Card carrying member of Medicaid

Off Our Backs, Nov/Dec 2002 by Witherow, Judith K

women and disability

I am the canary in the mine. My throat is hoarse from trying to warn others that their health insurance is in imminent jeopardy. The powers that be have found they can si less amounts of money de health care to others. Man nies already feel no need medical coverage and sick. employment benefits. The people's desperation concerning their health care is enormous. Corporations have found that employees are willing to pay even more of their premiums to keep the barest of coverage in force. They can gauge just how tight to squeeze by watching what the government has done to Medicaid and Medicare recipients. There has been almost no outcry as healthcare money is decreased and diverted to other programs.

The fear of being turned away by doctors and hospitals when you are at one of the most vulnerable points in your life allows these unspeakable acts to be set in motion. Don't wait until you are closed in a state-controlled cage to do something. Fight against these despicable actions while there is still time. Don't waste your words misjudging women like me--those too diabled to work-who have no other option for obtaining healthcare. I am not devaluing your paycheck with my myriad of illnesses. Blame the pharmaceuticals, docters, hospitals and everyone else who is reaping huge profits from the suffering of others. Not to mention our government. which would rather bomb people in other countries than spend money on the most helpless in our country.

I use the word Medicaid to describe my "insurance" coverage even though it is technically an MCO. A number of states now use the initials MCO (Managed Care Organization) to represent this same service. These letters presumably lull you into thinking that they are akin to an HMO or a PPO. They all basically blend into alphabet soup that leaves little to stick to your ribs except the illnesses you are trying to have treated.

Maryland is one of the states that opted for this form of coverage. I fought for a year to try to get the state to fix the problems in the medical system that already existed. Yes, there were problems, but none that couldn't be fixed at a cheaper price. Revamping the entire system was something that could only have benefited those who didn't need the state's so called "entitlement" help anyway.

When the new plan-ironically called "Health Choice" by Maryland-was implemented, you were required to pick an MCO you thought you would like to belong to. The MCOs were not allowed to solicit our business. We had no basis on which to make our decision. Our choice was comparable to drawing a name out of a paper bag. Hopefully your pick was one of the ones that offered a decent choice. Unless you knew someone who had experience with the few carriers offered, your only hope was that your pick was a livable one. We're talking about something as important as our health, but what it amounts to is the luck of the draw.

On the anniversary of the enrollment date, you are permitted to change to one of the other MCOs if you are dissatisfied. Each year you are mailed a piece of paper with a list of insurance names. It's the blind date of medical care. Some of my previous choices would have been easier to take if I had put the brown bag over my head.

Last year I wanted to change plans, but because our area postal system was contaminated with anthrax, my papers did not arrive. When my partner called the state, she was told that it was up to me to prove that I hadn't received the packet. The only way to prove it was if the postal service returned the packet to the state. No one, including the state, was getting mail, but that was of no consequence. I had no choice but to limp along for another year with less than satisfactory coverage.

This was truly a hardship because I am under the Special Populations section of Maryland Medicaid due to a number of incurable illnesses. These illnesses require seeing different specialists. This presents a problem because many specialists do not want to deal with Medicaid or the mountain of paperwork the government heaps on them. A number of doctors have told me that they have to either not participate in the program or spend extra money to hire someone to handle the paperwork. If you wanted a system to collapse under its own mismanagement, this is how you would go about arranging it.

You are not allowed to have any of the books that explain what the insurance covers to make an informed choice. The doctors, hospitals, pharmacies, and specialists that take part in each plan remain a mystery until you are enrolled. Through the years I have been enrolled in this system I have learned to lower my expectations.

Everyone is required to choose a primary care doctor who will be in charge of decision making. Hopefully, you will find someone who is compassionate and willing to send you to a specialist when needed. Don't expect to find the address or phone number of numerous providers in your book. Many times you will find doctors listed who do not accept your plan. When you phone their office, it helps if you've developed a thick skin. Numerous people, including office personnel, feel that those who need the state's help must also be lawbreakers.