Tuesday, July 21, 2009
I Lost My Health Insurance, and What You Need to Do to Keep from Losing Yours
In an irony that could not be more timely, I've now lost my Medicaid coverage. Due to a variety of circumstances too complex to repeat here, my coverage terminates at the end of the month. I am now in a rush to find a way to reinstate it, while knowing that even if I am put back on the program rolls it will be 90 to 120 days before my coverage resumes. Even if I file a request, there is absolutely no guarantee that I can even get it back. Even if I didn't have one of those dreaded pre-existing conditions/chronic illnesses requiring lifelong treatment, I would still be absolutely furious at what has transpired. My situation is neither unique, nor more timely, but it does illustrate how desperately we need real Health Care Reform and how dire is the need for millions of Americans. The reforms needed go beyond wonkery and require us to change our pre-set mentality regarding the nature of government-assistance and the too-often ephemeral reality of tax revenue.
In formulating a new system, we must use caution not to perpetuate the flaws and inequalities of the current system. What might be the most infuriating reality of many is that Medicaid, the only option now available for poor and/or low income residents adopts a sternly suspicious attitude that automatically treats everyone who uses its coverage as though they seek to cheat or otherwise misuse the system for their own selfish ends and, in doing so, waste taxpayer funds in the process. In many states, particularly red states, taxpayer dollars are allocated grudgingly at best so the system must be constantly careful not to run out of money. This creates ridiculous cost-cutting measures like eliminating basic dental care and only allowing visits to a psychologist for those under the age of twenty-one. The message, whether directly stated or implicit, is that children and teens can have good teeth and good emotional health, but adults cannot. When a particular state or district's Medicaid program advertises up front with a great degree of pride that it actually covers dentistry, one cannot be struck with how completely unfair and nonsensical are the rules and regulations that govern the system in every part of this country.
No military contractor, major banking conglomerate, large corporation, government agency, or recent receiver of bailout funds is, or has ever been monitored so closely or forced until quite recently to resort to draconian tactics in a desperate effort to keep from depleting its budget. We sit idly by while all of these dubiously necessary entities waste money by swelling to ridiculous, ungainly sizes, adding department upon department as well as important-sounding but ultimately meaningless management positions that cost thousands upon thousands of dollars each to maintain. They perpetuate their own existence by formulating field-specific jargon and loudly proclaim their supposedly essential role in the grand scheme of things but once bad decisions are made and enacted that threaten to topple not merely themselves, but every American, they are pronounced too big to fail and swiftly bailed out. I suppose I just don't understand.
At the other extreme is the manner by which we raise and allocate health care funds for those not nearly fortunate enough as ourselves. As the line of logic goes, if poor, underprivileged people need health insurance, we have no other choice but to use Gestapo style, Machiavellian tactics to make sure they're using the system the way it was intended. Medicaid and Social Security, two federal/state based agencies linked together in a spirit of common purpose, are actively encouraged to find every way they can to turn off Medicaid coverage and in doing so free up available resources. Since the focus is on acute care, not on maintaining long-term health, nor even on proactive measures which seek to prevent severe illnesses that often result in hospitalization, those who clearly have achieved some modicum of basic health are closely scrutinized. If, for any reason coverage can be terminated, it is swiftly done with a surgeon's precision. Applicants, not wishing to lose their coverage, are often forced to lie about the severity of their illness in order to maintain Medicaid.
The immediate assumption that lies underneath our current, highly inadequate government-run health care system is something to which I take most offense. The idea that those most needy and least blessed by the advantages we routinely take for granted need to be governed harshly by some kind of cruel overseer lest they take a mile when granted, at best, a half-inch raises my ire to unprecedented heights. I'd use a charge of racism or classism here if I wasn't aware that the real problem includes these societal ills but goes well beyond them. Implicit in the formulation of any kind of government assistance is as a mean-spirited attitude on our part and of those who drew up the legislation which callously asserts that fellow citizens must all, collectively, be in search of a free lunch and in so doing will use every means they can to manipulate the system to their own ends. One can never fairly paint a complex situation with such a cavalierly nonchalant brushstroke. Offenders can be found in every system, in every class, and in every race.
I think perhaps we might think that we ourselves are not big enough, nor powerfully enough to make an impact upon the massive corporation or the military-industrial complex but that we can somehow exert some degree of influence upon a few thousand ordinary human lives. And I suppose some ought to be satisfied that such a thing can be done, though I'd scarcely feel any reason to rejoice at the way it turns out in the end. As for right now with our current health care debate, whatever system we adopt must avoid this immediate, prejudicial attitude of suspicion and condescension. If we are honest with ourselves, we will admit that we all are guilty of it in some way, shape, or fashion. Instead of expecting the worst, for once, I think it might not hurt us nearly as much as we might think to us to instead expect the best. The people now who desperately cry out for medical insurance and the ability to heal themselves have a genuine need and currently have few, if any substantive means to achieve it. If we do not act decisively now to assist those less fortunate than us, you might be the next to be told, by way of an maddeningly impersonal form letter, that it is your coverage that will be the next to go. We are the ones impeding change and we will be the ones that ensure its defeat unless we are honest with ourselves.