Mr. Romney/Mr. Ryan: Medicaid as block grant

September 9, 2012 at 10:42 AM (Uncategorized) (, , , , , , )

Mr. Romney/Mr. Ryan:

Let me just state right up front:

I don’t have enough money to pay for a tax cut for you and those in your tax bracket.

If you get your wish about Medicaid…cutting it by 30% over the next ten years and changing it into state block grants…in effect asking me to pay for your tax cut, this is the direct effect it could have on me:

Let’s look at the best case scenario first. At the end of the ten years, I’d arrive at a scenario where

I’d lose 30% of services for the same amount of spenddown (read money-I-presently-have-to-pay-before-Medicaid services start.)

Right at this moment, I would lose my present doctor a rare young fellow who listens to me, and get a new physician who’s job it is to tell me what drugs, and procedures are no longer covered, and therefore no longer really necessary… I’d have to reargue the case for a certain kind of asthma medicine for me, or which anxiety medication is best to help with my depression.

Therapy that among other things, slows the progress of my incurable lymphedema, ‘wakes up’ the lymphatic system to get things moving, physical therapy that does a bit to counter the tightening stiffening muscles that come when you have cerebral palsy and get older, that I’ve been dealing with, the therapy that has been at least partially covered, up to a certain dollar amount, would reduce by 30% (It’s limited now, and I have to give it up entirely ’til January, even before you get your mitts on it.)

In order to pay for your tax cut, I’d have to pay 30% of my medical transport costs…presently the only transport I have available in this county to get to a doctor or specialist. (FYI full cash cost of one round trip to my lymphedema therapist would be approximately 180.00 one way. I was going 2x a week. If you can, you do the math.)

That’s best case.

Middle of the road case: In addition to the above cuts in order to pay for your tax cut, my spenddown would go up…money that I now use for rent, non covered medical expense, food, phone bill, internet access…

Worst case: the 30% cut means cutting *people* not just services, and since I’m relatively new to the program, in order to pay for your tax cut, I could be one of the ones to go.

So

Still lose my doctor…

All medical transportation costs

and 20% of medical expenses covered by my remaining Medicare would become my responsibility. (I’m eligible for Medicare due to disability…many of my fellow Medicaid beneficiaries *only* have Medicaid, so their situation would be even more desperate than mine.)

My earned benefit of disability only goes so far Mr. Romney…
I’ve given up a lot by my estimation:

I love books. I had 400 or so. I still like reading books you can pick up and hold in your hand. I’m now down to 30

I love movies. I used to have about 150. I sold them to pay for groceries. Now I’m down to about 30 of those too.

I had to give up a loved pet because there was no contingency money for her if she fell ill…and not enough to make sure both she and I had the basics. And, for what it’s worth I loved her enough to do what was best for her, not put her on top of a damn car for a roadtrip.

Luxuries like a dinner out or a movie out don’t happen unless someone else is kind enough to pay. (This is as it should be. I am in no way asking anyone to subsidize a trip to the movies for me. Doesn’t mean I don’t miss them. )

In summation, Mr. Romney, and Mr. Ryan too.

Mr. Ryan has been called bold for advancing the plan that would force me and every single present Medicaid beneficiary to pay for your tax cut, Mr Romney…

What’s bold, or brave about forcing benefits away from poor people and people with disabilities and forcing more of their small store of money into your pockets?

Smells like cowardice to me.

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Santorum, Peter Singer and “culling.”

February 19, 2012 at 2:01 PM (Uncategorized) (, , , , , , , , )

Thanks so much for making me feel squeezed this morning /snark.I’m feeling goddamned stuck in the middle between the utilitarian streak of some on the left, [Peter Singer and his, “Well a disabled child isn’t really a person,” remark on Chris Hayes show a few months ago comes to mind.] and nutcases like Santorum.

Evidently Santorum made the argument earlier today that the reason prematal testing is part of the Affordable Care Act is to cull people with disabilities out of existence. There are so many vital reasons for prenatal testing….he cannot concieve of more than one outcome after a genetic test. Whatever.

We’re smart enough to know Santorum is being vile, using this for political expediency. He, like every conservative today is talking out of both sides of his mouth. “Save the babies!” on the one hand, and “never pay for their care!” on the other. Not that there isn’t a genuine left utilitarian streak that PWDs have to fight all the time.

Uses of prenatal testing need to be discussed, and not in Santorum’s context. It needs to be discussed to avoid PWD invisibility on the issue.

I state categorically that I would never presume to “argue” with any woman who chose to terminate on the basis of disability alone. I wouldn’t know enough about the circumstances that caused her to do so. In general, I am against, seriously against, terminating on the basis of disability alone, but it isn’t my place to impose what I think on another woman faced with this, and there are individual cases (no brain at all?, etc) where I think I’d step out of my general opposition)

However,

When a pregnancy is terminated for disability alone, there is sometimes, depending on the condition involved, an unavoidable message sent.

“We want a perfect society. We don’t want you.”
“We’re uncomfortable around you. You remind us of our own mortality.”

“We don’t believe in our own ability to handle a child child with disabilities.” (IMO this is a really sad one. I’ve seen so many handle what they did not think they could, and be glad.)

Or the one that both the left and right use.

“I/We can’t afford it.”

I’d imagine my parents, Steven Hawking’s parents, Maysoon Zaid’s parents, might have had thoughts like that.

Those arguments like to be couched on the left sometimes as against the mother.

They aren’t. They are against being devalued. They are against giving anybody any leg to stand on to cut existing supports for us.

But it’s also important to point out the dumbestassery of all of any of the Rightward folks that talk about this in terms of “culling.” They cull, themselves. All the time. Every time cuts in Medicare or Medicaid are done. When the health care industry puts profit ahead of care.

When they cut Medicaid in Alabama for persons over 21 years of age, ventilator dependent quadriplegics died. Or had to flee the state.

When a pharmaceutical company didn’t self correct in a timely manner *in the name of profit* they allegedly may have caused my husband’s death and the death of many like him.

Call Santorum on the vileness of the remark, absolutely,

but lefties, clean your own utilitarian house too.

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Physical Rehab, Reinvent, Retrench-Insanity

January 20, 2012 at 8:17 PM (Uncategorized) (, , , , , , , , , , , )

My legs are not wrapped.  This vital process will not happen the way I was told.

Because of my cerebral palsy, I cannot wrap and unwrap by myself.  there may be a way to figure part of the unwrapping, which I will work on tomorrow, but the wrapping is flat out impossible.

I was told my aftercare until I graduate to compression socks would be covered under Medicare part A.  That someone would come to the house and unwrap my legs, help me clean them (not entire bathing, simply my ankles and feet. Rewrap my legs since they would be certified to do it. )

Now, the home health care agency will not wrap my legs (its a non-skilled service)

There is no way to send someone certified to wrap that would be covered under Medicare part A

I’m supposed to be set up with an outpatient clinic instead, that Medicare may not cover, even under part B.   I advised of the transportation problem making the cost of that prohibitive, they said then I’d have to be in a rehab place or an SNF [ even tho medicare wouldn’t cover a return—-] until I graduated to compression socks, or live with someone who could transport me.  I won’t go into details here, but living with my parents would be, um…problematic and risk my mental health.  I don’t mean that snarkily or as satire.  It’s a real issue.

I am not leaving my home.  I worked too hard to get here.

I AM NOT LEAVING MY HOME!  Not over a 45 minute process.  I AM NOT LEAVING my home.

So, it’s be institutionalized or lose all the progress and leave myself at risk for congestive heart failure, or come up with a way to be transported to these lymphadema clinics every day, pay for that, and pay for either 20% or 100 % of those costs.  Even having Medicaid waiver fixed would not necessarily solve this problem.

I’m contacting the patient ombudsman for Medicaid in my state, to get the transportation set up, at least.  I’m also contacting my church.

But that has to wait til Monday, and the damn legs have already begun to ‘reinflate,’ because all the home care folk can manage is a simple ace bandage.

And yes, I’ll be dumb enough to stay at risk to stay in my home.

There’s such a thing as quality of life and I will not surrender it to bureaucratic forces that cannot speak to each other or bend to necessity.

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Apparently, Diabetics and hypoglycemics

June 2, 2011 at 5:00 PM (Uncategorized) (, , , , )

the opposite ends of the spectrum where out of wack blood sugar levels are concerned, are out of luck if they are   Medicare or Medicaid recipients.

“Manifestation of poor glycemic control” is a broad stroke and Medicaid will no longer reimburse doctors or hospitals for treating these manifestations…

 

I know of cases where the person was monitored by a family member, following their diet and taking their insulin in a timely manner.

But they were caring for their terminally ill son at the time so their blood sugar spiked to 300.  in this scenario, if she’d had a diabetic coma, neuropathy, Medicaid would not reimburse for her care.

I know who they’re going after.  Folks who know they are diabetic who do not test, take glucophage or insulin and do not monitor their diet.   But…there will be too many doctors or hospitals that will not see diabetics now, and there’s no way to distinguish “good diabetics” from “bad diabetics” prior to evaluation, so they”ll solve that by not seeing them at all…

If they’re not seen, they’ll have more manifestations.  Like say blindness or amputation.  And their life expectancy will decrease.  And whatever manifestations hypoglycemics have (blood sugar too low) if you’re on Medicare/Medicaid and have that issue.  Good luck to you too.

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Oh, hell, why don’t you just give them everything they want?

May 25, 2011 at 8:50 AM (Uncategorized) ()

I’m so freaking tired of people talking about playing around with Medicare. If the right has been backpedaling away at a frantic rate from Mr. Ryan’s plan, a near election year is not the time to say, Okay, cuts are on the table…” but apparently, Hoyer has done so.

According to Talking Points Memo, requoted at the Great Orange Satan:

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