By Laura Remson Mitchell
While physical violence against Americans with disabilities
is more prevalent than
most of us may want to believe, much of the problem for the disability community
is subtler. Still, at least some of the forces prompting violence in Germany exist here,
too. Perhaps most powerful of these is a prevailing view that people with disabilities
are a "problem" to be solved rather than a resource to be tapped in pursuit of
solutions to the problems facing all of us.
The "problem" was made clear in the taunts of German teenagers
as they attacked a
46-year-old amputee: "Under Hitler you would have been gassed! You're a waste of
That view is increasingly evident in this country as policymakers
respond to tight
budgets. The scenario might unfold this way:
Example: A draft of Medicare's new supplier manual states:
equipment is covered when it is medically necessary for use in a patient's home.
Equipment and/or features that are needed for use outside the home... will not be
That's a prison sentence for many of us with disabilities.
The landmark Americans
with Disabilities Act notwithstanding, Medicare's approach segregates potentially
productive disabled people at home, even though the right equipment would give
them access to the kind of educational, social and employment opportunities they
need to be truly independent.
And private insurers and managed-care plans often follow
Medicare guidelines. All of
this has chilling implications for the way in which national health-care reforms might
deal with our most basic needs.
Example: In the great California Budget Showdown of 1992,
Governor Wilson initially
proposed a 20% cut in In-Home Supportive Services, the state program that provides
attendant care and other essential services.
Although disability rights advocates managed to limit
the reduction to 12%, the action
left many recipients reeling. Despite paper assurances that the cuts wouldn't be made
if they endangered beneficiaries or put them at risk of nursing-home placement, some
counties gave out misleading or false information about appeal rights. (Ultimately,
the state obtained federal funds to pay for restoring these services, but the way the
program will operate in the future remains uncertain.)
The Governor has proposed more cuts in other programs
critical to Californians with
disabilities. Fiscal pressures already have led officials to divert state money away
from certain jointly funded disability programs and into the General Fund.
There's more — much more. Whether intentional or
not, parts of the scenario
described above already are in place. That's why many of us in the disability
community are terrified by the prospect of a growing "right to die" movement that
coincides with increasingly limited access to the support services that help us to live.
More often than not, what makes living with a disability
unbearable isn't the disability
itself but the messages of helplessness and worthlessness that go with it. Those
messages can kill.
Two weeks after the disabled man in Germany was attacked,
he committed suicide.
The note he left behind explains why: "Under Hitler I would have surely been gassed;
maybe all these kids have a point." He had bought the lie that disability equals
Unless public officials, business leaders, social service
agencies and charitable
organizations start treating disabled people as partners rather than as burdens, we
will continue to be in jeopardy — and not only in Germany.
Laura Remson Mitchell, who has multiple sclerosis, is a Los Angeles-based
analyst, consultant and writer specializing in disability and health-care issues.
Copyright 1993 by Laura Remson Mitchell
Last revision: Jan. 16, 1999
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