If it is it doesn't matter

Friday, March 17, 2006

Dr. Kafka, I presume

Finally I get a chance to write this, since the events it describes are, temporarily, quieted down.
And LOOK EVERYBODY, Prup can actually write a post and not mention Islam or Muslims. (Well, there was this one Muslim couple sitting in front of us at one trip to an office who overheard me discussing one of my posts and the man seemed to be annoyed, but he's only an extra in this script.)

Now I live in America, in Brooklyn. Which has a lot of very good points, but we are the only Western country I know of for which health care is not considered a right. (Which is rather dumb, since American industry loses more days to illness that could be cured than it cost to insure everybody, and large companies that are unionized wind up having to pay a major amount of cash for private insurance for their workers -- and those are just the Republican arguments for Universal Health Care.)

Due to our own situation, which i don't need to describe, both Em and I were on Medicaid -- and if you get them confused the way most people do, Medicaid is for those who are broke, Medicare is the one for those who are broken down by virtue of age, or other disability. In our case we belong to a Medicaid HMO, as al people now are required to do.

Things were going fine for two years. We had filled out our renewal form in Mid-October, knowing it would take until March before it went through and we were renewed for the next year. (We'd be technically kicked off for a day until the new list was put on, but we were used to such technological wizardry.)

In mid-February, Em was going to her therapist when she is told "You've been kicked off Medicaid." Her shock and confusion and annoyance can be consewrvatively expressed as "HUH???!!!!!?????"

We called the HMO. "Why were we kicked off?"

We were told, "You didn't get your renewal forms in on time." Interesting, since I'd gotten an extra set of forms and had called Medicaid and was told they had received them. So I called the NYC HRA.

After checking, "Yes, we have your forms. You were kicked off because of, let me see, the code is S87."

"What does S87 mean?"

"I don't know, it's a new code."

"Could you please find out what it means?" (In retrospect, I might not have been that polite, but I wasn't screaming and cursing either, might as well make myself look good.)

The person on the other end puts the reciever down, and either doesn't push the 'hold' button, or it is broken. I hear all sorts of conversation going on. "What's an S87?" "I don't know?" "Where do I look," and general confusion, with at least one person saying "Never MIND about the code."

Finally the person comes back. "You have too large assets."

(Our situation has not changed in the time since we applied. Our bacnk account has remained at the 4-figure level, with the first number only going over 1 immediately after we receive a Christmas gift from Em's parents. And that is max, some months it hits the two-figure level. We own neither a car, a house, or much of anything, we live in Em's parents' house since they moved South. Our cats are, of course, valuable assets to us, but financially they wind up on the debit side. Five cats use a LOT of cat litter and food.)

But this is a general Medicaid number. I figure I should call a local office. So I call 311, the number for the City's non-emergency help line. These people are very nice, but they don't HAVE numbers for the local Medicaid offices. "Wait a minute, one of them is located in the nurse's residence at X Hospital. I can connect you there."

The hospital must have been used to these calls because before i could get the question finished they gave me the right number.

I get through, and the office confirms that we have been cut off -- even though we've filled presecriptions at our pharmacist that day and are able to do for the next few days. And yes, it is an "S87."

"What's an S87?"

"I haven't the faintest idea. You'll just have to go to an office and reapply."

"Wait a minute," says I, having had some experience with public assistance in the time before I was married. "If we're cut off, don't we have to be notified and given a chance to appeal?"

"Oh, yes. That's handled automatically by computer. The notice should have gone out already." (We have yet to receive it.) "But you'll still have to reapply."

The hospital office isn't convenient. The one on Coney Island -- not an island, btw, for non-NewYorkers, just a neighborhood (and there haven't been rabbits there for centuries, for the linguists among you) -- is an easy subway ride away.

So, after about a day of panic attacks -- usually Em's specialty and one reason why we are on Medicaid to begin with, but this time I am keeping up with her shudder for shudder -- we go down there.

It is February, remember. It's been very warm this winter, but not this day. And Coney island is not an island, but it is on the Ocean. And the office is right up against the Boardwalk, overlooking the Ocean. (If I'd had a pair of stilts, i could have waved to The Religious policeman in England.) But we manage to get there, and the 'Bentoncicle" phase only lasts a few minutes. The building's heat supply is working, which in retrospect was an unexpected blessing.


To Be Continued tonight if possible.

2 Comments:

Blogger wxjames said...

Prup, You are up to your ears in why we don't want public healthcare. In fact, there is a move afoot to pay for healthcare with cash only. Why run the gauntlet of red tape for every aspirin ? Why support the lives and families of millions of red tape handlers and clerks ?
Efficiency, efficiency, efficiency

10:37 PM  
Blogger Prup (aka Jim Benton) said...

You've got it exactly wrong. My experience is an argument for why we NEED a properly funded Universal Healthcare System. First, a healthy populace, a healthy workforce is GOOD for the country. People are not always able to afford private doctors, I know that when I was not insured -- which was most of my life -- I only went to doctors in an emergency, and usually when I did need treatment I used an emergency room at the hospital. I had to let an ear infection that could have been fixed with antibiotics get so bad I almost needed surgery, because I couldn't afford a doctor.

And later, I did need surgery for an infected foot -- and if I had delayed THAT, I would have lost it according to the surgeon. No insurance, and the only reason I don't have a debt of $30,000 over my head is that when I came to the clinic for my checkup, a blunder by the hospital -- not properly attaching a bench, almost resulted in a broken leg for me. We agreed they wouldn't sue me and I wouldn't sue them.

Taking this to the general, there is a reason why inner cities have infant mortality rates approaching third-world countries, and it is both the lack of insurance and the underfunding that hurts these hospitals the worse.

The red tape -- and no, you don't need to run a gauntlet for any non-prescription drug -- comes from the complicated sysytem of HMOs that take the place of a sensible, well-funded Universal System (which would be a LOT cheaper, even if funded at a sensible level)

The key to the problems I had -- and believe me, you ain't seen nuttin' yet, wait till part II -- is the starvation funding the government supplies so they can keep the tax rate low, which, of course, costs state and local and even federal governments much more in the long run.

(And, btw, the one benefit to the current system is the amount of employment it DOES provide.)

Efficiency yes, and a Universal System is MUCH more efficient, despite the myths of the conservatives.

11:44 PM  

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