Recovery Board
: RfM
Recovery from Mormonism (RfM) discussion forum.
I am totally blind so this is one of my every-now-and-then postings related to that subject. I will have more to say about my personal situation at the bottom of this post.
https://www.npr.org/sections/health-shots/2022/12/01/1139730806/blind-disability-accessibility-medical-bills
From NPR's story:
"A Missouri man who is deaf and blind said a medical bill he didn't know existed was sent to debt collections, triggering an 11% rise in his home insurance premiums.
In a different case, from California, an insurer has suspended a blind woman's coverage every year since 2010 after mailing printed "verification of benefits" forms to her home that she cannot read, she said. The problems continued even after she got a lawyer involved.
And still another insurer kept sending a visually impaired Indiana woman bills she said she could not read, even after her complaint to the Health and Human Services' Office for Civil Rights led to corrective actions.
Across the U.S., health insurers and health care systems are breaking disability rights laws by sending inaccessible medical bills and notices, a KHN investigation has found. The practice hinders the ability of blind Americans to know what they owe, effectively creating a disability tax on their time and finances.
Crucial notices are often in small print, impossible to read
More than 7 million Americans age 16 and older have a visual disability, according to the National Federation of the Blind. And having medical information and bills delivered in an
accessible manner is the right of each of those people, protected under various statutes, including the Americans with Disabilities Act, the Affordable Care Act, and the Rehabilitation Act, disability rights legal experts said.
But some blind patients told KHN that the letters they receive can be impossible to read. Some websites contain coding that is incompatible with screen reader technology, which reads text aloud. Some health care systems and insurers fail to mail documents in Braille, which some blind people read by touch.
And others who are visually impaired can read large print, with the possible aid of glasses or magnifying lenses, but the small-print medical bills they get are indecipherable."
Fortunately for me, I live with a fully sighted younger sister who can read the bills to me so that I can pay them. Of course, that situation could end end at any time if she moves out or dies and then I'd be in the same boat as the people being discussed in this article.
Unfortunately, we humans have a terrible habit of victim-blaming. Calvinism/Puritanism gives the justification in the U.S., but other religions and philosophys in other countries also justify the same blame game. We blame women for getting raped; poor people for being poor; and the disabled (including the blind) for being disabled. The result is that even when victories are achieved to right some of the injustices, holes will be found by those determined to see that either 1) the injustices still occur; and/or 2) people who are on top remain on top no matter what the costs to both individuals and society are.
https://www.npr.org/sections/health-shots/2022/12/01/1139730806/blind-disability-accessibility-medical-bills
From NPR's story:
"A Missouri man who is deaf and blind said a medical bill he didn't know existed was sent to debt collections, triggering an 11% rise in his home insurance premiums.
In a different case, from California, an insurer has suspended a blind woman's coverage every year since 2010 after mailing printed "verification of benefits" forms to her home that she cannot read, she said. The problems continued even after she got a lawyer involved.
And still another insurer kept sending a visually impaired Indiana woman bills she said she could not read, even after her complaint to the Health and Human Services' Office for Civil Rights led to corrective actions.
Across the U.S., health insurers and health care systems are breaking disability rights laws by sending inaccessible medical bills and notices, a KHN investigation has found. The practice hinders the ability of blind Americans to know what they owe, effectively creating a disability tax on their time and finances.
Crucial notices are often in small print, impossible to read
More than 7 million Americans age 16 and older have a visual disability, according to the National Federation of the Blind. And having medical information and bills delivered in an
accessible manner is the right of each of those people, protected under various statutes, including the Americans with Disabilities Act, the Affordable Care Act, and the Rehabilitation Act, disability rights legal experts said.
But some blind patients told KHN that the letters they receive can be impossible to read. Some websites contain coding that is incompatible with screen reader technology, which reads text aloud. Some health care systems and insurers fail to mail documents in Braille, which some blind people read by touch.
And others who are visually impaired can read large print, with the possible aid of glasses or magnifying lenses, but the small-print medical bills they get are indecipherable."
Fortunately for me, I live with a fully sighted younger sister who can read the bills to me so that I can pay them. Of course, that situation could end end at any time if she moves out or dies and then I'd be in the same boat as the people being discussed in this article.
Unfortunately, we humans have a terrible habit of victim-blaming. Calvinism/Puritanism gives the justification in the U.S., but other religions and philosophys in other countries also justify the same blame game. We blame women for getting raped; poor people for being poor; and the disabled (including the blind) for being disabled. The result is that even when victories are achieved to right some of the injustices, holes will be found by those determined to see that either 1) the injustices still occur; and/or 2) people who are on top remain on top no matter what the costs to both individuals and society are.
BG, I get where you are coming from.
https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/
Despite over 90% of the United States population having some form of health insurance, medical debt remains a persistent problem. For people and families with limited assets, even a relatively small unexpected medical expense can be unaffordable. For people with significant medical needs, medical debt may build up over time. People living with cancer, for example, have higher levels of debt than individuals who have never had cancer.
High deductibles and other forms of cost sharing can contribute to individuals receiving medical bills that they are unable to pay, despite being insured. People with medical debt report cutting spending on food, clothing, and other household items, spending down their savings to pay for medical bills, borrowing money from friends or family members, or taking on additional debts.
In this brief, we analyze data from the Survey of Income and Program Participation (SIPP) to understand how many people have medical debt and how much they owe. A recent Census Bureau analysis on medical debt at the household level found 17% of households owed medical debt in 2019. Here, we analyze medical debt at the individual level for adults who reported owing over $250 in unpaid medical bills as of December 2019. We focus on people with over $250 in medical debt, a threshold we define as “significant” medical debt to distinguish from people who owe relatively small amounts.
We find that 23 million people (nearly 1 in 10 adults) owe significant medical debt. The SIPP survey suggests people in the United States owe at least $195 billion in medical debt. Approximately 16 million people (6% of adults) in the U.S. owe over $1,000 in medical debt and 3 million people (1% of adults) owe medical debt of more than $10,000. Medical debt occurs across demographic groups. But, people with disabilities, those in worse health, and poor or near-poor adults are more likely to owe significant medical debt. We also find that Black Americans, and people living in the South or in Medicaid non-expansion states were more likely to have significant medical debt.
https://www.healthsystemtracker.org/brief/the-burden-of-medical-debt-in-the-united-states/
Despite over 90% of the United States population having some form of health insurance, medical debt remains a persistent problem. For people and families with limited assets, even a relatively small unexpected medical expense can be unaffordable. For people with significant medical needs, medical debt may build up over time. People living with cancer, for example, have higher levels of debt than individuals who have never had cancer.
High deductibles and other forms of cost sharing can contribute to individuals receiving medical bills that they are unable to pay, despite being insured. People with medical debt report cutting spending on food, clothing, and other household items, spending down their savings to pay for medical bills, borrowing money from friends or family members, or taking on additional debts.
In this brief, we analyze data from the Survey of Income and Program Participation (SIPP) to understand how many people have medical debt and how much they owe. A recent Census Bureau analysis on medical debt at the household level found 17% of households owed medical debt in 2019. Here, we analyze medical debt at the individual level for adults who reported owing over $250 in unpaid medical bills as of December 2019. We focus on people with over $250 in medical debt, a threshold we define as “significant” medical debt to distinguish from people who owe relatively small amounts.
We find that 23 million people (nearly 1 in 10 adults) owe significant medical debt. The SIPP survey suggests people in the United States owe at least $195 billion in medical debt. Approximately 16 million people (6% of adults) in the U.S. owe over $1,000 in medical debt and 3 million people (1% of adults) owe medical debt of more than $10,000. Medical debt occurs across demographic groups. But, people with disabilities, those in worse health, and poor or near-poor adults are more likely to owe significant medical debt. We also find that Black Americans, and people living in the South or in Medicaid non-expansion states were more likely to have significant medical debt.
And yet there is no political will in the U.S. for a nationalized health care system. It boggles the mind.
In the year 2525, if man is still alive, if woman can survive, they will still be doing this sort of lazy, un-empathetic, hurtful crap. And of course it is ten times harder for a blind person to straighten out the porblem once it occurs I imagine. Pollyanna I am not.
The United States of "Not My Problem" too often.
We have a monthly bill to pay and my other half has taken to calling or emailing to remind them to send the invoice so we get it before the notice that we didn't pay on time. Every month. Not kidding. Sometimes he goes to the office and five people are sitting around gabbing like it was a workplace on a sitcom.
That is why I wait for evidence when I hear people brag about how good they are at their jobs. I'll believe it when I see it.
This stuff should be making the news more and I mean the front page.
The United States of "Not My Problem" too often.
We have a monthly bill to pay and my other half has taken to calling or emailing to remind them to send the invoice so we get it before the notice that we didn't pay on time. Every month. Not kidding. Sometimes he goes to the office and five people are sitting around gabbing like it was a workplace on a sitcom.
That is why I wait for evidence when I hear people brag about how good they are at their jobs. I'll believe it when I see it.
This stuff should be making the news more and I mean the front page.
Wow. That is not OK. It's bad enough when a bill gets lost or has so much print that it's impossible to figure out what you are supposed to do and why.
Medical debt is a growing problem for many and it doesn't look like there is any end in sight. The least they could do is make their thievery system understandable and accessible for blind people!
Thanks for bringing up things like this that many of us would not realize is happening.
Medical debt is a growing problem for many and it doesn't look like there is any end in sight. The least they could do is make their thievery system understandable and accessible for blind people!
Thanks for bringing up things like this that many of us would not realize is happening.
Blindguy: I will risk being politically incorrect here, by pushing back a little. I am confident that you will not see my comments as insensitive to the real and significant problem you describe, or your personal experience with such problem.
COMMENT: What is conspicuously absent here is any argument for the feasibility of any proposed remedy. You state:
"Some websites contain coding that is incompatible with screen reader technology, which reads text aloud. Some health care systems and insurers fail to mail documents in Braille, which some blind people read by touch. And others who are visually impaired can read large print, with the possible aid of glasses or magnifying lenses, but the small-print medical bills they get are indecipherable."
The above suggests three proposed changes: (a) on-line billing information with screen reader technology; (b) Mailed billings available in Braille; and (c) Larger print. Is there any cost-benefit analysis--formal or informal--as to of any of these remedies?
The linked article stated:
"It's the year 2022. Everything is being done electronically; everything is being done online," said Patrick Molloy, a blind 29-year-old in Bucks County, Penn. "It shouldn't, in theory, be terribly difficult to make websites and billing platforms accessible to customers with visual impairments. But it's the world we live in."
The primary solution seems to be online access of billing information that the blind can access through specialized software. Is there an argument that such an option is more than just theoretical, but also logistically and economically practicable?
_______________________________________
"More than 7 million Americans age 16 and older have a visual disability, according to the National Federation of the Blind. And having medical information and bills delivered in an
accessible manner is the right of each of those people, protected under various statutes, including the Americans with Disabilities Act, the Affordable Care Act, and the Rehabilitation Act, disability rights legal experts said."
COMMENT: If in fact such statutory protections are in place through specifically stated legal requirements, then such requirements should be enforced. Apparently--since the problem persists--such statutes are inadequate, either in their specific content or scope.
Moreover, when arguing for aggressive social policy--e.g. a mandate that all health care providers and insurance companies make billing statements available online in blind-accessible format--the statistical cost-benefit ratios should be kept in mind; namely the 7 million blind Americans over 16 that might be benefited (assuming unrealistically that all have both the need and the software to benefit from such a policy), as compared to the cost of implementation. (Keeping in mind that such costs will be passed on the consumers.)
According to the U.S. 2020 census, there are 258 million in the U.S. over 18. This means--in rough numbers--that the adult blind population represents less than 3 percent of the population. (In comparative contrast, the Black population of the U.S. is approximately 14%) When engaging in social policy, the number of positively affected individuals as relative to the social cost is an appropriate consideration. Is there an argument that ANY proposed remedy is either (a) cost effective, all things considered; or (b) an economically insignificant burden given the benefits? THAT SEEMS TO ME WHAT IS NEEDED FOR A COMPELLING ARGUMENT.
_________________________________________
"Fortunately for me, I live with a fully sighted younger sister who can read the bills to me so that I can pay them. Of course, that situation could end end at any time if she moves out or dies and then I'd be in the same boat as the people being discussed in this article."
COMMENT: The point is well-taken, but it begs the question as to where the burden of blindness should ultimately lie. Perhaps the remedy is first and foremost within families, or absent that, with local community resources, rather than global business mandates. I frankly don't know and am only asking. (Throughout this response, I find myself saying to myself, "Yeh, that's easy for you to say!") Moreover, certainly in some cases general principles of fundamental fairness should prevail notwithstanding the cost. Maybe this is one of those cases.
____________________________________
"Unfortunately, we humans have a terrible habit of victim-blaming. Calvinism/Puritanism gives the justification in the U.S., but other religions and philosophys in other countries also justify the same blame game. We blame women for getting raped; poor people for being poor; and the disabled (including the blind) for being disabled. The result is that even when victories are achieved to right some of the injustices, holes will be found by those determined to see that either 1) the injustices still occur; and/or 2) people who are on top remain on top no matter what the costs to both individuals and society are."
COMMENT: Frankly, this strikes me as grossly disingenuous and unfair. The vast majority of Americans are sympathetic and sensitive to the blight of the blind, however casually. They certainly do not blame people for being blind. Unfortunately, the real world dishes out natural injustices of a wide variety to a wide variety of people, leaving society to consider what responsibility it has to assist or remedy such injustices with limited resources and Constitutional commitments. As a socialist, I personally think that much more should be done on all such fronts. But simply identifying a problem that happens to be personal does not of itself support the claim of an injustice, a requirement for a social response to it, or moral blame.
COMMENT: What is conspicuously absent here is any argument for the feasibility of any proposed remedy. You state:
"Some websites contain coding that is incompatible with screen reader technology, which reads text aloud. Some health care systems and insurers fail to mail documents in Braille, which some blind people read by touch. And others who are visually impaired can read large print, with the possible aid of glasses or magnifying lenses, but the small-print medical bills they get are indecipherable."
The above suggests three proposed changes: (a) on-line billing information with screen reader technology; (b) Mailed billings available in Braille; and (c) Larger print. Is there any cost-benefit analysis--formal or informal--as to of any of these remedies?
The linked article stated:
"It's the year 2022. Everything is being done electronically; everything is being done online," said Patrick Molloy, a blind 29-year-old in Bucks County, Penn. "It shouldn't, in theory, be terribly difficult to make websites and billing platforms accessible to customers with visual impairments. But it's the world we live in."
The primary solution seems to be online access of billing information that the blind can access through specialized software. Is there an argument that such an option is more than just theoretical, but also logistically and economically practicable?
_______________________________________
"More than 7 million Americans age 16 and older have a visual disability, according to the National Federation of the Blind. And having medical information and bills delivered in an
accessible manner is the right of each of those people, protected under various statutes, including the Americans with Disabilities Act, the Affordable Care Act, and the Rehabilitation Act, disability rights legal experts said."
COMMENT: If in fact such statutory protections are in place through specifically stated legal requirements, then such requirements should be enforced. Apparently--since the problem persists--such statutes are inadequate, either in their specific content or scope.
Moreover, when arguing for aggressive social policy--e.g. a mandate that all health care providers and insurance companies make billing statements available online in blind-accessible format--the statistical cost-benefit ratios should be kept in mind; namely the 7 million blind Americans over 16 that might be benefited (assuming unrealistically that all have both the need and the software to benefit from such a policy), as compared to the cost of implementation. (Keeping in mind that such costs will be passed on the consumers.)
According to the U.S. 2020 census, there are 258 million in the U.S. over 18. This means--in rough numbers--that the adult blind population represents less than 3 percent of the population. (In comparative contrast, the Black population of the U.S. is approximately 14%) When engaging in social policy, the number of positively affected individuals as relative to the social cost is an appropriate consideration. Is there an argument that ANY proposed remedy is either (a) cost effective, all things considered; or (b) an economically insignificant burden given the benefits? THAT SEEMS TO ME WHAT IS NEEDED FOR A COMPELLING ARGUMENT.
_________________________________________
"Fortunately for me, I live with a fully sighted younger sister who can read the bills to me so that I can pay them. Of course, that situation could end end at any time if she moves out or dies and then I'd be in the same boat as the people being discussed in this article."
COMMENT: The point is well-taken, but it begs the question as to where the burden of blindness should ultimately lie. Perhaps the remedy is first and foremost within families, or absent that, with local community resources, rather than global business mandates. I frankly don't know and am only asking. (Throughout this response, I find myself saying to myself, "Yeh, that's easy for you to say!") Moreover, certainly in some cases general principles of fundamental fairness should prevail notwithstanding the cost. Maybe this is one of those cases.
____________________________________
"Unfortunately, we humans have a terrible habit of victim-blaming. Calvinism/Puritanism gives the justification in the U.S., but other religions and philosophys in other countries also justify the same blame game. We blame women for getting raped; poor people for being poor; and the disabled (including the blind) for being disabled. The result is that even when victories are achieved to right some of the injustices, holes will be found by those determined to see that either 1) the injustices still occur; and/or 2) people who are on top remain on top no matter what the costs to both individuals and society are."
COMMENT: Frankly, this strikes me as grossly disingenuous and unfair. The vast majority of Americans are sympathetic and sensitive to the blight of the blind, however casually. They certainly do not blame people for being blind. Unfortunately, the real world dishes out natural injustices of a wide variety to a wide variety of people, leaving society to consider what responsibility it has to assist or remedy such injustices with limited resources and Constitutional commitments. As a socialist, I personally think that much more should be done on all such fronts. But simply identifying a problem that happens to be personal does not of itself support the claim of an injustice, a requirement for a social response to it, or moral blame.
Before I respond to each of your points, let me say up front that I do *not* consider your comments to be politically incorrect. In fact, I agree with many of your proposed solutions and so does a majority of the blind community. Further, many of these solutions are available now. The problem, as the article states (and as you hint at below) is primarily enforcement and a lack of will (probably because of the expense) by the insurance and medical industries to do what they should be doing in this regard.
Henry Bemis Wrote:
-------------------------------------------------------
> Blindguy: I will risk being politically incorrect
> here, by pushing back a little. I am confident
> that you will not see my comments as insensitive
> to the real and significant problem you describe,
> or your personal experience with such problem.
>
> COMMENT: What is conspicuously absent here is any
> argument for the feasibility of any proposed
> remedy. You state:
>
> "Some websites contain coding that is incompatible
> with screen reader technology, which reads text
> aloud. Some health care systems and insurers fail
> to mail documents in Braille, which some blind
> people read by touch. And others who are visually
> impaired can read large print, with the possible
> aid of glasses or magnifying lenses, but the
> small-print medical bills they get are
> indecipherable."
>
> The above suggests three proposed changes: (a)
> on-line billing information with screen reader
> technology; (b) Mailed billings available in
> Braille; and (c) Larger print. Is there any
> cost-benefit analysis--formal or informal--as to
> of any of these remedies?
>
> The linked article stated:
>
> "It's the year 2022. Everything is being done
> electronically; everything is being done online,"
> said Patrick Molloy, a blind 29-year-old in Bucks
> County, Penn. "It shouldn't, in theory, be
> terribly difficult to make websites and billing
> platforms accessible to customers with visual
> impairments. But it's the world we live in."
>
> The primary solution seems to be online access of
> billing information that the blind can access
> through specialized software. Is there an argument
> that such an option is more than just theoretical,
> but also logistically and economically
> practicable?
First, all of the proposed solutions can be done right now. The means are here to do them. The problem, as alluded to above, is the cost-benefit. Because I don't read large print, I cannot tell you about that end. However, because I am a braille reader (and a braille proofreader for the state in which I live as well), I can tell you that braille is the costliest medium to produce. If you consider that a single print page can occupy from one-and-a-half to two-and-a-half braille pages, depending on the size of the print being used (there is no size differentiation in braille), then you can see why it would take more braille pages (and volumes) of braille to create a print book. In addition, there are very few trained braillists, and those that are available can command a high price, especially if they are contracting with a large company. When I proofread for a private nonprofit agency, I earn now $1 per braille page. People who do the actual brailling earn more and they are usually paid per page produced as well. And, while your analysis of the figures at the bottom of this article is correct, keep in mind that the vast majority of visually impaired people are legally blind but not totally blind; only a tiny minority are totally blind like myself.
Sending the bills in an accessible format is probably the cheapest and best solution here, and it can be done--I receive my cable bill each month in my email box. In addition, several of my non-health bills go directly to the bill pay section of my bank account, and I pay them directly through that account. (I don't do automatic billing, frankly because I live primarily on Social Security Disability Income now, that isn't a lot of money, and I need to therefore be in total control of when checks are sent to whom.)
Yes, all of this can be done now, so why isn't it. One reason is cost. Another is that not all blind people have computer access. Still another (and this is one that will surprise a lot of folks) is security. It turns out that a number of the items used to make sites more secure (such as using capchas to insure that you are not a robot) make the site either difficult or completely inaccessible to the blind. Screen readers can read many things, but they can't, for example, readily read text inside of pictures. Finally, most websites were built without blind access in mind, and rewriting the code to make them friendlier for screen reader technology becomes much harder in that instance.
> _______________________________________
>
> "More than 7 million Americans age 16 and older
> have a visual disability, according to the
> National Federation of the Blind. And having
> medical information and bills delivered in an
> accessible manner is the right of each of those
> people, protected under various statutes,
> including the Americans with Disabilities Act, the
> Affordable Care Act, and the Rehabilitation Act,
> disability rights legal experts said."
>
> COMMENT: If in fact such statutory protections are
> in place through specifically stated legal
> requirements, then such requirements should be
> enforced. Apparently--since the problem
> persists--such statutes are inadequate, either in
> their specific content or scope.
>
> Moreover, when arguing for aggressive social
> policy--e.g. a mandate that all health care
> providers and insurance companies make billing
> statements available online in blind-accessible
> format--the statistical cost-benefit ratios should
> be kept in mind; namely the 7 million blind
> Americans over 16 that might be benefited
> (assuming unrealistically that all have both the
> need and the software to benefit from such a
> policy), as compared to the cost of
> implementation. (Keeping in mind that such costs
> will be passed on the consumers.)
>
> According to the U.S. 2020 census, there are 258
> million in the U.S. over 18. This means--in rough
> numbers--that the adult blind population
> represents less than 3 percent of the population.
> (In comparative contrast, the Black population of
> the U.S. is approximately 14%) When engaging in
> social policy, the number of positively affected
> individuals as relative to the social cost is an
> appropriate consideration. Is there an argument
> that ANY proposed remedy is either (a) cost
> effective, all things considered; or (b) an
> economically insignificant burden given the
> benefits? THAT SEEMS TO ME WHAT IS NEEDED FOR A
> COMPELLING ARGUMENT.
The email solution would be a relatively inexpensive one, assuming the medical insurance companies do not have to use some of their security procedures for blind people to access their accounts. As to blind and visually impaired people reading the bills on companies' websites, that will largely depend on how accessible those websites are to begin with, what kinds of security hoops the companies are making blind people jump through to get that information, and how easy it would be to rewrite portions of the websites' codes to make it more accessible.
I should make a note about the laws here, specifically the Americans with Disabilities Act (ADA). That law was passed in 1992 and does not specifically mention Internet activity, specifically because a lot of disabled people at that time, including yours truly, were not using the Internet to get information then. There has been a battle going on for many years now between the disabled community and businesses about whether the ADA applys to the Internet and the worldwide web. In the latest ruling, handed down by a California Appeals Court two months ago and that the California State Supreme Court let stand, businesses that have both a brick-and-motar and a Web presence must make their websites accessible to the disabled, but businesses that operate only on the web do not have to worry about the issue. Other state and Federal courts in different jurisdictions have ruled differently and it is believed that the U.S. Supreme Court will make a decision on the matter in the not-too-distant future.
> _________________________________________
>
> "Fortunately for me, I live with a fully sighted
> younger sister who can read the bills to me so
> that I can pay them. Of course, that situation
> could end end at any time if she moves out or dies
> and then I'd be in the same boat as the people
> being discussed in this article."
>
> COMMENT: The point is well-taken, but it begs the
> question as to where the burden of blindness
> should ultimately lie. Perhaps the remedy is first
> and foremost within families, or absent that, with
> local community resources, rather than global
> business mandates. I frankly don't know and am
> only asking. (Throughout this response, I find
> myself saying to myself, "Yeh, that's easy for you
> to say!") Moreover, certainly in some cases
> general principles of fundamental fairness should
> prevail notwithstanding the cost. Maybe this is
> one of those cases.
Blind people, including yours truly, believe that they should have the right to the same access as sighted folks. There has been a blind independence movement that has been going on since at least the 1960s that has encouraged blind, Deafblind, and visually impaired people to live away from home as their sighted counterparts do. Perhaps the answer my late mother gave to me several years back when I asked about knowing any blind people when she was a teenager in the 1950s will explain that. What she said, and I'm paraphraising here, was that back then, blind people and disabled people of all types were not seen on the streets or in the stores. They were hidden from view and their existance was never acknowledged, except perhaps by their closest kin. We have come a long way from that, and I would hate to see us go backwards.
And, as to your last question in this section, it is a matter of fairness, regardless of cost. We blind people are here to stay, and regardless of cost, the state and the private sector should be helping to support us in our right to be independent and to lead full and fulfilling and public lives!
> ____________________________________
>
> "Unfortunately, we humans have a terrible habit of
> victim-blaming. Calvinism/Puritanism gives the
> justification in the U.S., but other religions and
> philosophys in other countries also justify the
> same blame game. We blame women for getting raped;
> poor people for being poor; and the disabled
> (including the blind) for being disabled. The
> result is that even when victories are achieved to
> right some of the injustices, holes will be found
> by those determined to see that either 1) the
> injustices still occur; and/or 2) people who are
> on top remain on top no matter what the costs to
> both individuals and society are."
>
> COMMENT: Frankly, this strikes me as grossly
> disingenuous and unfair. The vast majority of
> Americans are sympathetic and sensitive to the
> blight of the blind, however casually. They
> certainly do not blame people for being blind.
> Unfortunately, the real world dishes out natural
> injustices of a wide variety to a wide variety of
> people, leaving society to consider what
> responsibility it has to assist or remedy such
> injustices with limited resources and
> Constitutional commitments. As a socialist, I
> personally think that much more should be done on
> all such fronts. But simply identifying a problem
> that happens to be personal does not of itself
> support the claim of an injustice, a requirement
> for a social response to it, or moral blame.
What you are raising is the question of intent versus outcome, and this applys to other minorities as well. The argument for intent says that an injustice hasn't occurred because I didn't intend injustice, no matter what the results may be. From a legal perspective, it makes proving an injustice much harder because not only do you have to prove the unjust outcome of a certain action or policy but you also have to prove that the perpetrator of that policy *intended* that outcome to occur. This is why I personally support an outcomes-driven policy; that is, whether a policy is specifically just or unjust to a different group should be determined by the particular policy's outcomes, regardless of the intent of the policymaker(s). Justice for all, including policymaker(s), would be better served if outcomes, not intent, were the goal.
As to your narrower point, I believe that you are arguing that you are individually responsible for creating the system we live under that is selling me, and people like me, short. You personally are not, though the ideology you echo may well be. Whether we like it or not, the individual decisions we make are based on how we view the world and our role in it. And those roles are based upon how we were raised, including our religions and schooling, and the beliefs of the friends we met along the way. The problems described in the article are problems created by a system that was not set up to assist blind and visually impaired people specifically, and the disabled in general. Why was this done? Because the people who created and designed this system had certain beliefs about the blind and disabled, not borne out by knowledge, that they used to create the system in the first place. So, while I agree with you that there are many natural world injustices that plague blind and visually impaired people not created by humans, there are many more that are created by humans and that need to be changed if blind and visually impaired people ever wish to become statistically as successful as their sighted counterparts.
Edited 1 time(s). Last edit at 12/02/2022 04:37PM by blindguy.
Henry Bemis Wrote:
-------------------------------------------------------
> Blindguy: I will risk being politically incorrect
> here, by pushing back a little. I am confident
> that you will not see my comments as insensitive
> to the real and significant problem you describe,
> or your personal experience with such problem.
>
> COMMENT: What is conspicuously absent here is any
> argument for the feasibility of any proposed
> remedy. You state:
>
> "Some websites contain coding that is incompatible
> with screen reader technology, which reads text
> aloud. Some health care systems and insurers fail
> to mail documents in Braille, which some blind
> people read by touch. And others who are visually
> impaired can read large print, with the possible
> aid of glasses or magnifying lenses, but the
> small-print medical bills they get are
> indecipherable."
>
> The above suggests three proposed changes: (a)
> on-line billing information with screen reader
> technology; (b) Mailed billings available in
> Braille; and (c) Larger print. Is there any
> cost-benefit analysis--formal or informal--as to
> of any of these remedies?
>
> The linked article stated:
>
> "It's the year 2022. Everything is being done
> electronically; everything is being done online,"
> said Patrick Molloy, a blind 29-year-old in Bucks
> County, Penn. "It shouldn't, in theory, be
> terribly difficult to make websites and billing
> platforms accessible to customers with visual
> impairments. But it's the world we live in."
>
> The primary solution seems to be online access of
> billing information that the blind can access
> through specialized software. Is there an argument
> that such an option is more than just theoretical,
> but also logistically and economically
> practicable?
First, all of the proposed solutions can be done right now. The means are here to do them. The problem, as alluded to above, is the cost-benefit. Because I don't read large print, I cannot tell you about that end. However, because I am a braille reader (and a braille proofreader for the state in which I live as well), I can tell you that braille is the costliest medium to produce. If you consider that a single print page can occupy from one-and-a-half to two-and-a-half braille pages, depending on the size of the print being used (there is no size differentiation in braille), then you can see why it would take more braille pages (and volumes) of braille to create a print book. In addition, there are very few trained braillists, and those that are available can command a high price, especially if they are contracting with a large company. When I proofread for a private nonprofit agency, I earn now $1 per braille page. People who do the actual brailling earn more and they are usually paid per page produced as well. And, while your analysis of the figures at the bottom of this article is correct, keep in mind that the vast majority of visually impaired people are legally blind but not totally blind; only a tiny minority are totally blind like myself.
Sending the bills in an accessible format is probably the cheapest and best solution here, and it can be done--I receive my cable bill each month in my email box. In addition, several of my non-health bills go directly to the bill pay section of my bank account, and I pay them directly through that account. (I don't do automatic billing, frankly because I live primarily on Social Security Disability Income now, that isn't a lot of money, and I need to therefore be in total control of when checks are sent to whom.)
Yes, all of this can be done now, so why isn't it. One reason is cost. Another is that not all blind people have computer access. Still another (and this is one that will surprise a lot of folks) is security. It turns out that a number of the items used to make sites more secure (such as using capchas to insure that you are not a robot) make the site either difficult or completely inaccessible to the blind. Screen readers can read many things, but they can't, for example, readily read text inside of pictures. Finally, most websites were built without blind access in mind, and rewriting the code to make them friendlier for screen reader technology becomes much harder in that instance.
> _______________________________________
>
> "More than 7 million Americans age 16 and older
> have a visual disability, according to the
> National Federation of the Blind. And having
> medical information and bills delivered in an
> accessible manner is the right of each of those
> people, protected under various statutes,
> including the Americans with Disabilities Act, the
> Affordable Care Act, and the Rehabilitation Act,
> disability rights legal experts said."
>
> COMMENT: If in fact such statutory protections are
> in place through specifically stated legal
> requirements, then such requirements should be
> enforced. Apparently--since the problem
> persists--such statutes are inadequate, either in
> their specific content or scope.
>
> Moreover, when arguing for aggressive social
> policy--e.g. a mandate that all health care
> providers and insurance companies make billing
> statements available online in blind-accessible
> format--the statistical cost-benefit ratios should
> be kept in mind; namely the 7 million blind
> Americans over 16 that might be benefited
> (assuming unrealistically that all have both the
> need and the software to benefit from such a
> policy), as compared to the cost of
> implementation. (Keeping in mind that such costs
> will be passed on the consumers.)
>
> According to the U.S. 2020 census, there are 258
> million in the U.S. over 18. This means--in rough
> numbers--that the adult blind population
> represents less than 3 percent of the population.
> (In comparative contrast, the Black population of
> the U.S. is approximately 14%) When engaging in
> social policy, the number of positively affected
> individuals as relative to the social cost is an
> appropriate consideration. Is there an argument
> that ANY proposed remedy is either (a) cost
> effective, all things considered; or (b) an
> economically insignificant burden given the
> benefits? THAT SEEMS TO ME WHAT IS NEEDED FOR A
> COMPELLING ARGUMENT.
The email solution would be a relatively inexpensive one, assuming the medical insurance companies do not have to use some of their security procedures for blind people to access their accounts. As to blind and visually impaired people reading the bills on companies' websites, that will largely depend on how accessible those websites are to begin with, what kinds of security hoops the companies are making blind people jump through to get that information, and how easy it would be to rewrite portions of the websites' codes to make it more accessible.
I should make a note about the laws here, specifically the Americans with Disabilities Act (ADA). That law was passed in 1992 and does not specifically mention Internet activity, specifically because a lot of disabled people at that time, including yours truly, were not using the Internet to get information then. There has been a battle going on for many years now between the disabled community and businesses about whether the ADA applys to the Internet and the worldwide web. In the latest ruling, handed down by a California Appeals Court two months ago and that the California State Supreme Court let stand, businesses that have both a brick-and-motar and a Web presence must make their websites accessible to the disabled, but businesses that operate only on the web do not have to worry about the issue. Other state and Federal courts in different jurisdictions have ruled differently and it is believed that the U.S. Supreme Court will make a decision on the matter in the not-too-distant future.
> _________________________________________
>
> "Fortunately for me, I live with a fully sighted
> younger sister who can read the bills to me so
> that I can pay them. Of course, that situation
> could end end at any time if she moves out or dies
> and then I'd be in the same boat as the people
> being discussed in this article."
>
> COMMENT: The point is well-taken, but it begs the
> question as to where the burden of blindness
> should ultimately lie. Perhaps the remedy is first
> and foremost within families, or absent that, with
> local community resources, rather than global
> business mandates. I frankly don't know and am
> only asking. (Throughout this response, I find
> myself saying to myself, "Yeh, that's easy for you
> to say!") Moreover, certainly in some cases
> general principles of fundamental fairness should
> prevail notwithstanding the cost. Maybe this is
> one of those cases.
Blind people, including yours truly, believe that they should have the right to the same access as sighted folks. There has been a blind independence movement that has been going on since at least the 1960s that has encouraged blind, Deafblind, and visually impaired people to live away from home as their sighted counterparts do. Perhaps the answer my late mother gave to me several years back when I asked about knowing any blind people when she was a teenager in the 1950s will explain that. What she said, and I'm paraphraising here, was that back then, blind people and disabled people of all types were not seen on the streets or in the stores. They were hidden from view and their existance was never acknowledged, except perhaps by their closest kin. We have come a long way from that, and I would hate to see us go backwards.
And, as to your last question in this section, it is a matter of fairness, regardless of cost. We blind people are here to stay, and regardless of cost, the state and the private sector should be helping to support us in our right to be independent and to lead full and fulfilling and public lives!
> ____________________________________
>
> "Unfortunately, we humans have a terrible habit of
> victim-blaming. Calvinism/Puritanism gives the
> justification in the U.S., but other religions and
> philosophys in other countries also justify the
> same blame game. We blame women for getting raped;
> poor people for being poor; and the disabled
> (including the blind) for being disabled. The
> result is that even when victories are achieved to
> right some of the injustices, holes will be found
> by those determined to see that either 1) the
> injustices still occur; and/or 2) people who are
> on top remain on top no matter what the costs to
> both individuals and society are."
>
> COMMENT: Frankly, this strikes me as grossly
> disingenuous and unfair. The vast majority of
> Americans are sympathetic and sensitive to the
> blight of the blind, however casually. They
> certainly do not blame people for being blind.
> Unfortunately, the real world dishes out natural
> injustices of a wide variety to a wide variety of
> people, leaving society to consider what
> responsibility it has to assist or remedy such
> injustices with limited resources and
> Constitutional commitments. As a socialist, I
> personally think that much more should be done on
> all such fronts. But simply identifying a problem
> that happens to be personal does not of itself
> support the claim of an injustice, a requirement
> for a social response to it, or moral blame.
What you are raising is the question of intent versus outcome, and this applys to other minorities as well. The argument for intent says that an injustice hasn't occurred because I didn't intend injustice, no matter what the results may be. From a legal perspective, it makes proving an injustice much harder because not only do you have to prove the unjust outcome of a certain action or policy but you also have to prove that the perpetrator of that policy *intended* that outcome to occur. This is why I personally support an outcomes-driven policy; that is, whether a policy is specifically just or unjust to a different group should be determined by the particular policy's outcomes, regardless of the intent of the policymaker(s). Justice for all, including policymaker(s), would be better served if outcomes, not intent, were the goal.
As to your narrower point, I believe that you are arguing that you are individually responsible for creating the system we live under that is selling me, and people like me, short. You personally are not, though the ideology you echo may well be. Whether we like it or not, the individual decisions we make are based on how we view the world and our role in it. And those roles are based upon how we were raised, including our religions and schooling, and the beliefs of the friends we met along the way. The problems described in the article are problems created by a system that was not set up to assist blind and visually impaired people specifically, and the disabled in general. Why was this done? Because the people who created and designed this system had certain beliefs about the blind and disabled, not borne out by knowledge, that they used to create the system in the first place. So, while I agree with you that there are many natural world injustices that plague blind and visually impaired people not created by humans, there are many more that are created by humans and that need to be changed if blind and visually impaired people ever wish to become statistically as successful as their sighted counterparts.
Edited 1 time(s). Last edit at 12/02/2022 04:37PM by blindguy.