Medicaid Madness

Unidentified Woman: You have awakened a sleeping giant.

Unidentified Man #1: Amen.

Unidentified People: Yes.

Unidentified Woman: We are tired of this. This is why everybody in this room is so ticked off. I don't want this country turning into Russia, turning into a socialized country.

Unidentified Man #2: We cannot afford this, period. Keep the government out of it. We're doing just fine.

Unidentified Man #3: To me it is obviously written with the assumption that government has the right to control our lives from pre-birth to death. For that reason it's not worth considering, it's not worth modifying, it's not worth amending. It's needs to be dumped.

The thing that I want to ask these people is: do you have health care?

Because if you do, maybe you should sit your butt down.

Okay, I know people have a right to speak. But everyone I hear talking about how terrible this is going to be are people who start it off by saying, "I have health insurance, and it works just fine for me."

Awesome. Because unless you're going to pay for this uninsured journalist's doctor visits, I don't actually care.

Medicaid takes a lot of paperwork.

But I digress.... Medicaid.

Medicaid is a bit of an administrative nightmare. But, the good news is, the health care is pretty good.

Liz had to fill out a crazy amount of paperwork to get on medicaid. She keeps this huge folder with every piece of information she had to fill out and then keep in case something should happen. 

People told Liz it was difficult to get on medicaid. But what they didn't tell her is it's also very easy to lose medicaid once you have it, often through no fault of your own.

To explain, I first have to tell you how medicaid works. It's so bizarrely meted out that you may not even believe it.

I would like to say Medicaid is stuck in 20th century technology. But the truth is, it's more like 19th century technology. In a world where I can pre-order the next best seller on Amazon with one click or tell my iphone (if I had one) to locate me by satellite and direct me whereever I want to go, medicaid is traveling by horse and buggy while the rest of us zoom by on hoverboards.

If you're on medicaid, every month, the state sends you a slip of paper.

That's it.

If you don't get that slip of paper and you have a doctor's appointment on the first of the month, you're screwed. 

Our wonderfully efficient system for delivering health care to the poor.

There are no identification or insurance cards. Nothing you can swipe. Just a slip of paper, easily ruined by a child knocking over a glass of Purplesaurus Rex kool-aid at the dinner table.

In 2006, there were 1.8 million Illinois residents on medicaid. And we're wasting 44 cents a pop per month on every one, when the efficacy and administration of a card system is technology that could have been had 20 years ago.

If you have used the postal service lately, you can imagine the inefficiency and potential problems this could cause. And if you can imagine how efficient the rest of a service must be if they distribute essential health benefits monthly through the postal service, you'll have an idea of how Liz almost lost her medicaid benefits.

In April, Liz and Nathan moved less than a mile from Ravenswood to Andersonville. They needed a bigger apartment for the baby coming. 

In this move, they crossed a boundary which made them change medicaid offices. They went from using the Wicker Park office to using the Uptown office.

All of this is fine and good, until it was the end of the month, and Liz hadn't received her medicaid mailing. 

She called. And called again. Where was it? she asked. She had filled out a change of address card, so it should have come to her new apartment.

Well, when she changed offices, she had to be assigned a new caseworker. And she hadn't been assigned a caseworker because she hadn't been put in the system by the new Uptown office. And there was no one to process her change of address forms because she hadn't been assigned a caseworker.

If she had not called before the first of the month, she would have lost her medicaid benefits. Completely. She would have had to start over at square one - giant stack of paperwork be damned.

Just a small selection of Liz's medicaid paperwork.

Now a lot of people have said to me, "Well, it's the government. You can't expect it to be efficient."

Passports. Drivers license. Parking tickets. Incorporation papers. Lawsuits. Professional Licenses. License plates. Public school registration. Laws and regulations.

These are all things managed by the government. And all things that aren't terribly inefficient. When I moved to Illinois, it took me about 45 minutes to get a drivers license. My parking ticket hearing at the city took about a half an hour. I can look up lawsuits filed in the Circuit Court of Cook County.

Are these systems perfect? No. There is no end to DMV stories. And don't get this journalist started about what the city and the state could make available online for the public.

But in general, they all seem to operate without throwing people out of the system randomly and perilously.

Shouldn't we expect the same in the medical care we provide to the least of these?

However, unlike the nutritional value of WIC or the insanity of TANF (coming tomorrow), Liz gets good medical care. That's why I get pissed when I hear buffoons whining on All Things Considered. If you like your expensive private insurance, keep it. 

Let the rest of us clamour for our monthly government medical stubs.