The more subjective and unfalsifiable the criteria (e.g. chronic pain, depression) the easier it's going to be for looters to fake their way into the system. Even if it was possible, effectively gerrymandering the definition to include all and only those in need is going to be exceptionally difficult and expensive. A little bit of fraud is part of operating costs.

The problem we have with social media is that volume is the only thing that seems to count. Tribes don't generally police their own because the small hit to the overall credibility (which can be explained away as agent provocateurs) is a small price to pay for the additional 'voice'.