One of the worst features of our absurd Rube Goldberg non-system of Medicine is that it buries people in paperwork in order to get the benefits they're entitled to. When my mother went into a nursing home, I assumed I could complete the application to get her onto Medicaid myself, but it turned out that even for a guy with a Ph.D. in Social Policy who was a full-time professor of health services, policy and practice, it was impossible. I had to hire a lawyer, and we have to pay the lawyer every year to do the required re-determination. And by the way, the only entity that's ultimately paying my mother's lawyer is the state of Connecticut, because they get all her money and the lawyer's fee just come out of it.
Every Medicaid beneficiary has to go through redetermination every year, or rather they did until the requirement was temporarily suspended during the Covid-19 pandemic. But now it's been reinstated and I expect you can imagine the snarls, FUBARS and SNAFUS that are happening all over the country. Most people who properly lose Medicaid will be able to get insurance through the ACA, but they're going to face a coverage gap until they can get that figured out. And people who are improperly denied -- and there will be a lot of them -- will have to appeal if they are able to. Obviously most people who are Medicaid eligible can't afford lawyers, and if they can't manage to do what I couldn't do, and pull together the required piles of paperwork, they're out of luck. (My mother is "medically indigent," which means she has too much income to ordinarily qualify for Medicaid but she has unaffordable medical expenses, which is why she can afford a lawyer.)
The linked story tells about a guy who "spends his days driving winding roads across the state providing free legal services to people who have lost coverage or need help filling out pages of forms the state has mailed to them. In between his drives, he fields about a half-dozen phone calls daily from people seeking guidance on their Medicaid applications."
If this isn't ridiculous enough, one of the infinity of outrages in the House bill to raise the debt ceiling is imposition of a federal work requirement for Medicaid. Republican politicians like to paint a picture of lazy shiftless leeches living off the honest taxpayers, but the actual true fact is that the vast majority of Medicaid beneficiaries either are already working or can't. All this does is impose an additional paperwork burden that is just going to get some people improperly denied benefits and create more work for the legal services philanthropies.
We need universal, comprehensive, singe payer national health care. Then all this crap will go away.
5 comments:
I live in a condo development that is almost all Canadians and while they like the free part, they don't like the delivery system.
They complain about the wait time to get an appointment mostly, sometimes as much as six months.
Maybe other universal care systems are better, but hearing them talk about it is disappointing.
I grew up on the U.S./Canada border. I've lived in Canada. I know Canadians who really like their health care system. It's great for elder care.
U.S. citizens complain about wait times too, especially surgeries and specialist appointments.
The main difference is that their health care is free.
It's rather puzzling that your neighbors live in the U.S. but get their medical services in Canada. That aside, the same, alas, is true in the U.S. It can take months to get an appointment. In fact, in some parts of the country it's difficult to find a primary care physician at all, most of them aren't taking new patients. I may go into the reasons for this anon. Meanwhile, I'll just say that in a single payer system, the problem is at last easy to solve, it just takes political will. And for people who are uninsured or underinsured, the wait time for an appointment is forever.
Why are people on Medicare or welfare recipients 'lazy, shiftless, leeches' because they get a little money while not working for it, but beneficiaries of an estate of a wealthy person aren't, even if they receive much, much more and haven't worked a bit for it.
There seems to be an unstated assumption that the offspring of the rich are somehow morally superior to those of everyone else. I wonder if this is a testable hypothesis.
There are many Canadian Expats not only in the US, but elsewhere. They travel back to Canada every few months to keep qualified for their free medical coverage.
They also pay for international healthcare insurance in their country of residence.
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