One of the tragic legacies of the Great Society is the violence inflicted upon the family as an institution. Through a series actions, calculated or not, the family has been devalued as the bedrock of civil society and replaced with the government acting in loco parentis for not only the children it comes into contact with but also for the parents.

While we are all familiar with the incentives provided by the government to discourage marriage by women living in poverty through the provision of various allowances and services so long as they are unemployed and unmarried and have children, fewer are aware of the incentives provided to the people living at the poverty level (though evidence indicates that 199% of federal poverty line may be the real ceiling) to have their children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in order to boost their family income by about $8400 per year.

What makes this even more shocking is that the New York Times’ leftist columnist Nicholas Kristof has noticed it:

THIS is what poverty sometimes looks like in America: parents here in Appalachian hill country pulling their children out of literacy classes. Moms and dads fear that if kids learn to read, they are less likely to qualify for a monthly check for having an intellectual disability.

Many people in hillside mobile homes here are poor and desperate, and a $698 monthly check per child from the Supplemental Security Income program goes a long way — and those checks continue until the child turns 18.

“The kids get taken out of the program because the parents are going to lose the check,” said Billie Oaks, who runs a literacy program here in Breathitt County, a poor part of Kentucky. “It’s heartbreaking.”

This is painful for a liberal to admit, but conservatives have a point when they suggest that America’s safety net can sometimes entangle people in a soul-crushing dependency. Our poverty programs do rescue many people, but other times they backfire.

Some young people here don’t join the military (a traditional escape route for poor, rural Americans) because it’s easier to rely on food stamps and disability payments.

Antipoverty programs also discourage marriage: In a means-tested program like S.S.I., a woman raising a child may receive a bigger check if she refrains from marrying that hard-working guy she likes. Yet marriage is one of the best forces to blunt poverty. In married couple households only one child in 10 grows up in poverty, while almost half do in single-mother households.

I don’t want to quote more of the column because of Fair Use concerns but I encourage everyone to read it.

When the SSI program was created in 1974 (thank you, Richard Nixon) the idea was to replace a patchwork of federal-state programs with one program that would cover all claimants and have uniform eligibility criteria. At some point children, under age 18, were made eligible for payments as disabled

“if the individual has a medically determinable impairment or combination of impairments that causes marked or severe functional limitation(s), and can be expected to result in death, or has lasted or can be expected to last for a continuous period of not less than 12 months.”

Enter ADHD, stage left. I don’t want to engage in a discourse on the controversies about the existence and prevalence of ADHD other than to make this points. ADHD has no clinical diagnosis, that is, there is no physical test you can conduct on a patient that can diagnose ADHD. Rather it is an observational diagnosis governed by the Diagnostic and Statistical Manual of Mental Disorders, version IV (DSM IV).

This subdivision is based on presence of at least six out of nine long-term maladaptive symptoms (lasting at least 6 months) of either inattention, hyperactivity–impulsivity, or both. Thus, a child who is diagnosed with the inattention subtype may also show signs of hyperactivity–impulsivity, and vice-versa. To be considered, the symptoms must have appeared before the age of 6, manifest in more than one environment (e.g. at home and at school or work), and not be better explained by another mental disorder.

Two points need to be kept in mind here. People who live in long term poverty aren’t stupid. They may have made some profoundly stupid choices that have resulted in poverty but they aren’t stupid. The second is, as someone once said; there is a difference between being broke and being in poverty. Broke is the state of your bank account. Poverty is a state of the soul. When you combine financial incentives with an impoverished soul you cant reasonably be surprised when bad things happen.

A correspondent in Ben Domenech’s indispensable The Transom (if you aren’t subscribing to it you are missing tons of stuff) describes the process this way:

“A typical anecdote from any given day would go like this: A parent would arrive for the appointment, late, of course, leaving only 10 minutes to talk to the child. The child would have a small television or video game, something distracting, and wouldn’t be paying attention. The child would be asked to put it away, and the child would talk back. The parent would do nothing. Finally, the parent would be asked to take away the thing. The parent would get defensive and say they already know what the problem is, the kid has ADHD, evidenced by the child’s inability to listen to the parent, and proven to the doctor by the child’s inability to pay attention. Incredulous, the doctor would realize that the parent was raising this child alone, and so the child was frequently acting out, and that the easiest way for the parent to get the kid to behave was to put the kid on Ritalin. For the parent, it had the additional benefit of allowing her to get a check in the mail every month.

While Krisof’s story is focused on Breathitt County, KY, I am intimately familiar with the situation in the neighboring Perry County. My mother lives there (no I’m not from there originally though I have struggled against the effects of a rural Southern education my entire life) and I have never met a more canny group of consumers of government goods and services in my life. Until the mid 1990s USDA surplus processed cheese (think Velveeta with generic food markings) was used as a type of currency to pay for lawn mowing and other odd jobs in lieu of cash. I know, personally, of families who keep their children out of school or discourage academic achievement because lack of academic achievement can be used as a criterion for retaining the SSI check. The colloquial term you hear is that someone is receiving a “head pension.”

As we look at the morass of fiscal and moral problems facing the nation today, most can be directly traced to government acting to rectify something perceived as wrong. The egregious pollution of American rivers and indiscriminate use of pesticides has given rise to a regulatory regime that treats an isolated bog the same as an interstate waterway and encourages the spread of malaria. A desire to improve the “happiness” of the individual led to divorce on demand. Easy divorce, and I might add, the “right” to contraception, produced a bumper crop of children being raised by single mothers. The programs designed to keep them from starving had the perverse incentive of both encouraging out of wedlock births and discouraging marriage. Public housing, first conceived during the Depression as a stop gap measure, became a fixture in most American cities with a multigenerational base of clients.

While we have every right to be stunned by the impoverished single mother in rural Kentucky who is keeping her child – or children — out of school,  so she can receive an additional several hundred dollars per month per child and thereby condemning her children to continue the tradition of subsistence living we should recoil in horror from the government programs and subsidies that not only support such behavior but actively encourage it.