Saturday, December 12, 2015

Loopholes Exploited in Health Care Coverage

It was only $5.37, but it was the principle of the thing.

A cluster of recent hospitalizations and Emergency Room visits has resulted in my being sent four separate bills for a variety of services rendered. A routine EKG was performed each time, a test that is relatively cheap by American health care standards. I know from my bill that it costs $15 for five minutes of monitoring the heart. I have found, much to my annoyance, that it takes another five minutes to painfully pick electrodes off of my body hair. Such is life.

I'm federally disabled and rely upon Medicare as my primary coverage. Medicare is sound insurance, but as some may know, it doesn't cover everything, every expense. I use Washington, DC's Medicaid program to cover the remainder of my expenses. Usually this arrangement is not problematic, but I find increasingly that hospital administrators are discovering ways around it. For example, some enterprising soul decided to outsource EKG payments to Michigan, where Medicaid cannot be charged because it is out-of-state.

It must make sense on paper, but it's not fair to those of us who subsist uncomfortably on monthly disability payments. They are designed to thrust one into the workforce, not for long term dependence. In my case, the latter has to suffice. I have never been able to hold a job for long and the shame has been terrible. Our system doesn't treat every case individually and perhaps doing so is impossible, but I nevertheless encourage reformers to take into account my story. It is not the only one.

No act designed for Affordable Care doesn't fray at the seams with enough time. As healthcare costs continue to soar, I fear that other hospital centers will use this precedent to wiggle through the loopholes. From the perspective of those who accept Medicaid, they always claim that the paperwork is extreme, the bureaucracy excessive, and the payments slow to arrive. This may be true, but what we may need is to cut through the clutter.

Medicare for all is not a bad aim. It is accepted almost everywhere, except in the field of mental health and psychiatry, but that is another story for another post. And rest assured I am thankful for the sacrifices and toil of the American taxpayer. They keep my head afloat, not totally dependent upon others for every penny. Medicaid, of course, is a different story. Red State governors continue to refuse Federal dollars to expand their programs. I'm glad, once again, that I live in a blue bubble.

As I peer from my bedroom window each morning, I see the cops pulling over speeders down a busy stretch of roadway. You'd think people would learn eventually. Every ticket paid goes towards my care and keeps my dental bills minimal. I'm not ungrateful, though I'd much rather be one of the faceless, nameless men in a business suit and professional clothes headed to work downtown. And I'm not alone, trapped in a body and a brain that has betrayed me. I'm educated, yes, but poor.

Government cannot be reset to a time before the New Deal, before the Great Society. We may never be a nation that embraces democratic socialism. But we can and should embrace looking out for those of us who are less fortunate. I don't wallow in my limitations. Instead, I ask for a leg up and usually don't complain. I don't believe that the world owes me anything, but I do believe that I have a right to add my voice into the discourse. Doing so is uniquely American, wouldn't you agree?

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