vendredi 29 février 2008
A Wicked Week in the Hopeless Maze of Children's Healthcare
TGIF!
I've been running round on the ground in the health care wars this week, and let me tell you, friends <*snark*,> its not pretty. The overwhelming reality of what too many parents live with; the trade- offs and choices that go round on a roulette wheel, with the possibility of a disastrously wrong choice as the winning number. It may be a necessity for some parents to just turn a blind eye to what is missing in the struggle just to keep a roof over their heads, but the tragic legacy is allaround the neighborhoods where impossibly young girls push strollers and young thugs shuffle by with pants around their knees speaking in an indecipherable language. When you relegate an entire portion of society to a certain part of town you cant really expect them to be able to integrate themselves back into general society on command; at some point they are going to make their own culture, and that will ensure their separateness forever.
And much like I'll talk to people about dogs...and say that the doggy dental was SO expensive, as well heeled pure-bred dog owners will say, matter offactly, that they don't go in for that dental stuff, because we never used to do that for our pets in the old days. Well, I guess you couldn't say that about a child, could you? But what if you come from a country where medical or dental care is not readily available, and what if the clinic lines, hours away from work, and co-pays, and even the daunting process of applying for state aid, are an impenetrable wall. What difference will it make for an inner city kid to lose his teeth, as he or she is growing up and trying to get themselves out of the neighborhood? What puts someone over the edge? Is it the lack of skills? The lack of language or growing up around people who are not really aware of what is going on in the world? The lack of just having someone to talk to and some small choices in life?... The lack of any empowerment at all.
So, why do Medicaid, and similar services for the very poor, only provide for the pulling out of teeth and not for the saving of teeth? Isn't it incredibly short sighted for the government to not realize the ramifications of saving a tiny bit of money now only to have to spend heavily later? Its not just the bone loss in the face from not having teeth. Its the loss of self assurance and the loss of clear speech in some cases. Its all of the complications that happen later in life regarding nutrition and health. This should not happen to anyone, much less a child! Oh, there are programs to find out there to help with these tough cases. What I've found here are far away clinics that demand transportation and time to sit on line. You take the appointment you're given, and you don't complain...and hope that your job is still going to be there when you're done. And then, of course, the specialist only comes in once a month, so the first available appointment is months away.
Some people are not going to be able to pull themselves up by their bootstraps and realize the American Dream in the way that has been advertised, but their kids might be able to. So, in the interest of giving the second generation, at least, a chance, and in the interest it seems, of maintaining the maze of bureaucracy that is involved in getting care, why not let the parents care for the kids rather than making them work a minimum wage job that is not possibly enough to lift their family out of poverty, but which does assure that their children spend an inordinate amount of time either alone and wandering, or in daycare, cared for by others who are getting maybe just above the minimum.
Here we have a mother who is working 24/7 as a home health aide. Because she is making some amount below the poverty line her children are able to get the Husky plan,here in CT. Because her income surpasses some line in the sand, her children are forced off of the A plan, which is reserved for the very poor and which has no premium, and on to the B plan, which is for the slightly less poor and has reduced premiums based on what she makes. Because she makes so little there is no premium. The difference? The A program covers many more services, more fully. Why is that? Would the citizens of Connecticut want to cover the children of the very poor more than the children of the slightly less poor? The maze to even get into this program is daunting, and there certification every year is a nightmare.
To hear the mayor of this town boasting about his lean machine, reminds me of how Rudy notes cutting the budget of New York City partly by making the maze to social services more difficult to navigate so that people had to give up on trying to get services. Where is the morality in trying to deny care to anyone? How does that provide for a happy life for anyone? How does someone who boasts of that sort of behavior sleep at night?
If there is a God, which seems pretty unlikely in the face of all of this, maybe this is just a huge test....and really, it could go either way. because if what science has learned is true in that the fittest need to survive in order to better the race, then it's wrong to bring along the weaker members; they should be cut loose on an ice floe, and I'm the overly empathetic weak one. What I see happening here though, is that many of the kids of the very rich, raised in a bubble and unaware of how things fit together in the world, are more likely to be the weak links in a Darwinian sense. The hard working immigrants are tough as nails and those who work hard can really make a life. Take away the cushy surroundings from most of the rich kids around here and they couldn't survive. There is seemingly an active campaign against the poor brown kids pouring into this country, because they are tougher, and it could be that the only way that we have to fight them is to keep them part of the underclass, lest they overtake us.
With an eye to the crumbling middle class, and many in the upper classes having to downsize, it will be a pretty telling time regarding who is resilient enough to survive. Money is a construct that used to based on something valuable kept in a vault somewhere, but its so much more abstract than that. Just as a foreign government can buy our debt or an official can raise or lower interest rates, or print more money, its all just an idea. The only truth worth holding on to is that we are really only one or two steps removed from the homeless person on the street or the hardworking immigrant trying to scrape together enough money to take their kid to the doctor. Just as we don't torture people because we don't want our soldiers tortured in other lands, we cant deny care to anyone lest we be denied ourselves.
There is no doubt that this country needs a single payer health care system with no qualifiers. it needs to cover everyone and it needs to cut the insurance corporations out of the process. There are enough issues to overcome as a human being on this planet, without having to worry about what should be a right to everyone; not just the rich.
I don't know why, but to me the saddest part was that after the tooth cleaning, the kids didn't even get a new tooth brush, much less that array of samples which is like a prize for being good.
That was the dentist...next came the pediatrician, the blood lab, the psychologist...and school...
c/p RIPCoco
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