Lecture 9 - The Politics of Disability

Question 1

cycle of disability

Answer 1

• > injury/disease onset
• > participation and activity limitations
• > inactivity/isolation/devaluation
• > decline in health/co-morbidities
• > repeat

Question 2

why are the politics of “who gets services and who pays” significant

Answer 2

if you go into a training profession, you will have to balance what you feel is needed vs what can actually get paid for
- > both of these questions are inherently dependent upon the definition of “being disabled”
- > the reason why we have so many disability models, like ICF is to provide a framework for making these decisions
- > when given limited resources, careful decisions must be hade about how to maximize benefits to all involved
- > you don’t decide if you’re disabled, someone in a government benefits office decides if you’re disabled

Question 3

steps involved with being considered disabled in the healthcare system

Answer 3

• > Intake
• > medical Ax
  privatized health care might come in and bypass the policy Ax and give you services
• > policy Ax
• > are you disabled y/n
  *if yes are you eligible for services y/n
  BOTTOM LINE
• > people with a disability only have decisions making power if they can afford it

Question 4

how do aging populations relate to the politics of disability

Answer 4

with population aging due to longer life expectancy, health services policy will be critical in maintaining high quality of life in canada
- > the need for rehab services in canada will steadily increase over the next 20-30 years, the move towards privatized care for chronic conditions/disabilities seems very likely

Question 5

severity of disability and their costs

Answer 5

as severity increases, so does costs and the greater chance of services being denied

Question 6

how could more complex cases of disability be eventually pushed out of rehab clinics

Answer 6

• > clinics must deal with insurance companies/federal services and these payment systems are complex and there tends to be a motivation to select cases in which a clear (positive) outcome can be predicted

Question 7

EI Program (US public health system)

Answer 7

Early intervention program is designed to identify children who are not meeting developmental milestones
- > the goal is to intervene early in order of to increase the likelihood of minimizing the effects of the delay
- > children are referred by primary care or by pediatrician, school nurse ect.

Question 8

Three stages of assessment in the EI program

Answer 8

1. Initial identification
   - > the referral process, usually involves the parent
2. Eligebility assessment
   - > team assessment is performed, usually at the kids house
   - > assessment is performed using clinical instruments and give percentile scores on standardized scales
   consider the disability model and how its primarily medically focussed
   Ongoing assessment
   - > after services are rendered, child is re-assessed to determine if continued services are required
   *kids who were considered borderline cases are forgotten

Question 9

how does policy impact the labour force participation of those with disabilities

Answer 9

• > one of the most significant barriers to return to work is the socio-economic incentives to maintain disability benefits
• > there are also significant gams in communication between employers and the politicians who write policy

Question 10

what is the NIDMAR and why is it important

Answer 10

National institute of disability management and research
- > research plays a big tole and policy; it drives policy but government decide what research gets funding
- > sometimes policy can be used to create “priority focus areas” that researchers will want to work on

Question 11

Publish or perish model of Knowledge translation see slide 44

Answer 11

conduct scholarly research - > publish findings in journals - > hope that someone who cares will use the research (politicians)

Question 12

bring it on to the public or perish model

Answer 12

see slide 46

Question 13

arguments for better knowledge translation practicies

Answer 13

Firstly, as a matter of human rights, social justice, and respect for human dignity, people with disabilities ought to participate in processes that shape their lives
* Secondly, they are the principal stakeholders as they are the intended beneficiaries of the relevant policies and services
* Thirdly, they are the experts when it comes to knowing their needs and understanding their aspirations