Tuesday, July 19, 2005

Have you ever?

Have you ever been sitting in the movie theatre, paid $10, have your popcorn and soda in hand, another $10, and then the Jimmy Fund (for cancer research) commercial rolls, and the staff walk around the theatre with their plastic donation containers, and you pretend not to see? Cause you’ve already spent $20, and you’re not willing to fork out another one?

I can’t help myself. If I have any change in my handbag at all, it goes into the donation container. I mean, if I’ve already spent 20 bucks, what’s another 50 cents, another buck?

Have you ever been in a grocery store, and the woman with the unruly kids at the head of the line is holding things up cause her EBT card (food stamps) doesn’t have enough funds on it to cover her groceries? So she has to eliminate things one item at a time from her cart, till she hits the magic number and the EBT card goes through? And everyone in the line, including you, is visibly fuming because she’s holding things up and you’re all in a hurry?

I was in a store one night a few months ago, and a man with two small children was in line. He’d tried his EBT card, not enough funds. Ditto his debit card. A mere $13 bucks separated him and his kids from a meal that night (and no doubt the rest of the week). I wasn’t impatient (don’t tend to get that way—much more fun to people watch while I’m waiting). But I was right behind him in line, so I couldn’t help but see everything that was happening. He wasn’t extravagant—milk, pasta, potatoes, bread. I stood, looking at the few items, staring at them, and it dawned on me. That was me, 20 years ago. I stood in line, bought the same staples, ran out of food stamps at the end of the month, started watering down the milk to make it last. As I stood there, staring at the food, sneaking glimpses at the family still futilely trying to swipe the ebt and debit cards, I caught the cashier’s eye and whispered ‘put it on my bill.’ She looked at me in disbelief, but I nodded and said ‘do it.’ At this point the family hadn’t heard anything, and when the cashier started to bag their items, they looked at her in confusion. She said, ‘someone took care of it for you.’ And she nodded at me. I really wish she hadn’t done that. I’d wanted to remain as anonymous as possible, but there it was. So I endured the thank you’s from people who don’t deserve to live that way, was thankful that I was there to help, and went on my way.

Have you ever been asked to donate food to a food pantry, and you go to your cupboards and pick out all the canned foods that your family hasn’t/won’t ever touch, and give those? Cause after all, they’re hungry people, and they should be happy with whatever you give them, shouldn’t they? And, you can get that damned okra and sauerkraut out of your cupboard and make room for more of what your family likes, right?

I’ve been on the receiving end of this one. And I bought into the concept myself as a teen growing up. The idea that hungry people should be happy with what we give them. But that negates them. Allows us to see them not as a human being, but as one of the masses of ‘hungry’ for whom we are not responsible. Whom we don’t have to consider too closely. At the end of the month, when food stamps run out, hungry families try the local food pantry. You can go to the better run ones that are associated with a regional food bank, and they have good solid basic foodstuffs. But because demand is greater than supply, families are limited in how often they can visit these pantries. So they seek small, locally owned food pantries, for example in small, community churches. That’s where I encountered the okra and sauerkraut. And all the other little cans of food that people like to rid themselves of by donating to them to the hungry. We gagged down lots of disgusting donated foods, because yes, we were hungry. People will even donate canned food that is way beyond the expiration date. I found myself once with a can of spaghetti sauce, opened it, and the rancid smell permeated my little apartment immediately. Two years past the expiration date. What were the donors thinking anyway? Took weeks to get that smell out of the apt., and sometimes, in a damp rain, it’d come back a little.

Have you ever walked right by a homeless person on the street, or walked by their little ‘space’ on the sidewalk? The little pile of cardboard, papers, and if they’re lucky, shopping cart of odds and ends? And either not seen them at all, or plugged your nose because the smell emanating from their space was foul?

When I first moved to NY, I was directing a community based learning program at a university. We also did one-time volunteer projects throughout the year that students coordinated and participated in. One such opportunity was run through a program called the Midnight Run (run by a former homeless man). Basically, people outside of the city prepare sack lunches, hot soup, and coffee, and pull together donations of blankets, socks, clean used clothing appropriate to the season, and drive into the city at midnight. Because midnight is when you find homeless people on the streets. They tend to ‘hide’ during the day, make themselves invisible to the non-homeless (and the cops). But they are visible at night. We went in the middle of winter, during a cold snap that was so bitter that very few homeless would venture out of their ‘space,’ even for hot soup and coffee. We had opportunities to talk with individuals while they ate and picked out clothing. Not surprisingly, intelligent, articulate, witty, friendly, humorous. Human beings. Real people. Have you ever looked closely at the hands of a homeless person? Or their eyes? Because that’s where you can see what life has done to them. In the deep, deep lines and wrinkles around the eyes in their weather-beaten face. In the rough, callused hands, blistered from the cold air, and in the dirt around and under the fingernails that no amount of soap can completely erase. I can honestly say I’ve never walked by without noticing since.

So the next time you’re at the theatre, in line at a grocery store, asked to donate food, or walk past a homeless person, think for a minute about what you can do. Don’t save it for holiday time when you’re feeling magnanimous. Do it today.

Monday, July 18, 2005

NY Medicaid program under fire...

...and for good reason--fraud. Not fraud by the client/recipient, but fraud by unethical providers. And it sucks.

We have 4.2 million people--children and adults--who are income eligible, receiving Medicaid right now. But there are thousands more who are income eligible and on wait lists, with no medical. And, standard services are now being cut to save money. New York's program is the most costly in the nation, at $44.5 billion annually, while covering only 20% of the population. California, on the other hand, covers 55% of the population, for less than NY spends.

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Why? Because of people like this (from the NY Times):

-- Dentists like Dr. Dolly Rosen, who within 12 months somehow built the state's biggest Medicaid dental practice out of a Brooklyn storefront, where she claimed to have performed as many as 991 procedures a day in 2003.

--School officials around the state have enrolled tens of thousands of low-income students in speech therapy without the required evaluation, garnering more than $1 billion in questionable Medicaid payments for their districts. One Buffalo school official sent 4,434 students into speech therapy in a single day without talking to them or reviewing their records, according to federal investigators.

--Nursing home operators have received substantial salaries and profits from Medicaid payments, while keeping staffing levels below the national average. One operator took in $1.5 million in salary and profit in the same year he was fined for neglecting the home's residents.

--Medicaid has even drawn several criminal rings that duped the program into paying for an expensive muscle-building drug intended for AIDS patients that was then diverted to bodybuilders, at a cost of tens of millions. A single doctor in Brooklyn prescribed $11.5 million worth of the drug, the vast majority of it after the state said it had tightened rules for covering the drug. The Times concludes by stating: New York's Medicaid program, once a beacon of the Great Society era, has become so huge, so complex and so lightly policed that it is easily exploited. Though the program is a vital resource for 4.2 million poor people who rely on it for their health care, a yearlong investigation by The Times found that the program has been misspending billions of dollars annually because of fraud, waste and profiteering. A computer analysis of several million records obtained under the state Freedom of Information Law revealed numerous indications of fraud and abuse that the state had never looked into.

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I simply seethe with anger when greedy, unsconcionable people steal from government programs, leaving the poor who actually need the program sitting in the cold. Yes, I take things like this very personally. I've dealt with extremely serious illnesses in the past--things like viral encephalitis and pleurisy--because I couldn't get medical care. Something that could have been treated by a quick doc appt and meds if caught early became life-threatening illnesses because I was on a Medicaid wait list. When I get really, truly angry, I want to hurt someone -- bad. Lock me in a room with some of these thieves, and just see if I don't wreak a little vengeance on behalf of all those who were desperately ill and couldn't get medical treatment. GGGGGGGGRRRRRRRRRRRRRRR!!!!!!!!!!!!!!!