbers are just as big.
每月的伤残人数同样庞大。
Since the economy began its slow, slow recovery in late 2009, we have been averaging about 150,000 jobs created per month.
自 2009 年底经济开始缓慢复苏以来，我们平均每月创造约 15 万个就业岗位。
In that same period every month, almost 250,000 people have been applying for disability.
每个月同一时期，有近 25 万人申请残疾。
Wait, wait, wait.
等等，等等，等等。
It's 150,000 new jobs created every month, and it's 250,000 people applying for disability every month?
每月创造15万个新就业岗位，每月有25万人申请残疾？
Right.
正确的。
Every month 250,000 people want to be on the disability programs.
每个月有 250,000 人希望加入残疾人计划。
OK, so you're saying this massive change has been unfolding for 30 years, right?
好吧，你是说这种巨大的变化已经发生了 30 年，对吗？
It's millions of people, hundreds of billions of dollars?
是数百万人，数千亿美元？
Most of us have no idea that this is happening.
我们大多数人都不知道这种情况正在发生。
And so today on our program, we're going to look at why these numbers are ballooning, why so many people are going on to disability.
因此，今天在我们的节目中，我们将探讨为什么这些数字不断膨胀，为什么这么多人会陷入残疾。
I have to say, this is a view of the country that upends a lot of the stories that we tell ourselves about the economy, that we hear about the economy.
我不得不说，这种对国家的看法颠覆了我们告诉自己、听到的许多有关经济的故事。
From WBEZ Chicago, it's This American Life, distributed by Public Radio International.
这是来自芝加哥 WBEZ 的《This American Life》，由国际公共广播电台发行。
I'm Ira Glass.
我是艾拉·格拉斯。
Stay with us for this hour.
和我们一起度过这个小时。
Chana Joffe-Walt has been trying to figure this out for a half of a year.
查纳·乔夫-沃尔特 (Chana Joffe-Walt) 半年来一直在试图解决这个问题。
She will be our guide.
她将成为我们的向导。
Here she is.
她在这里。
Hale County, Alabama is a place where people have nicknames.
阿拉巴马州的黑尔县是一个人们有绰号的地方。
Where people tell you whether the man they just mentioned is white or black before they tell you his last name.
人们在告诉你他们刚才提到的那个人的姓氏之前，会先告诉你他是白人还是黑人。
And it's a place so deeply shaped by the fact that one in four adults are disabled.
四分之一的成年人患有残疾，这一事实对这个地方产生了深刻的影响。
That fact explains daily life in town.
这一事实解释了镇上的日常生活。
It's why the banks are open late on the first and the third of the month, when the disability checks come in.
这就是为什么银行在每个月的第一天和第三天营业到很晚的时候，也就是伤残支票发放的时候。
It's why it's hard to find a parking spot on Main Street that entire week, and grocery carts are always full to the brim.
这就是为什么整个星期在大街上都很难找到停车位，而且杂货车总是满满的。
Pam Dorr moved to Hale County 10 years ago.
帕姆·多尔 (Pam Dorr) 十年前搬到了黑尔县。
And she didn't know the disability numbers when she arrived.
当她到达时，她并不知道残疾号码。
So she spent her first year so totally confused about the local economy.
因此，她第一年对当地经济感到非常困惑。
Well, I love yard sales, and I'm such a crazy yard saler.
嗯，我喜欢庭院旧货出售，而且我是一个疯狂的庭院旧货出售者。
But I'd be on my bike the third weekend of the month or the fourth weekend of the month, and there'd be no yard sales.
但我会在这个月的第三个周末或第四个周末骑自行车，而且不会有庭院销售。
I'd be like really?
我真的会这样吗？
What's going on?
这是怎么回事？
And then I'd notice the first of the month, every place in town had a yard sale.
然后我注意到这个月的第一天，镇上的每个地方都有庭院旧货出售。
So it just took me a while to understand why.
所以我花了一段时间才明白为什么。
If you live in Hale County, and you've got an old TV or armchair you're looking to sell, you put it out when you know the neighbors have money to spend.
如果您住在黑尔县，并且您有一台旧电视或扶手椅想要出售，那么当您知道邻居有钱可以花时，您就会把它卖掉。
A retired judge in town, Sonny Ryan, told me here is what Hale County's got-- lawyers and trees.
镇上的一位退休法官桑尼·瑞安 (Sonny Ryan) 告诉我，这就是黑尔县所拥有的——律师和树木。
One gets you your disability, the other keeps you breathing.
一个让你残疾，另一个让你呼吸。
Judge Ryan's court didn't hear disability cases.
瑞安法官的法庭没有审理残疾案件。
But he says it came up all the time anyway.
但他说无论如何，这个问题一直都在出现。
When they would come to court, I'd say, where do you work?
当他们出庭时，我会问，你在哪里工作？
I'm on disability.
我是残疾人。
I'd just shake my head, and I would say sometimes to the clerk, I wonder what his disability is, because he doesn't look like he's disabled to me.
我只是摇摇头，有时我会对店员说，我想知道他的残疾是什么，因为在我看来他并不像有残疾。
When you live in a place where disability is so common, the question inevitably arises, how come I'm working, and you're not?
当你生活在一个残疾如此普遍的地方时，不可避免地会出现这样的问题：为什么我在工作，而你却没有？
I remember I had one guy in court one day.
我记得有一天法庭上有一个人。
And I mean he was robust looking.
我的意思是他看上去很健壮。
And I said, just out of curiosity, what is your disability?
我说，出于好奇，你有什么残疾？
I have high blood pressure.
我有高血压。
I said, so do I.
我说，我也一样。
I said, what else?
我说那还有什么？
He says, I have diabetes.
他说，我有糖尿病。
I said, so do I.
我说，我也一样。
What else?
还有什么？
The reason this question can come up at all is that disability is basically a made up concept.
这个问题之所以会出现，是因为残疾基本上是一个虚构的概念。
There's no diagnosis called disability.
没有所谓的残疾诊断。
There's not a blood test you can take.
您无法进行血液检查。
You don't go to the doctor and the doctor says, well, we've run the tests, and it looks like you have disability.
你不去看医生，医生就会说，好吧，我们已经做了检查，看起来你有残疾。
It is, by definition, squishy.
根据定义，它是软的。
Squishy enough that you can end up with one person with high blood pressure who's labeled disabled and another who's labeled judge.
足够软弱以至于你最终可能会遇到一个患有高血压的人被贴上残疾人的标签，而另一个人则被贴上法官的标签。
When it comes down to it, all disability is is the label we as a society give to people who, when we hear their story, we decide they've suffered enough, and it's not fair to make them work anymore.
归根结底，所有残疾都是我们作为一个社会给那些人贴上的标签，当我们听到他们的故事时，我们认为他们已经受够了痛苦，让他们再工作是不公平的。
I was in a 1990 Jeep Cherokee Laredo.
我开着一辆 1990 款吉普切诺基 Laredo。
I flipped it both ways.
我把它双向翻转了。
Flew 165 feet from the Jeep, going through 12,000 to 14,000 volts of electrical lines.
距离吉普车 165 英尺，穿过 12,000 至 14,000 伏的电线。
Then I landed into a briar patch.
然后我降落在一片荆棘丛中。
This is Dane Mitchell.
这是戴恩·米切尔。
He's a 23-year-old in a Greensboro coffee shop.
他是一名 23 岁的年轻人，在格林斯伯勒的一家咖啡馆里工作。
And you just feel like, meeting him, OK buddy, you have earned it.
你只是觉得，遇见他，好吧，伙计，你赢得了它。
And he's not even done.
他甚至还没有完成。
I broke all five of my right toes, my right hip, 7 of my vertebrae, shattering one, breaking a right rib, punctured my lung, and then I cracked my neck.
我折断了我所有的五个右脚趾、我的右臀部、我的七块椎骨，打碎了一根，折断了右肋骨，刺穿了我的肺，然后我折断了我的脖子。
So I'm on disability for that very reason.
所以我就是因为这个原因而残疾的。
I talked to person after person on disability in Hale County.
我与黑尔县的一个又一个残疾人进行了交谈。
And there were plenty of stories like this, where it's like if anyone deserves disability, it is this person in front of me.
有很多这样的故事，如果有人应该残疾，那就是我面前的这个人。
But there was a range.
但有一个范围。
There were definitely stories where it just didn't seem that clear.
肯定有一些故事看起来不太清楚。
It seemed bad, but maybe not bad enough?
看起来很糟糕，但也许还不够糟糕？
It was hard to tell.
很难说。
A car hit us from behind.
一辆车从后面撞到了我们。
I felt it right then.
我当时就感觉到了。
I got about five herniated discs in my back.
我的背部有大约五个椎间盘突出。
So that's what disabled me, the herniated disc in my back.
这就是我背部突出的椎间盘突出的原因。
And that was the end of my work.
我的工作就这样结束了。
I sat with lots and lots of women in Hale County who told me how their backs kept them up a night.
我和黑尔县的很多女性坐在一起，她们告诉我她们的背部如何让她们彻夜难眠。
Made it hard for them to stand on the job, to lift children, to lift the elderly.
让他们很难站立工作、抬起孩子、抬起老人。
I used to cry to try to work.
我曾经哭着尝试工作。
It was so painful.
太痛苦了。
I would cry at work.
我会在工作中哭泣。
I was hurting so bad, I would cry.
我真的很痛，我会哭。
Because they didn't allow us to sit down.
因为他们不让我们坐下。
Our job was to stand.
我们的工作就是站立。
I met people who filleted fish at the fish plant with shoulder injuries, had asthma attacks, diabetes, and lots of back pain.
我遇到了一些在鱼厂切鱼的人，他们肩部受伤，患有哮喘、糖尿病和严重的背痛。
Back pain is everywhere.
背痛无处不在。
The number of people suffering from disabling back pain in Alabama doubled in 10 years.
阿拉巴马州患有致残性背痛的人数在 10 年内翻了一番。
But it's confusing.
但这很令人困惑。
I have back pain.
我有背痛。
My editor has a herniated disc, and he works harder than anyone I know.
我的编辑患有椎间盘突出，他比我认识的任何人都更努力。
So who gets to decide this?
那么谁来决定这个呢？
Who decides if the story, the condition, is bad enough?
谁来决定故事、条件是否足够糟糕？
Who makes that determination?
谁做出这个决定？
Well, in Hale County, it basically seems like there's one guy, a man whose name was mentioned in almost every story people told me about becoming disabled, Dr. Perry Timberlake.
嗯，在黑尔县，基本上似乎有一个人，他的名字几乎在人们告诉我的每个关于残疾的故事中都被提及，他就是佩里·汀布莱克博士。
He saw Dr. Timberlake, and Dr. Timberlake sent him right on to a heart doctor.
他见到了汀布莱克医生，汀布莱克医生直接把他送到了一位心脏病医生那里。
Dr. Perry Timberlake.
佩里·汀布莱克博士。
He suggested I apply for my disability.
他建议我申请残疾。
Dr. Timberlake from here.
汀布莱克博士来自这里。
Chana Joffe-Walt I became very curious about Dr. Timberlake.
查纳·乔夫-沃尔特 我对汀布莱克博士非常好奇。
And I began to wonder if he was the reason for the one in four.
我开始怀疑他是否是四分之一的原因。
That could explain it, right?
这样就可以解释了，对吧？
There's one doctor in town, and he's running some sort of disability scam, referring every person he sees to the program.
镇上有一位医生，他正在实施某种残疾骗局，将他见过的每个人都推荐给该计划。
And here is what I knew about Dr. Timberlake.
以下是我对汀布莱克博士的了解。
He's the only general practitioner in Greensboro.
他是格林斯博罗唯一的全科医生。
He dodged me and my request for an interview.
他回避了我和我的采访请求。
And he spent some time abroad.
他在国外呆了一段时间。
Nobody could tell me why.
没有人能告诉我为什么。
And then after sitting in his clinic waiting room several mornings in a row, Dr. Timberlake finally agreed to see me.
连续几个早上坐在诊所候诊室后，汀布莱克医生终于同意见我。
In the first two minutes, he explained his international travels.
在前两分钟里，他解释了他的国际旅行。
I started a project in Africa, and I ran out of money.
我在非洲启动了一个项目，但我的钱用完了。
So I came back to work.
于是我又回来工作了。
Where were you in Africa?
你在非洲哪里？
Dr. Perry Timberlake Uganda.
乌干达佩里·汀布莱克博士。
We give people-- help them get mosquito nets.
我们为人们提供帮助他们获得蚊帐。
There's absolutely nothing shifty about Dr. Timberlake.
汀布莱克博士绝对没有什么狡猾的地方。
He is a doctor willing to move permanently to Hale County and serve the rural population.
他是一名医生，愿意永久搬到黑尔县并为农村人口服务。
I was told he's one of only a few white people in town who chooses to live in a black neighborhood.
有人告诉我，他是镇上仅有的少数选择住在黑人社区的白人之一。
Dr. Perry Timberlake, it turns out, is your classic bleeding heart.
事实证明，佩里·汀布莱克博士是典型的心血来潮者。
A doctor in a very poor place, where pretty much every person comes into his office to tell him they are in pain, usually back pain.
一位医生在一个非常贫穷的地方，几乎每个人来到他的办公室告诉他他们感到疼痛，通常是背痛。
Well, we talk about the pain and what it's like.
好吧，我们谈论疼痛及其感觉。
Does it move in your legs?
它在你的腿上移动吗？
And I always ask them what grade did you finish.
我总是问他们你完成了多少年级。
What grade did you finish is not a medical question.
你完成了多少年级不是一个医学问题。
But Dr. Timberlake feels this is information he needs to now.
但汀布莱克博士认为这是他现在需要的信息。
And rarely, rarely-- I'm not sure if ever-- they've said, well, I've finished college, four years.
很少，很少——我不确定是否有——他们说，好吧，我大学毕业了，四年了。
A lot of them have finished the 12th grade.
他们中的很多人已经完成了12年级的学业。
But a lot of them have finished less than that.
但他们中的很多人的完成度都低于这个数字。
And just a high school education and not too many sit down jobs with that.
而且只有高中学历，并没有太多坐下来工作的人。
I don't care how smart you are.
我不在乎你有多聪明。
You just don't get the chance.
你只是没有机会。
So you think about that when you think about whether or not somebody is going to benefit from disability?
因此，当您考虑某人是否会从残疾中受益时，您会考虑这一点吗？
Yeah, yeah, right.
是啊是啊，没错。
Chana Joffe-Walt He's asking about their education, because what the disability paperwork asks about is a patient's ability to function.
Chana Joffe-Walt 他询问的是他们的教育程度，因为残疾文件询问的是患者的生活能力。
And the way Dr. Timberlake sees it, with little education and poor job prospects, his patients can't function.
在汀布莱克医生看来，由于受教育程度低且就业前景不佳，他的病人无法正常生活。
So he fills out the paperwork for them.
所以他为他们填写了文件。
Well, on the exam, I say what I see and what turned out.
好吧，在考试时，我会说我所看到的和结果。
And then I say they're completely disabled to do gainful work, gainful way you earn money, now or in the future.
然后我说他们完全无法从事有酬工作，无论是现在还是将来。
Now could they eventually get a sit down job?
现在他们最终能找到一份坐下来的工作吗？
Is that possible?
这可能吗？
Yeah, but it's very, very unlikely.
是的，但这非常非常不可能。
Dr. Timberlake is saying one in four people in Hale County are disabled, not because they eat bad food or party too hard or because they're cheating.
汀布莱克博士说，黑尔县四分之一的人是残疾人，并不是因为他们吃的食物不好、聚会太频繁，也不是因为他们作弊。
He's basically saying one in four people should be classified as disabled because they can't get a job.
他基本上是说四分之一的人应该被归类为残疾人，因为他们找不到工作。
A fact that doesn't really seem like it should be taken into account at all.
一个事实似乎根本不应该被考虑。
You're either disabled or you're not.
你要么是残疾人，要么不是。
But the more I talked to people in Hale County, the more I wondered how important a person's education or job skills really were when it came to a disability.
但我与黑尔县的人们交谈得越多，我就越想知道一个人的教育或工作技能对于残疾来说究竟有多重要。
Because of this interaction I kept having over and over again, I'd listen to someone's story of how back pain meant they could no longer work or a shoulder injury had put them out of a job.
由于我一遍又一遍地进行这种互动，我会听某人的故事，讲述背痛如何意味着他们无法再工作，或者肩伤如何让他们失业。
And when I said things like, what about a job where you don't have to lift people, or a job where you don't have to use your shoulder or where you don't have to stand all night long, or just simply, have you thought about other jobs that you could do, people gave me such bewildered looks.
当我说，比如，一份不需要抬起人的工作，或者一份不需要用肩膀，或者不需要整晚站着的工作，或者只是简单地说，你有没有想过你可以做的其他工作，人们给了我如此困惑的表情。
It was as if I was asking well, how come you didn't consider becoming an astronaut.
就好像我问得好，你为什么不考虑成为一名宇航员。
So by the time I was sitting with Ethel Thomas, I had had this conversation with so many people, that after hearing about her work at the fish plant and then as a nurse's aid until she got disability for back pain, I tried to ask the question in a different way.
所以当我和埃塞尔·托马斯坐在一起的时候，我已经和很多人进行了这样的对话，在听说她在养鱼厂的工作，然后作为护士的帮助直到她因背痛而残疾后，我尝试以不同的方式提出这个问题。
In your dream world, if you could have a different job that you could do with your back, what would that be?
在你的梦想世界中，如果你可以从事一份不同的工作，并且可以用背部来做，那会是什么？
You're shaking your head.
你在摇头。
Ethel and I talked for another long while, about the town, her church.
埃塞尔和我又聊了很长一段时间，谈论了这个小镇和她的教堂。
I met her husband Joseph, who's also on disability, who has nerve damage in his hands.
我遇到了她的丈夫约瑟夫，他也患有残疾，双手神经受损。
A good 45 minutes passed.
足足45分钟过去了。
And I was getting ready to leave.
我正准备离开。
And Ethel stopped me.
埃塞尔阻止了我。
You asked me a while back what would be the perfect job.
不久前你问我什么是完美的工作。
I thought about it, and I said that the perfect job, it would be like I would sit at a desk like the Social Security people, and just weed out all the ones that come in and file for disability.
我想了想，我说这是一份完美的工作，就像我会像社会保障人员一样坐在办公桌前，剔除所有进来并申请残疾的人。
I could sit and weed out all the ones that don't need it.
我可以坐下来淘汰所有不需要的人。
At first, I thought Ethel's dream job was to be the lady at Social Security, because she thought she'd be good at weeding out the cheaters.
起初，我以为埃塞尔的梦想工作是成为社会保障局的女士，因为她认为自己擅长清除作弊者。
But no. After a confusing back and forth, it turned out Ethel wanted this woman's job because she gets to sit.
但没有。经过一番令人困惑的来回之后，埃塞尔想要这个女人的工作，因为她可以坐下来。
That's it.
就是这样。
And when I asked her, OK, but why that lady?
当我问她，好吧，但是为什么是那位女士？
Why not any other job where you get to sit?
为什么不找其他能让你坐下来的工作呢？
Ethel said she could not think of a single other job where you get to sit all day.
埃塞尔说，她想不出还有什么工作可以让你整天坐着。
She said she'd never seen one.
她说她从没见过。
I brushed this off in the moment.
我当时就忽略了这一点。
I was getting in my car.
我正要上车。
It was getting late.
天色已晚。
And also, it just did not seem possible to me that there would be a place in America today where someone could go her whole working life without any exposure to jobs where you get to sit, until she applied for disability and saw a woman who gets to sit all day.
而且，在我看来，今天的美国不可能有一个地方，有人可以在整个工作生涯中不接触任何可以坐着的工作，直到她申请残疾并看到一个可以整天坐着的女人。
There had to be an office or storefront in town where Ethel would have seen a job that's not physical.
镇上一定有一个办公室或店面，埃塞尔会在那里找到一份非实体的工作。
And I started sort of casually looking.
我开始随意地寻找。
At McDonald's, they're all standing.
在麦当劳，他们都站着。
There's a truck mechanic, no. A fish plant, definitely no. I looked at the jobs listings in Greensboro-- occupational therapist, McDonald's, McDonald's, truck driver heavy lifting, KFC, registered nurse, McDonald's.
有一个卡车修理工，不。鱼植物，绝对不是。我查看了格林斯博罗的职位列表——职业治疗师、麦当劳、麦当劳、重型卡车司机、肯德基、注册护士、麦当劳。
I actually think it might be possible that Ethel could not conceive of a job that would accommodate her pain.
事实上，我认为埃塞尔可能无法想象出一份能够适应她的痛苦的工作。
It is that gap between the world I live in and Ethel's world that's a big part of why the disability program has been growing so rapidly.
我生活的世界和埃塞尔的世界之间的差距是残疾人项目发展如此迅速的一个重要原因。
A gap that prevents someone from even imagining the working world I live in, where there are jobs where you can work and have a sore back, or, in her husband Joseph's case, damaged nerves in his hands.
这种差距让人们甚至无法想象我所生活的工作世界，那里有你可以工作但背部酸痛的工作，或者，就她丈夫约瑟夫的情况而言，他的手部神经受损。
Did you try to look for jobs that didn't involve your hands?
您是否尝试过寻找不涉及您双手的工作？
What would you do?
你会怎么办？
What kind of work could you do without your hands?
没有双手你能做什么工作？
I don't know.
我不知道。
What could I do?
我能做什么？
I don't think mashing grapes is going to work here.
我认为捣碎葡萄在这里不起作用。
We don't do that kind of stuff here.
我们这里不做那种事。
With your feet.
用你的脚。
So we don't do that here.
所以我们在这里不这样做。
So that's probably all I could have done.
所以这可能就是我能做的一切。
So I don't think I know.
所以我想我不知道。
Every job I ever be in my life, I had to use my hands to do it.
我一生中所做的每一项工作，我都必须用手来完成。
Joseph and Ethel Thomas live in a depressed town in a poor state in a national economy that is basically in the process of fully abandoning every kind of job they know how to do.
约瑟夫和埃塞尔·托马斯生活在一个贫穷的小镇上，这个小镇的国民经济基本上处于完全放弃他们知道如何做的各种工作的过程中。
Being poorly educated in a rotten place, that in and of itself has become a disability.
在一个腐烂的地方受教育程度很低，这本身就成了一种残疾。
This is a new reality.
这是一个新的现实。
This gap between workers who are fit for the US economy and millions of workers who are increasingly not.
适合美国经济的工人与数百万越来越不适合美国经济的工人之间存在这种差距。
And it's a change that's spreading to towns and cities that have thrived in the American economy.
这种变化正在蔓延到在美国经济中蓬勃发展的城镇。
Places that made cars and steel and batteries and textiles.
制造汽车、钢铁、电池和纺织品的地方。
The disability programs are acting like a sponge, sopping up otherwise desperate people.
残疾人计划就像海绵一样，吸走了原本绝望的人们。
This is happening so often in so many parts of the country, this shift from work to disability programs, that I have actually been reporting on it for years, and I didn't even know it.
这种从工作到残疾计划的转变在这个国家的许多地方经常发生，我实际上已经报道了很多年，但我什至不知道。
A small town already struggling through financial troubles just found out a major employer is shutting down.
一个已经陷入财务困境的小镇刚刚发现一家主要雇主即将倒闭。
Warehouses were closed.
仓库被关闭。
One of the largest sawmills in the state.
该州最大的锯木厂之一。
This is a familiar narrative, a small town or city loses its main industry.
这是一个熟悉的故事，一个小镇或城市失去了它的主要产业。
When the mill closed in Aberdeen in Washington state, I covered it.
当华盛顿州阿伯丁的工厂关闭时，我负责覆盖它。
I stood in the dead mill with a bunch of laid off workers, memorializing the end of an era.
我和一群下岗工人站在死气沉沉的磨坊里，纪念一个时代的结束。
An era in America where you could graduate high school, get a job at a mill, and live a good life.
在美国的那个时代，你可以高中毕业，在工厂找到一份工作，过上美好的生活。
We grew up together.
我们一起长大。
We've gotten married.
我们结婚了。
We've had children.
我们已经有了孩子。
We've raised families.
我们已经养育了家庭。
Them were the best jobs on the harbor.
他们是港口里最好的工作。
When you had one of them jobs, you had a great job.
当你从事其中一项工作时，你就得到了一份很棒的工作。
And that was it.
就是这样。
That was the end of the story.
故事就这样结束了。
That is always the end of the story.
这就是故事的结局。
I had no idea what would actually become of these guys, because I, like every other reporter, showed up at the worst possible time to answer that question.
我不知道这些人实际上会变成什么样子，因为我和其他记者一样，在最糟糕的时间出现来回答这个问题。
The exact moment no one knows what this new reality will look like.
没有人知道这个新现实会是什么样子。
So a couple weeks ago, I called some of the guys I met four years ago in Aberdeen.
所以几周前，我给四年前在阿伯丁认识的一些人打了电话。
OK, is that better?
好吧，这样更好吗？
Scott Birdsall I can hear you, but not real well.
斯科特·伯索尔 我能听到你说话，但听得不太清楚。
Scott Birdsall told me after the mill closed, all the worker retraining agencies from the county came in.
斯科特·伯索尔告诉我，工厂关闭后，县里所有的工人再培训机构都进来了。
They set up a bunch of meetings, delivered a bunch of pep talks.
他们召开了一系列会议，发表了一系列鼓舞士气的演讲。
Scott says he went to every one, even though they all basically had the same message.
斯科特说他去了每一个人，尽管他们基本上都传达了相同的信息。
Oh, just there's programs available and schooling and stuff like that.
哦，只是有可用的项目和学校教育之类的东西。
Retraining programs and they could help you with resumes and things like that.
再培训计划，他们可以帮助你处理简历之类的事情。
Scott was 56 at the time.
斯科特当时 56 岁。
The last time he set foot in a classroom was 1972.
他最后一次踏入教室是1972年。
And he hated school.
他讨厌学校。
But the worker retraining people were encouraging a forestry degree.
但对人们进行再培训的工人却鼓励获得林业学位。
Scott had his doubts.
斯科特对此表示怀疑。
And then he went to yet another worker retraining meeting at a place called WorkSource.
然后他又去了一个名为 WorkSource 的地方参加了另一场工人再培训会议。
And right in the middle of a pep talk about resumes and the value of education, one the staff pulled him aside.
就在一场关于简历和教育价值的鼓舞人心的谈话中，工作人员把他拉到一边。
There was an older guy there that worked for WorkSource, and he just looked at me, and he goes Scott, I'm going to be honest with you.
那里有一个在 WorkSource 工作的老家伙，他只是看着我，然后他说斯科特，我要对你说实话。
He goes, there's nobody going to hire you.
他走了，没有人会雇用你。
He goes, we're just hiding you guys.
他走了，我们只是把你们藏起来了。
That's all we're doing.
这就是我们正在做的一切。
We're just keeping you, you know, out of the picture.
你知道，我们只是把你排除在外。
And there's no place for you around here where you're going to get a job.
而且这里没有你可以找到工作的地方。
Just draw your unemployment, and just suck all the benefits you can out of the system until everything's gone.
只要减少你的失业，并从系统中吸取你能得到的所有福利，直到一切都消失。
And then you're on your own.
然后你就得靠自己了。
Scott says it was the most real thing anyone had said in a while.
斯科特说这是一段时间以来人们说过的最真实的话。
After the mill closed, Scott had a heart attack.
工厂关闭后，斯科特心脏病发作。
And he did try school for a while, hated it once again.
他确实尝试过上学一段时间，但再次讨厌它。
I thought well, you know, since I've had a bypass, maybe I can get on disability, and then I won't have to worry about this stuff anymore.
我想，你知道，既然我有了搭桥，也许我可以得到残疾，然后我就不用再担心这些事情了。
Scott was essentially taking the advice of the rogue staffer at the worker retraining office.
斯科特本质上是听取了工人再培训办公室流氓员工的建议。
He could have stayed in school until he was 60 in the hopes of getting a park ranger job, making half the salary he made at the mill.
他本可以留在学校直到 60 岁，希望能找到一份公园管理员的工作，薪水只有他在工厂的一半。
He made about $60,000 a year at the mill.
他在工厂的年薪约为 60,000 美元。
Or, as he says, he could just accept that he was no longer useful to this economy.
或者，正如他所说，他可以接受自己对经济不再有用的事实。
Didn't have the right education, right skills.
没有受过正确的教育，没有正确的技能。
He could just accept that and check out.
他可以接受并退出。
Turns out, there is a way to do that.
事实证明，有一种方法可以做到这一点。
And then that's how I wound up getting into the disability thing.
这就是我最终陷入残疾的原因。
And it wasn't just Scott.
不仅仅是斯科特。
I talked to a bunch of mill guys who took this path.
我和一群走这条路的工厂工人聊过。
One who shattered the bone in his ankle and his leg, one with diabetes, another with a heart attack.
其中一名脚踝和腿部骨折，一名患有糖尿病，另一名患有心脏病。
When the mill shut down, they all went on disability.
当工厂关闭时，他们都成了残疾。
And they all, like Scott, would prefer to be at the mill.
他们都像斯科特一样更愿意去工厂。
Scott says if circumstances had been different, if the entire economy had not changed underneath his feet and the mill was still open, he'd be there.
斯科特说，如果情况不同，如果他脚下的整个经济没有发生变化，而且工厂仍然开着，他就会在那里。
I don't know what that one rogue staffer meant when he told Scott Birdsall they were trying to hide those mill guys.
我不知道那位流氓员工告诉斯科特·伯索尔他们试图隐藏那些工厂工人时是什么意思。
But signing up for disability benefits is an excellent way to stay hidden.
但签署残疾福利金是隐藏的好方法。
People on disability, the way the government counts you, you're not part of the labor force, meaning you're not counted in the unemployment figures.
残疾人，按照政府计算你的方式，你不属于劳动力，这意味着你没有被计入失业数字。
An economist, David Autor at MIT, told me, macroeconomically speaking, people on disability are invisible.
麻省理工学院的经济学家大卫·奥托尔告诉我，从宏观经济角度来看，残疾人是隐形的。
Well, that's kind of an ugly secret of the American labor market, that part of the reason our unemployment rates have been low until recently is that a lot of people who would have trouble finding jobs are on a different program.
嗯，这是美国劳动力市场的一个丑陋的秘密，直到最近我们的失业率一直很低的部分原因是许多很难找到工作的人都参加了不同的计划。
They're on the disability insurance program.
他们参加了伤残保险计划。
And they don't show up in the labor force statistics.
他们也没有出现在劳动力统计数据中。
And so it artificially reduces the unemployment rate that we observe.
因此，它人为地降低了我们观察到的失业率。
So you're saying we all already knew it was bad.
所以你是说我们都已经知道这很糟糕。
It's actually worse than we think.
实际上比我们想象的更糟糕。
It is.
这是。
It's been worse than we thought for a long time.
很长一段时间以来，情况比我们想象的还要糟糕。
This has been going on pretty rapidly for now more than 20 years.
20 多年来，这种情况一直在快速发生。
David Autor says disability has become a sort of de facto welfare for people without a lot of education or job skills.
大卫·奥托尔表示，对于那些没有受过太多教育或缺乏工作技能的人来说，残疾已经成为一种事实上的福利。
Except it is the worst kind of welfare program, because it includes one feature you never, ever want from your social safety net.
但这是最糟糕的福利计划，因为它包含了你永远、永远不想要的社会安全网的一项功能。
Once people go in that direction, they're unlikely to come back.
一旦人们朝那个方向走，他们就不太可能回来。
The problem with using our disability programs as a sort of quiet de facto welfare system is they're not designed to help people to deal with their disabilities, to get jobs, to make increasingly more money over a lifetime.
使用我们的残疾人计划作为一种事实上的安静福利系统的问题在于，它们并不是为了帮助人们应对残疾、找到工作、在一生中赚越来越多的钱而设计的。
They're not there to catch you when you fall down and help you back on your feet.
当你跌倒时，他们不会扶住你并帮助你重新站起来。
Once a worker gets on disability, there are really only two ways out.
一旦工人残疾，实际上只有两种出路。
You get old enough that at 65, 66-years-old, you move on to a different government program, Social Security for seniors, or you die.
你已经足够老了，在 65 岁、66 岁的时候，你会转向另一个政府项目，即老年人社会保障，否则你就会死。
Those are the two ways people exit disability.
这是人们摆脱残疾的两种方式。
Almost no one gets better.
几乎没有人会好起来。
The benefits don't get you rehabilitative services or supportive technology.
这些福利不会为您提供康复服务或支持性技术。
They just give you a monthly income.
他们只是给你每月的收入。
And it's not a great income, about $13,000 a year.
而且收入也不算多，一年大约13,000美元。
But if your alternative is a minimum wage job that will pay you $15,000 a year-- a job you may or may not be able to get, may or may not be able to keep, that probably won't be full time, and very likely will not include health insurance-- disability may be a better option.
但如果你的替代方案是一份每年支付 15,000 美元的最低工资工作——这份工作你可能能得到也可能得不到，可能也可能无法保留，可能不是全职工作，而且很可能不包括健康保险——残疾可能是一个更好的选择。
Well let's just think about what that option means.
好吧，让我们想想这个选项意味着什么。
You will not work.
你不会工作。
You will not interact with coworkers, get promoted, make more money, get whatever meaning people get from work.
你不会与同事互动，不会升职，不会赚更多的钱，也不会获得人们从工作中获得的任何意义。
And assuming you rely only on those disability benefits, you will be poor for the rest of your life.
假设你只依靠这些残疾福利，你的余生都会贫穷。
That is signing up for disability.
那就是报名参加残疾。
That's the deal.
就是这样。
And it's a deal 14 million Americans have chosen for themselves.
这是 1400 万美国人为自己选择的协议。
Chana Joffe-Walt.
查纳·乔夫-沃尔特。
Coming up, we meet super nice, highly effective people who have one dream, and that is to get you-- yes, you-- onto disability.
接下来，我们会遇到超级友善、高效的人，他们有一个梦想，那就是让你——是的，就是你——陷入残疾。
That's in a minute, from Chicago Public Radio and Public Radio International, when our program continues.
稍后，芝加哥公共广播电台和国际公共广播电台将继续我们的节目。
It's This American Life.
这就是美国生活。
I'm Ira Glass.
我是艾拉·格拉斯。
Our program today, Trends with Benefits.
我们今天的节目，趋势与好处。
Why are so many people now ending up on disability?
为什么现在有这么多人落得残疾的下场？
And it's hard to talk about all the money that the government pays to poor and disabled people without getting to a very basic question-- what should the government do for people who are not making it in this country, for the nation's most vulnerable people?
在谈论政府向穷人和残疾人支付的所有资金时，很难不触及一个非常基本的问题——政府应该为这个国家的那些无法成功的人、为这个国家最脆弱的人做些什么？
We have argued about that question, answered that question in different ways at different times in our country's history.
我们在我国历史上的不同时期争论过这个问题，并以不同的方式回答过这个问题。
For decades now, there have been some efforts to get people off of government checks.
几十年来，人们一直在努力让人们摆脱政府的检查。
One of the biggest back in 1996, you may remember, President Bill Clinton signed legislation to quote, "end welfare as we know it." The idea was nudge people off of public assistance, give them job training.
您可能还记得，1996 年最大的一次立法之一是比尔·克林顿 (Bill Clinton) 总统签署的立法，其中引用了“结束我们所知道的福利”的内容。这个想法是让人们摆脱公共援助，为他们提供职业培训。
It has generally been seen as a big, big success, including by President Clinton.
人们普遍认为这是一次巨大的成功，包括克林顿总统。
Here he is in 1998, just two years after it was passed.
他现在是 1998 年，也就是该法案通过两年后。
We can be proud that after decades of finger pointing and failure, together we ended the old welfare system.
我们可以感到自豪的是，经过几十年的相互指责和失败，我们共同结束了旧的福利制度。
And we're now replacing welfare checks with paychecks.
我们现在正在用工资取代福利支票。
[APPLAUSE] President Bill Clinton Last year, after a record four-year decline in welfare rolls, I challenged our nation to move two million more Americans off welfare by the year 2000.
[掌声] 比尔·克林顿总统 去年，在福利人数连续四年下降后，我向我们国家提出挑战，要求到 2000 年让 200 万美国人不再享受福利。
I'm pleased to report we have also met that goal, two full years ahead of schedule.
我很高兴地报告，我们也实现了这一目标，比原计划提前了整整两年。
Now the premise of that, of course, was that there are jobs for all these welfare recipients to move into and get paychecks.
当然，前提是所有这些福利接受者都有工作可以搬进去并获得薪水。
But over the last 30 years, that has changed.
但在过去 30 年里，情况发生了变化。
The economy has changed.
经济已经改变。
Lots of good jobs have vanished.
很多好工作都消失了。
And government has not really kept up with all these changes.
而政府并没有真正跟上所有这些变化。
Has not figured out a way to address the needs of all of these workers.
尚未找到一种方法来满足所有这些工人的需求。
And so in the place of the government doing stuff, others have stepped in, volunteers from the private sector, to see to the needs of those workers.
因此，来自私营部门的志愿者代替政府采取行动，介入，以满足这些工人的需求。
Chana Joffe-Walt introduces us to some of these civic-minded Americans in this half of our show.
查纳·乔菲-沃尔特在本期节目中向我们介绍了一些有公民意识的美国人。
In the absence of a government answer to an enormous American labor problem, what I'm going to go ahead and call the vast disability industrial complex has sprung up.
在政府没有对美国巨大的劳工问题做出回应的情况下，我所说的巨大的残疾人产业综合体已经出现。
Its leaders are these guys.
它的领导人就是这些人。
Disabled and can't work?
残疾不能工作？
Get the money you deserve.
得到你应得的钱。
Call Al Gemma at 1-800-677-9030.
请致电 1-800-677-9030 联系 Al Gemma。
Al Gemma gets results.
艾尔·杰玛取得了成果。
Lawyers.
律师。
Lawyer At Brown Look, my law firm Brown and Crouppen has collected over a third of a billion dollars for injured people.
Brown Look 的律师，我的 Brown and Crouppen 律师事务所已为受伤者筹集了十亿美元中的三分之一以上。
Not million, billion.
不是百万，是十亿。
See, I fix problems.
看，我解决问题。
Disability lawyers offer to fix American's problems on billboards, taxis, and aggressively on television, often with props.
残疾律师在广告牌、出租车和电视上积极主动地提出解决美国航空的问题，通常还使用道具。
Gavels slammed down to show they mean business, or even better, swords.
敲下木槌以表明他们是认真的，甚至更好的是，用剑表示他们是认真的。
[SOUND OF SWORD] Sword-wielding Lawyer Has your disability claim been denied?
【剑之声】持剑律师 你的伤残索赔被拒绝了吗？
There are disability lawyers who golf, who dust their desk plants while making commercials, musical lawyers.
有打高尔夫球的残疾律师、在制作广告时掸掉桌上植物的灰尘的律师、还有音乐律师。
[SINGING] Call the Davis Disability Group.
[唱歌] 致电戴维斯残疾人小组。
Put us on your side.
让我们站在你这边。
Call a lawyer who is also a psychologist.
打电话给一位同时也是心理学家的律师。
Call Dr. Bill LaTour.
致电比尔·拉图尔博士。
Disabled?
残疾人？
Get the money you deserve.
得到你应得的钱。
And then there are the YouTube lawyers.
还有 YouTube 律师。
One disability lawyer, one webcam.
一名残疾律师，一个网络摄像头。
Usually the lawyer offers a handy anecdote that lets you know they're selling something you could buy.
通常，律师会提供一些方便的轶事，让您知道他们正在出售您可以购买的东西。
I want to talk to you today about how disabled you have to be in order to get Social Security disability benefits.
今天我想和您谈谈您的残疾程度必须达到何种程度才能获得社会保障残疾福利。
Well, the bottom line is you don't have to be an invalid.
好吧，最重要的是你不必是一个残疾人。
You don't have to be out on a stretcher.
你不必躺在担架上。
You don't have to be home wracked in pain to get Social Security disability benefits.
您不必痛苦地待在家里才能获得社会保障残疾福利。
Let me give you an example.
让我举个例子。
Almost every ad and YouTube tutorial makes sure to mention that the lawyers don't get paid unless you win.
几乎每个广告和 YouTube 教程都会提到，除非您获胜，否则律师不会获得报酬。
So let's talk about how the lawyers get paid for a second here.
那么让我们在这里谈谈律师是如何获得报酬的。
The economist, David Autor, was the first to explain this to me.
经济学家戴维·奥托尔是第一个向我解释这一点的人。
If a person applies for disability, is denied, hires a lawyer, and then wins, he gets back pay for the time he waited for his hearing.
如果一个人申请残疾，被拒绝，聘请律师，然后胜诉，他将获得等待听证会期间的工资。
Lawyers get a one-time fee, a portion of the back pay, up to 25%.
律师收取一次性费用，即欠薪的一部分，最高可达 25%。
The money comes out of the disabled person's back pay.
这笔钱来自残疾人的欠薪。
But the disabled person doesn't hand over a check to the lawyer, the government does.
但残疾人不会将支票交给律师，而是政府。
The Social Security Administration makes that payment directly to the attorney, not to the individual.
社会保障管理局直接向律师而非个人支付这笔款项。
So the individual gets their cut, the attorney gets their cut.
所以个人得到他们的分成，律师得到他们的分成。
So each year, the Social Security Administration makes more than $1 billion in payments directly to attorneys that have prevailed against it in front of ALJs.
因此，社会保障管理局每年都会直接向在行政法官面前胜诉的律师支付超过 10 亿美元的款项。
Wait, so the government employs lawyers to fight the government.
等等，所以政府聘请律师来对抗政府。
No, no. It doesn't employ the lawyers.
不，不。它不聘请律师。
It just pays them.
它只是付钱给他们。
It just pays the ones who win.
它只是支付给获胜者。
It pays the lawyers that win suing the government.
它向胜诉政府的律师支付费用。
Right, exactly.
对，完全正确。
It pays the lawyers that defeat it.
它付钱给击败它的律师。
Social Security set it up this way to encourage lawyers to represent poor clients.
社会保障局这样设置是为了鼓励律师为贫困客户提供代理服务。
But I think it's safe to say the government did not expect that this financial incentive would lead lawyers to find people who had been denied disability four times, put them on television, and tell them and the viewing public--
但我认为可以肯定地说，政府没想到这种经济激励措施会导致律师找到四次被拒绝残疾的人，将他们放在电视上，并告诉他们和观众——
Don't give up.
不要放弃。
If you've applied and been denied, call attorney Ed Tend.
如果您已提出申请但遭到拒绝，请致电律师 Ed Tend。
He's local.
他是本地人。
He knows your doctors.
他认识你的医生。
Social Security denies a lot of people, at least the first time around.
社会保障拒绝了很多人的申请，至少在第一次是这样。
Only about a third of those who apply are awarded benefits, and the rest are denied.
只有大约三分之一的申请者获得了福利，其余的都被拒绝。
So more and more people see these ads and appeal the decisions.
因此，越来越多的人看到这些广告并对决定提出上诉。
Not everyone appeals, a little more than half.
并不是每个人都提出上诉，只有一半多一点。
And those who do have much better chances.
那些这样做的人有更好的机会。
Almost 2/3 of the time, usually with the help of representation, they win.
几乎 2/3 的时间，通常是在代表的帮助下，他们获胜。
This fact is new, the explosion of appeals and disability lawyers.
这是一个新的事实，即上诉和残疾律师的激增。
And there is one firm that proudly takes credit for it, for transforming the way Americans win disability benefits.
有一家公司自豪地以此为荣，改变了美国人获得残疾福利的方式。
Nobody intimidates our clients, nobody.
没有人威胁我们的客户，没有人。
That's one reason we're America's most successful Social Security disability advocates.
这就是我们成为美国最成功的残疾人社会保障倡导者的原因之一。
America's most successful disability advocates are Binder & Binder.
美国最成功的残疾人倡导者是 Binder & Binder。
And we make you this very special promise.
我们向您做出这个非常特别的承诺。
We'll deal with the government.
我们会和政府打交道。
You have enough to worry about.
你要担心的已经够多了。
Call us.
给我们打电话。
Chana Joffe-Walt That guy making the promise is a cowboy-hatted Charles Binder, pointing straight into the camera.
查纳·乔夫-沃尔特 (Chana Joffe-Walt) 做出承诺的那个人是戴牛仔帽的查尔斯·宾德 (Charles Binder)，他直指镜头。
A man who has completely changed the game for disability lawyers.
他彻底改变了残疾律师的游戏规则。
It's funny, when we started-- I don't think when we started, anybody else was advertising Social Security.
有趣的是，当我们开始时——我认为当我们开始时，没有其他人在为社会保障做广告。
Something, and this number you're going to be shocked by, about 90% of the people who apply for disability never got to a hearing.
有件事，这个数字会让你感到震惊，大约 90% 申请残疾的人从未参加过听证会。
Because they would get denied once, and they'd get denied twice, and they'd say, well, you can't win this.
因为他们会被拒绝一次，他们会被拒绝两次，他们会说，好吧，你赢不了。
And now the number of people who go to a hearing is like 95%.
现在参加听证会的人数约为 95%。
The people who apply who lose go onto a hearing, because they're well represented.
申请失败的人会参加听证会，因为他们有很好的代表。
Binder's numbers are a bit high, but you get the picture.
宾德的数字有点高，但你明白了。
Things have really changed.
事情真的发生了变化。
To some extent, I take credit for that.
在某种程度上，我对此表示赞赏。
I've created some of the problems for the government, because so many people appeal.
我给政府制造了一些问题，因为有很多人呼吁。
In the old days, they had many fewer people.
以前，他们的人少得多。
When it comes to life accomplishments, it is unusual to find someone who can reasonably add "changed the US economy" to the list.
当谈到人生成就时，很少有人能够合理地将“改变了美国经济”添加到清单中。
Charles Binder arguably can.
查尔斯·宾德可以说可以。
This is a man who is personally responsible for the transfer of billions of dollars of disability payments.
这是一个亲自负责数十亿美元伤残补助金转移的人。
When he started in 1979, Binder and Binder represented less than 50 clients.
当他 1979 年开始工作时，Binder 和 Binder 只代表了不到 50 个客户。
Last year, 30,000-- 30,000 people who were denied disability appealed with the help of Charles Binder in one year.
去年，一年内有 30,000 至 30,000 名被拒绝残疾的人在查尔斯·宾德 (Charles Binder) 的帮助下提出上诉。
And for that work, the government wrote a check for $68.7 million.
为了这项工作，政府开出了一张 6870 万美元的支票。
The way Binder tells it, he is a guy helping desperate people get the support they deserve.
按照宾德的说法，他是一个帮助绝望的人获得他们应得的支持的人。
He's a cowboy-hatted Lone Ranger fighting the good fight for the everyman.
他是一位戴着牛仔帽的独行侠，为普通人而战。
He apparently keeps a picture of the Lone Ranger on his desk.
他的桌子上显然放着一张独行侠的照片。
So you've got 30,000 people denied disability who are appealing to a judge, taking their case to the courts.
因此，有 30,000 名被拒绝残疾的人正在向法官提出上诉，将他们的案件告上法庭。
And on the one side, the judge has this passionate persuasive lawyer making the case that his client is physically or emotionally incapable of working.
一方面，法官让这位充满热情、有说服力的律师证明他的委托人在身体或情感上无法工作。
And on the other side, who's on the other side?
而另一边，另一边又是谁呢？
Nobody.
没有人。
Nobody, really.
没有人，真的。
I couldn't believe this when I first heard it.
当我第一次听到这个消息时我简直不敢相信。
David Autor, the economist, told me with disability cases, there is no person in the room making the government's case.
经济学家戴维·奥托尔告诉我，关于残疾案件，房间里没有人为政府辩护。
You might imagine a courtroom where, on the one side, there's the claimant and their lawyer saying, my client needs these benefits.
您可能会想象一个法庭，一方面，原告和他们的律师说，我的客户需要这些福利。
On the other side, there's the government attorney saying, ah no, well, we need to protect the public interest, and your client is not sufficiently deserving, and here's why I think that, and so on.
另一方面，政府律师说，啊不，好吧，我们需要保护公共利益，而你的客户没有足够的权利，这就是我这么认为的原因，等等。
But it actually doesn't work like that.
但实际上并不是这样的。
Because the government is not represented.
因为政府没有代表。
There is no government lawyer on the other side of the room.
房间的另一边没有政府律师。
The Social Security Administration says disability hearings were never meant to be adversarial.
社会保障管理局表示，残疾听证会从来就不是对抗性的。
In these courtrooms, the judges are employees of Social Security.
在这些法庭中，法官是社会保障局的雇员。
So they have a dual role-- to represent the government and to make a fair and objective determination.
所以他们有双重角色——代表政府并做出公正客观的决定。
But when you talk to these representatives of the government, who also happen to be fair and objective judges, they will tell you this dual role can be uncomfortable, difficult.
但当你与这些政府代表交谈时，他们也恰好是公正客观的法官，他们会告诉你，这种双重角色可能会让人感到不舒服和困难。
One judge, Judge Randy Frye in North Carolina, who hears disability cases told me he will often find himself glancing to where he imagines there should be another chair, like in any normal courtroom.
北卡罗来纳州的一位法官兰迪·弗莱（Randy Frye）审理残疾案件，他告诉我，他经常会发现自己会看向他认为应该有另一把椅子的地方，就像在任何正常的法庭一样。
And there are always moments where you are concerned that maybe you missed something.
总有一些时刻你会担心自己错过了什么。
And you wish you could turn to that chair?
你希望你能转向那把椅子吗？
Absolutely.
绝对地。
You would turn to the chair and say, counsel, I'm having trouble with this issue.
你会转向主席说，律师，我在这个问题上遇到了麻烦。
Why does the government think this case should not be reversed?
为什么政府认为这个案子不应该翻案？
If someone is awarded disability benefits, that person will receive an average of $250,000 to $350,000 from the government in benefits and health care over a lifetime.
如果某人获得残疾福利，则该人一生中将从政府获得平均 250,000 至 350,000 美元的福利和医疗保健。
If you sued a company for that amount of money, even a tiny company, they would bring a lawyer with them to court.
如果你为了那么多钱起诉一家公司，即使是一家小公司，他们也会带律师去法庭。
Not so with the government's disability program.
政府的残疾人计划却并非如此。
The government is not even in the room.
政府甚至不在房间里。
So lawyers are making money moving people onto disability.
因此，律师通过帮助人们走向残疾来赚钱。
No big surprise there.
没有什么大惊喜。
They are, you know, lawyers.
你知道，他们是律师。
But there is another group of people who are quietly doing this too.
但还有另外一群人也在悄悄做这件事。
And who they're working for I found very surprising.
他们为谁工作让我感到非常惊讶。
I want to introduce you, I want to take you inside an entire office building of these people.
我想介绍你，我想带你走进一整栋写字楼，里面都是这些人。
But first I have to explain why they exist.
但首先我必须解释它们为什么存在。
It has a lot to do with this guy you heard from before.
这和你之前听过的这个人有很大关系。
We can be proud that after decades of finger pointing and failure, together we ended the old welfare system.
我们可以感到自豪的是，经过几十年的相互指责和失败，我们共同结束了旧的福利制度。
And we're now replacing welfare checks with paychecks.
我们现在正在用工资取代福利支票。
President Bill Clinton turned welfare checks into paychecks with the help of states.
比尔·克林顿总统在各州的帮助下将福利支票变成了薪水。
Mary Daly, an economist at the San Francisco Federal Reserve, says after the 1996 reforms, the government said states had to pay a much larger share of the cost of welfare.
旧金山联邦储备银行(San Francisco Federal Reserve)经济学家玛丽·戴利(Mary Daly)表示，1996年改革后，政府表示各州必须支付更大比例的福利成本。
So states had every incentive to try to get their welfare caseloads down.
因此，各州有充分的动力去尝试减少福利案件。
Hopefully by getting people jobs.
希望通过为人们提供工作。
Welfare rolls were cut in half in just a few years.
短短几年内，福利金就减少了一半。
And so we all assumed that's what was happening.
所以我们都假设这就是正在发生的事情。
Mary Daly wondered if there wasn't a different story.
玛丽·戴利想知道是否还有其他故事。
States wanted to get people off the rolls and save money.
各州希望让人们摆脱困境并节省资金。
If they couldn't get them jobs, there was another option-- disability.
如果他们找不到工作，还有另一种选择——残疾。
Disability is a federal program, so it's paid for by the federal government.
残疾是一项联邦计划，因此由联邦政府支付费用。
In other words, if states could get people on to disability--
换句话说，如果各州能让人们陷入残疾——
But they do have to pay for people who are on welfare.
但他们确实必须为领取福利的人付费。
They do.
他们确实这么做了。
And they don't have to pay for disability programs.
而且他们不必为残疾计划付费。
Mary Daly became more and more convinced this was happening.
玛丽·戴利越来越确信这一切正在发生。
She published papers.
她发表了论文。
In 2011, she coauthored a book about it.
2011年，她与人合着了一本有关此事的书。
But it was just a theory.
但这只是一个理论。
So I have my models and my theories, and I can write down what economists think.
所以我有我的模型和理论，我可以写下经济学家的想法。
But you're never sure.
但你永远不确定。
You look for the empirical data, but you're never sure that what your models say actually happens.
您寻找经验数据，但您永远不确定模型所说的是否真的发生。
Until Mary Daly was very, very sure, thanks to one chance encounter she had in Los Angeles.
直到玛丽·戴利非常非常确定，这要归功于她在洛杉矶的一次偶遇。
She was at a conference.
她正在参加一个会议。
It was a big hotel.
那是一家大酒店。
And this was like the second floor ballroom type of thing, where they put the coffee break.
这就像二楼的宴会厅一样，他们在那里喝咖啡休息。
Mary spotted a young guy in the corner looking a little nervous.
玛丽发现角落里有一个年轻人，看上去有点紧张。
He was wearing a suit.
他穿着一套西装。
He was probably in his late 20s.
他大概二十多岁。
Yeah, and I just tried to be social.
是的，我只是尝试社交。
And I said, so what do you do?
我说，那你怎么办？
He asked me what I did.
他问我做了什么。
I told him what I was there to do and what kind of research I did.
我告诉他我要去做什么以及我做了什么样的研究。
And he said, oh, I work for a private sector company.
他说，哦，我在一家私营公司工作。
And our job is to sell services to states.
我们的工作是向各州出售服务。
Specifically, this man told Mary states were hiring his company to help them comb through their welfare rolls and identify people who could qualify for disability.
具体来说，这名男子告诉玛丽州正在雇用他的公司来帮助他们梳理福利名单并确定有资格获得残疾的人。
And that they were now helping states move people onto the federal program.
他们现在正在帮助各州将人们纳入联邦计划。
So I said, really?
所以我说，真的吗？
We have this written in our book that this would likely happen.
我们在书中写道，这种情况很可能会发生。
You're like, my model predicts that this is going to happen.
你会说，我的模型预测这将会发生。
Yeah, I said this is what we wrote in our book.
是的，我说这就是我们在书中写的。
We have a diagram that suggests this will happen.
我们有一张图表表明这将会发生。
But you're telling me it actually is happening.
但你告诉我这确实正在发生。
And he said, yes.
他说，是的。
Maybe one of the biggest regrets I have is that I was so surprised to run into him and to learn this that I didn't question him more.
也许我最大的遗憾之一就是我很惊讶地遇到了他并得知这一点，以至于我没有更多地询问他。
No, it was a good conference.
不，这是一次很好的会议。
I believe I did speak with her outside of one of the sessions that had just ended.
我相信我确实在刚刚结束的一场会议之外与她交谈过。
We were kind of out in the coffee area there and talking.
我们在外面的咖啡区聊天。
This is Pat Coakley.
这是帕特·科克利。
He works for a company called Public Consulting Group.
他在一家名为公共咨询集团的公司工作。
He's the head of PCG's Social Security Advocacy management team, a subgroup of PCG that welfare reform created.
他是 PCG 社会保障倡导管理团队的负责人，该团队是福利改革创建的 PCG 下属小组。
PCG has competitors, but they're the biggest player offering welfare to disability services.
PCG 有竞争对手，但他们是为残疾人服务提供福利的最大参与者。
And Pat told me business is going well.
帕特告诉我生意进展顺利。
They have 17 contracts with states and counties around the country.
他们与全国各地的州和县签订了 17 份合同。
He just signed up a new one, Missouri.
他刚刚签了一份新合同，密苏里州。
So what we're offering is to work to identify those folks who have the highest likelihood of meeting disability criteria.
因此，我们提供的是努力找出那些最有可能满足残疾标准的人。
We will screen through their case loads.
我们将筛选他们的案件量。
We will look to identify these individuals.
我们将寻找这些人的身份。
It's also removing that person from the state welfare program.
它还将该人从国家福利计划中删除。
And Pat says it's a win-win.
帕特说这是双赢的。
For the people on welfare, disability is a much better deal.
对于领取福利的人来说，残疾是一个更好的选择。
In some states, you can make four times as much on that program than on welfare.
在某些州，您通过该计划赚取的收入是福利收入的四倍。
So the first step is identifying people who might qualify.
因此，第一步是确定可能符合资格的人。
And Pat says that's actually the least time consuming part of their work,.
帕特说这实际上是他们工作中最耗时的部分。
What takes a really long time is what happens next.
接下来发生的事情需要很长时间。
This is Cathy with Public Consulting Group.
我是公共咨询集团的凯茜。
The PCG office is in eastern Washington state.
PCG 办事处位于华盛顿州东部。
It's basically a call center, head-setted women in cubicles surrounded by pictures of their kids in Hawaii, making calls all day long to potentially disabled Americans.
它基本上是一个呼叫中心，戴着耳机的妇女们坐在小隔间里，周围都是夏威夷孩子的照片，整天给可能患有残疾的美国人打电话。
Trying to help them to discover and document their disabilities.
试图帮助他们发现并记录他们的残疾。
All right, moving on, the high blood pressure, how long have you been taking medications for that?
好吧，继续说高血压，你服用药物多久了？
And the sleep apnea since about 2008.
还有大约2008年以来的睡眠呼吸暂停。
OK, I'm going to change that date for you, OK?
好的，我为您更改日期，好吗？
OK, that's perfect.
好的，那就完美了。
Can you think of anything else that has been bothering you and disabling you and preventing you from working?
你能想到还有什么事情一直困扰着你、阻碍你、阻碍你工作吗？
The PCG agents will help the potentially disabled fill out the disability application over the phone.
PCG 代理将帮助潜在残疾人通过电话填写残疾申请表。
And by help, I mean the agents actually do the filling out.
我所说的帮助，是指代理人实际上负责填写。
When the potentially disabled don't have the right medical documentation to prove a disability, the agents at PCG will help them get it.
当潜在残疾人没有正确的医疗文件来证明残疾时，PCG 的代理人将帮助他们获取文件。
They will call doctor's offices, x-ray centers, get records faxed.
他们会打电话给医生办公室、X光中心，获取传真记录。
Sure, and that's fine.
当然，那很好。
We can actually-- do have an address to Quest Diagnostics?
实际上，我们可以——有 Quest Diagnostics 的地址吗？
Uh huh.
嗯嗯。
I can actually try to look that up for you, if you'd like for me to.
如果您愿意的话，我实际上可以尝试为您查找。
If the right medical records do not exist, PCG will set up doctor's appointments and call applicants the day before to remind them of those appointments.
如果不存在正确的医疗记录，PCG 将安排医生预约，并在前一天致电申请人提醒他们这些预约。
I just wanted to confirm with you that Zachary will be at that appointment.
我只是想向你确认扎卡里会出席那个约会。
And the address, I'll give you the address when you're ready.
还有地址，等你准备好后我会给你地址。
This is customer service in its most aggressive form.
这是最积极的客户服务形式。
If the agents at airlines and health insurance companies worked like PCG agents, the world would be a much happier place.
如果航空公司和健康保险公司的代理人像 PCG 代理人一样工作，世界将会变得更加幸福。
These people are thorough.
这些人都是彻底的。
And once you're in their sights, they're on your side.
一旦你进入他们的视线，他们就会站在你一边。
They want you to get onto disability.
他们希望你成为残疾。
And there is one simple reason for that.
原因很简单。
At the end of the PCG tour, I asked manager Leslie Jose--
在 PCG 巡演结束时，我问经理 Leslie Jose——
And how do you get paid?
你如何获得报酬？
Leslie Jose We get paid by-- our client would be like the state or the county.
Leslie Jose 我们的报酬来源是——我们的客户可能是州或县。
And so we'll get paid when we're successful with a person's claim.
因此，当我们成功解决某人的索赔时，我们就会获得报酬。
So for every person that you get onto disability.
因此，对于每个患有残疾的人来说。
For every file we get on, then we would submit an invoice for that person.
对于我们收到的每个文件，我们都会为该人提交一张发票。
In PCG's bid for the Missouri contract, it asked for $2,300 a person.
PCG 在竞标密苏里州合同时，要求每人 2,300 美元。
Every time one of these agents succeed in winning a client disability, the state will write PCG a check.
每当这些代理人中的一个成功赢得客户残疾时，州政府就会给 PCG 开一张支票。
If it's successful, PCG estimates it'll save Missouri about $80 million with all the people it will be getting onto disability and off welfare.
PCG 估计，如果成功，将为密苏里州节省约 8,000 万美元，帮助所有接受残疾人和脱离福利的人。
And PCG is used to being successful.
PCG 已经习惯了成功。
How often do you win?
你多久赢一次？
Pat Coakley We have a 70% to 75%.
Pat Coakley 我们有 70% 到 75%。
So 70% to 75% of the applications that you file win awards.
因此，您提交的申请中有 70% 到 75% 会获奖。
70% to 75% percent success rate, that is basically unheard of.
70%到75%的成功率，那基本上是闻所未闻的。
Again, without PCG, your chances of winning disability on first application are about 35%.
同样，如果没有 PCG，您在第一次申请时获得残疾的机会约为 35%。
But with PCG, you take some phone calls, maybe go to the doctor, and more likely than not, you win.
但对于 PCG，你接几个电话，也许去看医生，而且更有可能的是，你赢了。
Yeah, so the people are put into benefits.
是的，所以人们都得到了好处。
And they'll receive their Social Security disability income.
他们将获得社会保障残障收入。
We do.
我们做到了。
We're pretty proud of the work our staff are able to do.
我们对我们的员工能够完成的工作感到非常自豪。
There was one line in the PCG contract with Missouri that stood out to me.
PCG 与密苏里州的合同中有一句话让我印象深刻。
PCG requests a fee of $1,745 for each successful foster child SSI application.
PCG 要求为每个成功的寄养儿童 SSI 申请收取 1,745 美元的费用。
What that means is if PCG gets foster kids on disability, the program called SSI, it gets paid for that too.
这意味着，如果 PCG 收养残疾儿童（名为 SSI 的计划），它也会为此获得报酬。
Kids.
孩子们。
I heard this in Hale County that there were lots of kids on disability.
我听说黑尔县有很多残疾儿童。
I heard, actually, what you want is a kid who can pull a check.
我听说，实际上，你想要的是一个能开支票的孩子。
Many people mentioned this to me.
很多人向我提到过这一点。
And I basically ignored it.
而我基本上忽略了它。
It seemed like one of those things that maybe happened once or twice, got written up in the paper, and became conversational fact among neighbors.
这似乎是一件可能发生过一两次的事情，被写在报纸上，并成为邻居之间的谈话事实。
But I did look at the numbers.
但我确实看了数字。
And the number of kids on Supplemental Security Income, SSI, for poor disabled children and adults, the number of kids is almost five times greater than it was 25 years ago.
而领取补充保障收入 (SSI) 的儿童数量，对于贫困残疾儿童和成人来说，其数量几乎是 25 年前的五倍。
It's true.
这是真的。
Yet another rapidly growing group of disabled Americans, children.
另一个快速增长的美国残疾人群体是儿童。
Hi.
你好。
Hi.
你好。
What's your name?
你叫什么名字？
Jaleel Jaleel.
贾里尔·贾里尔。
Jaleel, how are you doing?
贾里尔，你好吗？
Jaleel Jaleel Johnson [INAUDIBLE].
贾里尔·贾里尔·约翰逊 [听不清]。
Jaleel is gap-toothed, 10, and vibrating with enthusiasm.
贾里尔 10 岁，牙齿有缝隙，充满热情。
He's excited to talk to someone new.
他很高兴能和新朋友交谈。
Excited to show me his map of his neighborhood in the Bronx.
他很高兴向我展示他在布朗克斯区的社区地图。
Just basically psyched about everything.
基本上对一切都感到兴奋。
Even things that aren't easy for Jaleel are exciting.
即使对于贾里尔来说并不容易的事情也令人兴奋。
He has a learning disability.
他有学习障碍。
But the way he talks about school--
但他谈论学校的方式——
My favorite periods is math and science and art and lunch and recess and snack and [INAUDIBLE] and ELA and social studies and writing are my fav--
我最喜欢的时间是数学、科学、艺术、午餐、课间休息和小吃，[听不清]、ELA、社会研究和写作是我的最爱——
That sounds like everything.
这听起来就是一切。
Jaleel --are my favorite periods.
Jaleel——是我最喜欢的时期。
I like school.
我喜欢学校。
School my favorite thing to go to.
学校是我最喜欢去的地方。
Jaleel's mom gets about $700 a month for his disability.
贾里尔的母亲因他的残疾每月领取约 700 美元。
And the idea with the program is if you have a kid with a disability, you may have to work less to help that child out.
该计划的想法是，如果您有一个残疾孩子，您可能需要减少工作来帮助那个孩子摆脱困境。
That child's probably likely to be more expensive.
那个孩子可能更贵。
When you're an adult applying for disability, you have to prove you can't function in a work-like setting.
当您作为成年人申请残疾时，您必须证明您无法在类似工作的环境中工作。
But when you're a kid, a disability can be anything that prevents you from progressing in school.
但当你还是个孩子的时候，残疾可能是任何阻碍你在学校进步的因素。
And in the last two decades, there's been an explosion of kids on disability for mental or intellectual issues.
在过去的二十年里，因精神或智力问题而残疾的儿童数量激增。
It's now 2/3 of the kids on the program.
现在有 2/3 的孩子参加了该计划。
Jaleel is a kid you can imagine doing very well for himself.
贾里尔是一个你可以想象为自己做得很好的孩子。
He is delayed.
他迟到了。
But given the right circumstances and support, it's easy to see that over the course of his schooling, Jaleel could catch up.
但只要有合适的环境和支持，很容易看出贾里尔在学习过程中可以迎头赶上。
School's his favorite thing to go to.
学校是他最喜欢去的地方。
So let's imagine that happens.
让我们想象一下这种情况发生。
Jaleel does well in school, overcomes some of his disabilities, and he doesn't need the disability program anymore.
贾里尔在学校表现很好，克服了一些残疾，他不再需要残疾计划。
That would obviously be great for every one, except it would also threaten Jaleel's family's livelihood.
这显然对每个人来说都是一件好事，但它也会威胁到贾里尔一家的生计。
Because Jaleel's family, like a lot of kids on disability, survives off that check.
因为贾里尔的家人和许多残疾孩子一样，靠这张支票生存。
Here's his mom, Nujima King.
这是他的妈妈努岛王。
She's got two other kids, and she's not working.
她还有另外两个孩子，但她没有工作。
Right now, the money that I'm receiving for him, it's extremely helpful.
现在，我为他收到的钱非常有帮助。
So you don't have any other income other than the disability right now?
那么您现在除了残疾之外没有任何其他收入吗？
Just disability and a little bit of savings.
只是残疾和一点积蓄。
Nujima wants Jaleel to do well in school.
努岛希望贾里尔在学校表现出色。
That's absolutely clear.
这是绝对清楚的。
It is also true that Nujima's income depends on Jaleel struggling to do well in school.
努岛的收入也确实取决于贾里尔努力在学校取得好成绩。
Depends on her kid continuing to be labeled disabled.
取决于她的孩子继续被贴上残疾人的标签。
There are lots and lots of poor families in exactly this same impossible situation.
有很多很多贫困家庭都处于同样的不可能的境地。
I talked to mothers who seem to find themselves advocating something that seems completely counter-intuitive for any parent.
我与一些母亲交谈过，她们似乎发现自己所提倡的东西对任何父母来说似乎完全违反直觉。
Like a woman named Darinda Cruise.
就像一个名叫达琳达·克鲁斯的女人。
Cruise I met in Greensboro, Alabama.
我在阿拉巴马州格林斯伯勒遇见了克鲁斯。
Darinda has told her 18-year-old son not to work, because it'll get in the way of a disability check.
达琳达 (Darinda) 告诉她 18 岁的儿子不要工作，因为这会妨碍残疾检查。
And he said he really want to work.
他说他真的很想工作。
He tell me every day he want to go to work.
他每天都告诉我他想去上班。
But you don't want that.
但你不希望那样。
You want him to not mess up the disability application.
你希望他不要搞砸残疾申请。
Yeah.
是的。
Not right now.
现在不行。
Chana Joffe-Walt Parents get their kids on the program when they're under 18.
Chana Joffe-Walt 父母在孩子 18 岁以下时让他们参加该计划。
And I guess it shouldn't be surprising, although I was pretty surprised by this-- 2/3 of them stay on disability when they become adults.
我想这并不奇怪，尽管我对此感到非常惊讶——其中 2/3 的人在成年后仍处于残疾状态。
They stay on a program that penalizes you if you start to do well in school or if you start to work as a grown up.
如果你在学校表现良好或者成年后开始工作，他们会继续执行一项会对你进行惩罚的计划。
I'm kind of scared to work.
我有点害怕工作。
Chana Joffe-Walt You're scared to work.
Chana Joffe-Walt 你害怕工作。
Yeah, because if I work, they'll go down on my check.
是的，因为如果我工作，他们就会记在我的支票上。
Talia McFadden is 27-years-old.
塔莉亚·麦克法登今年 27 岁。
She's been on the disability program most of her life.
她一生的大部分时间都在参加残疾计划。
She suffers from anxiety and depression.
她患有焦虑症和抑郁症。
When she was 17, she tried to kill herself.
17岁时，她试图自杀。
The one time Talia did have a very part time job tutoring, Social Security saw she was making some income, so they reduced her check.
有一次塔莉亚确实有一份兼职辅导工作，社会保障局看到她有一些收入，所以他们减少了她的支票。
Talia freaked out when this happened.
当这件事发生时，塔莉亚吓坏了。
She quit her job.
她辞去了工作。
She says her symptoms come and go, and she's just not confident she could hold down a full time job.
她说她的症状时有时无，她只是没有信心自己能保住一份全职工作。
So she doesn't want to do anything that can threaten a dependable, secure monthly check.
因此，她不想做任何可能威胁到可靠、安全的每月支票的事情。
That is incredibly valuable to her.
这对她来说非常有价值。
Although, when she talks about her experience working as a tutor, sounds like that was pretty valuable too.
不过，当她谈到自己作为导师的经历时，听起来也很有价值。
Most of my students said, I trust you.
我的大多数学生都说，我相信你。
And I felt like-- I felt appreciated, you know.
我感觉——我感到被感激，你知道。
Sometimes the parents would say that the kid wouldn't stop talking about me.
有时父母会说这孩子不停地谈论我。
So that must have been hard to give that up.
所以放弃它一定很难。
Yeah.
是的。
Because it kind of gave me a sense of wanting to be and wanting to live.
因为它给了我一种想要成为、想要生活的感觉。
It gave you a sense of wanting to be and wanting to live?
它给了你一种想要成为、想要生活的感觉吗？
Yeah, because I just feel like I don't belong.
是的，因为我只是觉得我不属于这里。
Like I'm not helping to make things better.
就像我没有帮助让事情变得更好一样。
The idea that we, as a society, should offer support to disabled children living in poverty, I haven't taken a survey or anything, but I'm guessing a large majority of Americans would be in favor of that in some form.
关于我们作为一个社会应该为生活在贫困中的残疾儿童提供支持的想法，我没有进行任何调查或任何东西，但我猜大多数美国人会以某种形式支持这一点。
We'd have a hard time agreeing exactly how we want to offer support.
我们很难就如何提供支持达成一致。
But I think there are some basic things we all agree on.
但我认为有一些基本的事情我们都同意。
Kids should be encouraged to go to school.
应该鼓励孩子们去上学。
Kids should want to do well in school.
孩子们应该想在学校取得好成绩。
Parents should want their kids to do well in school.
父母应该希望他们的孩子在学校取得好成绩。
Kids should be confident their parents can provide for them, regardless of how they do in school.
孩子们应该相信父母可以供养他们，无论他们在学校的表现如何。
And the goal should always be for children to become more and more independent as they grow older, and, if possible, support themselves, somewhere around the age of 18.
我们的目标始终是让孩子随着年龄的增长变得越来越独立，并且如果可能的话，在 18 岁左右能够养活自己。
This program stands in opposition to every one of these aims.
该计划与所有这些目标背道而驰。
So somewhere around 30 years ago, the economy started changing in some important ways.
因此，大约 30 年前的某个时候，经济开始在一些重要方面发生变化。
There are now millions of Americans who do not have the education or the skills for the current economy.
现在有数百万美国人没有接受当前经济所需的教育或技能。
And this does not seem temporary.
这似乎不是暂时的。
Politicians certainly pay lip service to this problem during election cycles and such.
在选举周期等期间，政客们肯定会口头上谈论这个问题。
But American leaders have not sat down and said, look, things have fundamentally changed.
但美国领导人并没有坐下来说，看，事情已经发生了根本性的变化。
What are we going to do for these people?
我们要为这些人做什么？
We need a plan.
我们需要一个计划。
In the meantime, the disability programs have become the default plan.
与此同时，残疾计划已成为默认计划。
Programs that, along with the associated health care, cost about $260 billion a year.
这些计划连同相关的医疗保健每年花费约 2600 亿美元。
And I know this is obvious, but a quarter trillion dollars?
我知道这是显而易见的，但是 25 万亿美元？
That's a lot of money.
那是很多钱。
That's eight times more than we spend on welfare.
这是我们福利支出的八倍。
In fact, it is more than we spend on welfare, food stamps, the school lunch program, and subsidized housing combined.
事实上，这比我们在福利、食品券、学校午餐计划和补贴住房上的支出总和还要多。
A lot more.
还有很多。
Think for a minute of what we could do with a quarter trillion dollars.
想一想我们可以用 25 万亿美元做什么。
We could decide what we want is to expand welfare payments or food stamps.
我们可以决定我们想要的是扩大福利支付或食品券。
We could decide that the best plan is just to hand out cash to every out of work American.
我们可以决定，最好的计划就是向每个失业的美国人发放现金。
Or we could decide not to spend the money.
或者我们可以决定不花这笔钱。
Let everybody pay less in taxes.
让大家少缴税。
There are options.
有选择。
We just never made a decision.
我们只是从未做出决定。
Chana Joffe-Walt.
查纳·乔夫-沃尔特。
She's with Planet Money, which is a co-production of our program and NPR News.
她是 Planet Money 的一员，该节目是我们的节目和 NPR 新闻的联合制作。
At the Planet Money website, you can see some really startling graphs and charts that tell this story in a way that you really can't tell a story on the radio.
在 Planet Money 网站上，您可以看到一些非常令人吃惊的图表，它们以一种您无法在广播中讲述故事的方式讲述这个故事。
Seriously, some of these are kind of amazing.
说真的，其中一些是令人惊奇的。
That is at planetmoney.com.
这是在planetmoney.com。
Our program today was produced by Alex Blumberg and our senior producer, Julie Snyder with Ben Calhoun, Sara Koenig, Miki Meek, Jonathan Menjivar, Lisa Pollak, Brian Reed, Robyn Semien, Alissa Shipp and Nancy Updike.
我们今天的节目由 Alex Blumberg 和我们的高级制片人 Julie Snyder 以及 Ben Calhoun、Sara Koenig、Miki Meek、Jonathan Menjivar、Lisa Pollak、Brian Reed、Robyn Semien、Alissa Shipp 和 Nancy Updike 共同制作。
Production help from [INAUDIBLE].
来自[听不清]的制作帮助。
Seth Lind is our operations director.
塞思·林德 (Seth Lind) 是我们的运营总监。
Emily Condon's our production manager.
艾米丽·康登是我们的生产经理。
Elise Bergerson is our administrative assistant.
埃莉斯·伯格森是我们的行政助理。
Music help from Damien Graef, from Rob Geddes.
达米安·格雷夫 (Damien Graef) 和罗布·格迪斯 (Rob Geddes) 提供音乐帮助。
[ACKNOWLEDGEMENTS] This American Life is distributed by Public Radio International.
[致谢]《美国生活》由国际公共广播电台发行。
WBEZ management oversight for our program by our boss, Mr. Torey Malatia.
我们的老板 Torey Malatia 先生对我们的项目进行 WBEZ 管理监督。
I don't know.
我不知道。
Sitting at a computer all day, I've been having this ache in my lower back.
坐在电脑前一整天，我的腰部一直酸痛。
And he and I were talking about it in the break room.
他和我在休息室谈论这件事。
And then Torey just burst into song.
然后托雷突然唱歌了。
[SINGING] Call the Davis Disability Group.
[唱歌] 致电戴维斯残疾人小组。
Put us on your side.
让我们站在你这边。
I'm Ira Glass.
我是艾拉·格拉斯。
Back next week with more stories of This American Life.
下周我们将带来更多《美国生活》的故事。
This American Life is produced in collaboration with WBEZ Chicago and delivered to stations by PRX The Public Radio Exchange.
《This American Life》与 WBEZ Chicago 合作制作，并由 PRX 公共广播电台传送到各电台。