Guaranteed Healthcare

In the early 90's my kids were school-age and I was a single mother struggling to make ends meet with a job that paid only a few dollars an hour over minimum wage. My son had a hernia since he was a child, but since he was born I never could afford the surgery and it was routinely ignored by doctors as "nothing to worry about".

When my son was 10, during a physical for school (which always went unpaid, causing me to never have records for the next year) I was told that his hernia had to be fixed immediately and I was also scolded for not taking care of it sooner. I called my healthcare provider that I had through my job. They wanted $2,000 up front as they considered the surgery "elective". In frustration of my economic situation and other difficulties, I quit my job and went on AFDC to go back to school. Consequently I received Medicaid in the package and within two months of that first warning, my son received that necessary surgery. I also was able to get my first PAP test I'd had in over five years and in addition found out my daughter, who was having trouble in school, needed glasses; she was acutely far sighted and also had a slightly wondering eye (that I'd always noticed) that unbeknownst to me makes her without depth perception.

What if I had never quit my job and received Medicaid? What would have happened to my children? In 2001 at another job I had an accident, I fell down outside and broke my ankle (tib/fib fracture) and qualified for worker's comp. Unfortunately, the lawyer for the comp case didn't do his work very well even though I won, (he complained the case wasn't worth much) I had to fight on my own to get creditors from the ambulance, anesthesiologist and others to stop calling me and file under my workman's comp claim. In addition, I was charged $350 for an "evaluation" because I missed the first appointment due to car problems and to this day I have no idea what the rating is for my ankle and leg as I haven't had the $350 to pay them, and they are holding the records. I imagine by now they've all but destroyed the records and I can't claim anything anyway. My ankle hurts often, and often is so stiff/painful that it interferes with my ability to walk.

In 2002 I started my own construction business and have been injured, luckily nothing bad, because I can't afford a comp policy nor can I afford regular health insurance for myself. On one job I picked up a tick on my leg and went to the hospital because it became infected and greatly swollen and I was out of sorts for three days. I had lyme disease or something similar. I was treated with two pills in the ER and sent home. The infection subsided, but I was billed $500 for the visit! My best carpenter in my business has had depression and alcohol problems for years, but he cannot afford the cost of treatment, which can run into thousands and for which no assistance is available. He also has had a congenital deafness problem for which he cannot get assistance in order to get hearing aids replaced that he lost long ago.

My teeth are bad, although the community here just started putting flouride in the water, so the decay has slowed, but I had perfect teeth until my adulthood when poverty and resulting poor eating habits have wreaked havoc on them. I had a tooth pulled while on Medicaid in 1995, the infection was so bad I was in tears. Only one dentist in the entire state services Medicaid patients. I was given a wonderful lecture about how he only receives one third of his normal pay through Medicaid. Is that my fault?

Also I was punched in the face in 1990 during an altercation with a street thug, my front tooth was permanently damaged, it is now ugly and brown and it effects my appearance and I'm sure my social standing (hiring, etc.). I have been told I have no choice but to spend thousands to get it replaced or repaired or just live with it. When my kids were young and I was working, the stress of managing my children alone on nearly nothing was getting the best of me. I had my kids in counseling and was in counseling myself through a non-profit, that allowed me to pay on a sliding fee scale. I quit my job and took on more responsibilities, (school and activism during the welfare reform debacle) and my stress only increased.

During the time that I switched from my private insurer for the children's care to Medicaid, there was much confusion over who would cover what and how services would be transferred over. I also was encouraged prior to getting on Medicaid to see a psychiatrist to find if there was a biological solution to my depression. There was much flurry about whether or not I'd get to have any counseling services under either Medicaid or my private insurer. During this time they came up with the idea that I was bi-polar and recommended that I go on a regimen of lithium. Might I add that this came about right around the time that my own counseling services would have to soon end. I was immediately out of sorts because of the lithium and also gained a huge amount of weight which only increased my depression. I quit school, dropped out of my activism work and decided that I was crazy and thus should give up everything. I was hospitalized for more serious depression during a time in the winter of '95 when my housing security was seriously threatened and I could find no immediate solution. The psych concluded that it was all me, I wasn't completely compliant with my medication and thus I should stay in the hospital for an entire week, even though the attending physician called her mandate "ludicrous". I told him I had trouble with the lithium and he put me on Depakote, which was even worse as it made me feel something like a zombie.

I stopped the medication after six months and continued with therapy and got my life back together. I visited the community mental health center a few years later to see about getting some counseling to deal with my math anxiety and social anxiety issues (I was going back to school again and this was coming up). The nurse looked in my file, "You are bi-polar?" she asked, "Are you still taking meds?" No, I replied and told her I haven't for about 5 years, she kept thumbing through the file and asking me if I was ok without it, did I have any episodes of depression? How am I coping? I told her I was not having depression and had never really experienced mania as I understood it. She said, "Well, I don't see anything in this file to support their diagnosis of bi-polar, this is very weird." In retrospect I don't think it was weird at all. They (the psych's office) needed to get paid and the best way to get paid is to tag on a diagnosis that doesn't require concrete proof, but would get by with subjective analysis.

The situation happened to my son, he had severe emotional problems and I had him in state custody for awhile. He had acted out on one occasion and was sent to an inpatient facility in a private hospital. There, the attending physician promptly tagged my son with a narcissistic personality disorder and severe depression. He recommended a medication regime and no follow-up therapy or any other cognitive/behavioral services. My son was 14. He read the file and asked me about it, I knew it effected his self esteem to be labeled like that. I was incensed; the psychiatrist spent a whole of one hour with my son to derive this diagnosis. Then my son was quickly whisked to a public hospital when space became available (apparently there was none prior). The attending psychiatrist there met with my son regularly for a week and met with me and said, "I think your son needs to go home, he's home sick, what do you think?" He assured me that in his analysis my son was otherwise fine, could use some further therapy and follow-up, but exhibited absolutely no signs of personality disorder of any kind. Why did the private hospital tag my son? To ensure that they would get reimbursed by Medicaid I'm sure.

My son went home with me, we discussed the conflicting diagnosis, we followed up with more behavior/cognitive therapy. He's a young, productive and cooperative adult today, he's been working steady, helps out his family and is preparing to enter college. I hope this all makes sense to you and hopefully you can use some of my story. I hate the current healthcare system, it has done only enough to keep my children and myself alive in the crudest sense of the word and only then, when I "qualify" for the meager public funds available.