On the presidential front, Clinton, Obama, and Williams will be vying for the democratic nomination. There will be more hopefuls making squeaking sounds of desire for the top spot. I hope that a truly effective coalition of the “screwed” will make their unifed voice heard, as sung by Woody Gutherie, from “California to the New York Island”. The consequences of failure are dire: Will the line “this land belongs to you and me” become a historical curiosity? Will this land belong only to the wealthy . . . for now, and then one day to the foreign interests that own ever increasing interests here?

The work and challange we face is about preserving economic justice (this includes our public policy on access to medical services) and the global environment. On the later issue, see the December 17, 2006 Sunday Tribune’s Front page story, presented as a “special report” titled “China’s Big Grab”.

The link to the Tribune is:
http://www.chicagotribune.com.

The link to the article is:

http://www.chicagotribune.com/news/specials/chi-china-cashmere-htmlstory,1,1760776.htmlstory?coll=chi-news-hed.

I just returned from my monthly visit to the doctor, and subsequently a visit to the pharmacy. Nothing unusual with my medications—they have been stabilized for several months. Yet this time the pharmacy could not provide my customary refills. My Medicaid will not pay for them. Not this time.

Together the whole lot of medications costs just less than $900. Nine hundred dollars that I don’t have, and nine hundred dollars that I have no way of getting. I have no other benefits, no Social Security checks to count on; no disability payments to pull together; no Medicare to meet me when the bottom falls out, again.

This surely is not the first time my Medicaid has not come through as a reliable source of payment. It is not even the second or third time. It’s more like the eight or ninth, maybe more often than that. I only recently qualified for Medicaid some eight months ago! Since then, I have already acquired several thousand dollars in unpaid medical expenses that have made their way to collection agencies.

I constantly ask myself why does this happen to me? Am I part of some diabolical scheme to do away with public health efforts? Silence the noisemaker! Or is it just a coincidence that I spent three years in a doctoral program studying health law and policy specific to mental health and Medicaid. Don’t they know how much more it hurts me to know exactly which systemic cracks I am falling through? Why have I encountered so many random barriers to health care in addition to those obstacles strategically placed in the system? We all know them: the endless forms, the incompetent employees, the negligence that already works to deter consumers such as myself from using the public health programs to which we are entitled. Yes, entitled. Medicaid is in fact an entitlement program no matter what they would have us believe.

Don’t they know who I am? Who I could be? Who I might be if only my mental health and medications would remain stable? If only my health could be stabilized, I could live the rest of my life in rhythm without having my peace of mind tampered with by bureaucratic negligence and oversight. Without having my benefits tampered with by bureaucratic negligence and oversight! I could be a real noisemaker, if only…

Unfortunately, no one in the Medicaid office knows who I am. I remain a faceless, quantifiable case number who means nothing to them. And I am not alone. But I need your help. Together we can fight to change Medicaid prescription limits and managed care formularies. I am not alone. Let your voice be heard.

Much of the arguementation over health care relates to cost. Turn the arguement around; What are the cost to the US for NOT covering Americans. The average hospital emergency room that treats simple injuries that got worse due to lack of immediate care is one clue. Later treatment for a bigger problem cost more than early treatment for a small problem.

Since the indigent patient can pay, at best, a small portion of the cost, the rest of the balance eventually get covered by other insured people or the government.

Since it is cheaper to treat mild illnesses and injuries, states have been slowly picking up the cost of preventative medicine like flu shots and vaccinations for children. There seems to be a slow movement to universal coverage.

It might just be cost effective to just get the matter over with and provide universal coverage.