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MEDICAID REFORM: It's Long Overdue

 article about MEDICAID REFORM: Its Long Overdue

Have you ever thought about what would happen to your health care if you should lose your job, either through termination or through a lay-off?  I doubt it, because it's not something we expect.  We always look at our jobs as secure, but in today's economy, that just isn't realistic.  Aside from that aspect, we need to look at the number of people who work jobs where there is no health insurance offered at an affordable price, or worse yet, it isn't offered at all.  I learned the hard way how sorry the Medicaid system really is when one of my daughters lost her job just a few months after she got married.  She had Medicaid before she married, and though she was living with her son's father, because they weren't married, his income didn't enter the picture.  After they got married, she took the health insurance at her job, but when she was terminated, the Cobra was more than they could afford. In spite of the fact that both she and her son had asthma and allergies, and that she had panic disorder and migraines requiring medication, she was not able to get Medicaid except Family Planning.  Additionally, her husband's income was too high for their son to be covered even though he was a seasonal worker.  In addition to the fact that she could not have health insurance for her child, she also had to put my grandson's much needed therapy on hold until after her husband was laid off for the season.  Somehow, I find something wrong with that.

What did I do?  My daughter was just 20, and she didn't know what to do, so I went to the supervisor of The Department of Health and Social Services (DHSS) who told me my daughter's best bet was to wait until her husband got laid off for the season and then come back in because her case would be good for a year.  It turns out that in order for a child to be covered under either Medicaid or 'ChiPs,' the parents can make up to 200% of the Federal Poverty Level but for the parents to be covered also, they can only make 100% of poverty which is currently $1,252 monthly before taxes.  I don't know about you, but I don't know anyone who can afford to purchase health insurance even for two people on that amount of money.  There is a basic plan through Blue Cross & Blue Shield of Delaware with a $500 deductible that costs $286 per month for an individual.  In Delaware we have no county hospital, so that isn't even an option.  DHSS will tell you that you can go to a clinic, but the wait is over two months there, so then what?  The only other alternative is to use the emergency room that has to take you regardless of ability to pay because of our lack of a county hospital. That cost, of course, goes back into the insurance pool and raises the cost of health insurance to compensate..

In the fall of 2002 my oldest daughter was also faced with the dilemma of the joke we call Medicaid when she lost her job.  Her unemployment was $265 per week, over the limit for Medicaid, especially when she was at that time also getting child support.  Her daughter was put into 'ChiPs' at a cost of $15 monthly, but even knowing my daughter has a seizure disorder and must take medication that costs over $50 monthly along with allergy and sinus medication, her case worker didn't even attempt to offer to insure both of them.  Certainly their website says they don't cover the parents, but when you call the toll free number directly to EDS, you are told it goes on a case by case basis and is up to the caseworker to decide if they want to insure the family based on their income and special needs.  After her unemployment and savings ran out, she was forced to go back on AFDC, putting her back into A Better Chance with a two year transitional period to find employment that offers health care. Still, why should she have to do that?  Why should anyone have to go on welfare to get affordable health care?

At the time my younger daughter was faced with the same dilemma, I asked the supervisor of the program what happened to the National Health Care issue that Hilary Clinton had been so diligently working on, and I was told that Congress voted it down in favor of a raise for themselves!  How sad is that?  What is really sad is that we are considered the most technologically advanced country in the world, yet we are the only civilized country without national health care, thus the reason our nation has more sick people than even in Canada or Great Britain.  Some of you will read this and say in a country with national health care, the government will decide who gets treated and who doesnt.  Do you think that isn't done already?  Look around you and see how many times the elderly are denied care because it is not considered to be cost-effective by their doctor or the hospital.  A patient with AIDS is denied further treatment because it will not guarantee the quality of life that could be afforded someone else.  Whether you want to admit it or not, the choice is already made by our insurance companies, doctors, and hospitals every single day, so at least everyone would have a fair chance at living a healthy life if they could go to the doctor on a regular basis.  Just yesterday someone in the United Kingdom said that depending on health and age, the average cost of health insurance is eight Great Britain pounds, and even at an exchange rate of $2.00, that would make it only $16 per month!  Why do you think that is?  Statistics have proven over time that both physicians, hospitals, and laboratories charge for procedures that were never performed, order tests that aren't necessary, and prescribe medication for conditions that will correct themselves.  I recall an incident in the early 1970s with my own mother.  She had gone to the emergency room after her legs had collapsed underneath her, and at that time the hospital sent a bill before billing insurance so that you would know what the charges were.  Lo and behold, when I looked the bill over for her I found they had charged for tests that were ordered but never performed; Blue Cross would have paid those invalid charges if I had not caught the mistake.

Can we change this?  Of course we can!  We need to get together as citizens and contact our representatives, stage a march in Washington, a filibuster, whatever it takes to get this situation resolved.  Remember, someday one of your relatives could be faced with this kind of dilemma, a dilemma that could have been prevented if each and every one of us just took a minute to join forces by writing our congressmen to do something about it.  Think your letter won't make a difference?  Think about this: If a bill is brought on the table that requires a 2/3-majority vote to pass, letters from just one state could cause that bill to pass or be tabled! 

Current reports tell us that under the Bush Administration more people are uninsured than under any other administration.  Of course, he would like for you believe that Senator Kerry's plan would increase that number dramatically.  We can only wait and see what happens, but I know from seeing it within my own family that Medicaid changes under the Bush administration have hurt the middle-income bread winner who is unable to financially afford health care for his family.  I look at my daughter and son-in-law and wonder what the world is coming to when a couple can't even afford the luxury of health insurance let alone the expense of medical care.  Something has to be done about this situation.  Whether you plan to vote for Bush or Kerry, you have to see this as an important issue.  No matter who takes the role of Commander-in-Chief for the next four years, we as taxpayers must take whatever steps are necessary to correct this situation.  Those opposed to a National Health Care will try to make you believe that it will mean the government deciding who lives and who dies, who has a procedure and who doesn't.  Wake up! Its happening right now with the insurance companies.  Its called Quality of Life.  What it means is if a medical procedure isnt going to help you live longer or improve your quality of life, the insurance companies arent going to pay for it.  Look around and ask yourself why the Canadians and Europeans are healthier than we are...



Brenda Coxe

copyright 2004



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