State of Confusion, California-style

As a follow-up to my earlier posts about my problems with Medi-Cal, I thought I'd post an update. Yesterday I received a notice from the County of San Diego that amounted to "nevermind."

The notice was automatically generated, stating that the county had received the "information that we needed" and would reinstate my Medi-Cal benefits. So, the whole imbroglio amounted to nothing, other than a waste of my time, my attorney's, and the county's itself. One wonders how often my little scenario has been repeated statewide, since the governor, allied with obstinate Republicans in the legislature, took a meat cleaver to government.

It seems the governor of this fine state hasn't realized that cutting 24% of the state's budget would have dire consequences, not only for the recipients of state services, but for the proper functioning of the state itself. If the State of California were a body, it's as if Surgeon Arnold cut off a leg and grabbed a crutch. You just can't hobble along on a crutch as easily as you can on your own two sturdy legs.

As the impaired state stumbles toward a near-complete breakdown, everyone will suffer. This is true not just for California's millions of residents, but for every American citizen. The decline and fall of the world's 6th largest economy will drag the whole nation down with it. The great inefficiencies induced by the recent decimation of California's budget will compound exponentially, possibly impeding the state's economic recovery indefinitely.

Grover Norquist, Republican strategist, once said that he wanted to shrink government down to the size where he could "drown it in the bathtub." Based on my experience, the rising tide of anti-government nihilism will sink all boats.

My Annual Fight with Medi-Cal

I just got a "Notice of Action" from Medi-Cal yesterday that they will discontinue my benefits on August 31. Of course, I immediately filed an appeal and mailed it off. Many recipients may not be aware (the information is in small, unreadable print on the back of the denial letter), but you can protect your benefits indefinitely by filing an appeal within 90 days of the Notice of Action.

In the notice, they claim I did not return my annual redetermination forms. However, I never received the redetermination forms this year. Their claim is bogus. I have dwelled in my apartment for 17 years, and I would have immediately filled out the forms, had I seen them in my mail.

I am frankly sick and tired of the state discontinuing my Medi-Cal every single year! How many times have I had to file appeals? Last summer I got the cut-off notice as I was lying in my hospital bed recovering from major surgery. The added stress did not help my healing process, obviously. That year, I had mailed in the redetermination forms on time, with a registered mail receipt from the agency, yet they still tried to discontinue my healthcare. The year before that, they tried to discontinue my coverage due to not having received my forms, even though the forms had been languishing on my social worker's desk for six weeks while he took a family vacation to his homeland in Egypt.

I’m beginning to think the state is singling out the “working disabled” like me for extra attention, in an attempt to hassle them off the Medi-Cal enrollment. I have asked Aleyda Toruno, my attorney at California Disability Rights, if she's ever heard of a client with as many erroneous discontinuations as I have experienced. My rough guess is, she hasn't encountered a client as persecuted as I have been.

Furthermore, I believe that these annual threats to discontinue my healthcare constitute a violation of my civil rights. When the state threatens to cut off the coverage of a person on life support, that is the equivalent of a death threat. A stranger would be arrested for showing up at my door and attempting to unplug my ventilator. By what right can the state claim to do the same thing?

Why is it only the crazed, right-wingnuts who yell and scream about their government? We, the disability community, are too docile. Our representative democracy has degenerated into mob-rule (the very thing feared by Hobbes, in "Leviathan.") The oppressed need to get out their pitchforks and torches too.

The Folly of Health Insurance Reform

I was just watching Michael Medved on MSNB's "The Ed Show" saying, "Most Americans don't want government healthcare, they want INSURANCE REFORM." In an odd coincidence, I taught Michael's snotty litte brother, Ben, in my first Muir Writing class at UCSD in 1978. Anyway, Michael isn't one of the neo-fascist screamers of the Limbaugh and Savage ilk. He at least couches his words in reason.

The problem with insurance-only reform is that it will merely inflate the Ponzi scheme we've already got. I saw Elizabeth Edwards state on the "Daily Show" that at one time a single insurance company CEO made 1 in every $700 spent on healthcare in this country. ONE CEO!

The type of reform Republicans endorse, eliminating pre-existing condition exclusions and requiring that all be insured, will simply add to all our health insurance costs. Why? Because insurance companies will use the new rules to jack up rates. Their excuse will be that covering the truly sick is expensive, and all these government regulations constitute an onerous burden. Their solution will be increased government subsidies to cover their inflated premiums. They'll make money coming and going.

So-called insurance reform, without a government plan to compete, will merely prolong the agony of our intractible and slowly dying system. For-profit insurance will continue to demand its 30% overhead, and that CEO will continue to aggregate his salary. For insurance companies, "single-payer" means we, the rate payers and taxpayers, will continue to pay singularly exhorbitant salaries to their CEOs.

On Lance Armstrong's Nuts & Bolts

I noted with interest today the CNN stories on Lance Armstrong's "medical miracle": his bolted-together broken shoulder blade. It's great that doctors are able to put in the screws, bars, and nuts to reassemble the great cyclist's shoulder. But it brings me back to a point that's often on my mind: doctors seem to favor fixing the "healthy" rather than performing the hard work of improving the lives of people with disabilities.

When I suffered the compound fracture of my right leg in 2004, the surgeon chose to fundamentally let my leg heal "as-is." "Your bones are too fragile to put screws in," he announced, which shouldn't be a big deal because "you aren't going to run or ski anyway." So, now I have a short leg, Toulouse Lautrec-style, with a knotted up shin bone that looks like I'm carrying around a baseball inside my leg, when you look at the X-ray films.

My 53 years as a patient in the medical world, makes me believe that the profession, like any other, prefers the easy cases. A cab driver would rather collect a hefty fare for driving an old lady around the block, than picking up three black guys in the hood. A TV repairman would rather order a replacement from the factory than rip the case off an old-fashioned tube TV. Doctors would rather treat a single malfunction in an otherwise healthy patient, than trouble themselves with the difficult choices a disability presents. It's totally understandable, of course--we're all human and we all prefer to walk downhill than to climb a ladder.

So--go, Lance! Win one for the team! But hey, doc--don't forget about the hard cases, too!