As I said, I've been trying to write this for a couple of weeks now. I keep thinking I should explain why I don't have insurance, but it's all bound up in the whole PTSD-over-benefits thing, so every time I try I either go blind with rage or get incredibly tired and have to take a nap. So let's instead talk about why I'm applying for insurance now.
Nope, can't do that either. To do that, I have to explain how it came to be that I don't have insurance, all about how my not having insurance is a major bone of contention between my true love and I, how he has offered to pay to cover me many many times but can't actually afford it, how I had really bad insurance through Whole Foods for awhile but at some point was so stressed out over the fruitless efforts I'd put forth to actually collect benefits due me that I developed the aforementioned PTSD and decided I'd rather be poor, uninsured, and constantly in danger for my life -- oh, wait, having cancer already puts me constantly in danger for my life; forgot for half a second -- than insured and spending even one moment of my precious, irreplaceable, and fragile existence that medicine can't really save but only occasionally patch at this time arguing with people about money they owe me but will never, ever pay because they know they can get away without paying it.
Instead, I shall talk only about my interactions with the Commonwealth of Massachusetts.
Quoting from a postcard I recently received in the mail,
Beginning July 1, 2007, a new Massachusetts law says that residents age 18 and over must have health insurance. With few exceptions, adults must be able to show that they have health insurance by December 31, 2007. Those who cannot will lose the tax benefit of their personal exemption on their 2007 Massachusetts income tax return, worth $219 for an individual. Penalties will increase for 2008.
Most adults already have health insurance, perhaps through an employer or a government program. If you do not, the Commonwealth Health Connector can help you or your employer to find the right health plan. The Health Connector has new health insurance choices for you and your family. These plans carry the state's Seal of Approval for quality and affordability. You can also purchase plans through approved Massachusetts health insurance carriers. To learn more or purchase a plan, visit www.MAhealthconnector.org.
So what's funny about this postcard is that I received it about four months after applying for state sponsored insurance, for MassHealth in fact. Everyone received one. It was a public service notice. It doesn't say it whether was printed on recycled paper.
There's a lot that's not funny about this. Sadly, I'm in no condition to get all political on anybody's ass. That, of course, is thanks to my interactions a few years ago with an approved Massachusetts health insurance carrier, incidentally. But I'm not going there, not today.
I'm just going to tell my latest little insurance story, the story of my application for MassHealth. I'm just going to talk about that.
In February, for reasons that have everything to do with my relationship with my true love and absolutely nothing to do with either my cancer or this impending threat of not being able to enjoy a basic tax benefit that won't even apply to me this year if I don't start making dramatically more money in the next month or so, I knuckled down and applied for MassHealth, which is this state's free medical coverage for poor people.
One inducement for me to do this over and above the state of my relationship is that this coverage is better for an amputee than the coverage I had at Whole Foods because prosthetics are covered 100%, and there is no lifetime cap. There is also, as far as I know, no need to worry about preexisting conditions. As you may recall, on a grocery cashier's salary, it took me quite some time to pay off the last $1,200 that I was left owing after insurance on the last $6,000 adjustment to my current socket, and the Whole Foods policy through United HealthCare included a $50K per-patient lifetime cap on all prosthetics. What I didn't tell you is that any of my whole amputation experience was covered at all only because I hadn't been to a doctor for my cancer in five years; if I had been at any time in the previous three years, I think it was, but it might have been two, all of my claims would have been denied, from the emergency room exam to the surgery to the prosthetic. Yeah, I would have been $40K out of pocket, at a time when I only earned about $9K per year, and I was working full-time, the low side of full-time, but not "mothers' hours" either, weekends and nights, five days a week.
I've got to say that after looking at pretty much the same prosthetics benefits the average Albanian farmer gets from the Red Cross after stepping on a land mine and waiting seven months -- yeah, I mean the one working prosthetic leg per lifetime, though I have already gotten more fittings and adjustments -- and all while working and being insured by my employer's policy, and only because I hadn't seen an oncologist recently, the thought of being unemployed yet not having to live in fear of being permanently crippled by poverty and mishap was pretty enticing. So I didn't really argue when my true love insisted I get medical coverage somehow for the sake of his peace of mind, because I figured what with being an amputee cancer patient with no job, something could be worked out with the state.
While recovering from a bout of mittelschmerz so severe I thought my ovary was going to rupture, and no way to find out, of course, since I didn't have insurance coverage (hence my true love's stress), I went to the MassHealth website and printed out the generic "Medical Benefit Request Form." At the time when I applied, it was the same form whether you were applying for MassHealth or for one of the new "affordable" insurance plans to be provided through the Commonwealth Health Connector mentioned on that postcard. "We have tried to make the Medical Benefit Request easy for you to fill out," reads the website, and it is -- at least, it was for me, five-time college dropout, former legal assistant (for 18 years), fluent in English, even while sitting in bed with a fever over 100°F that had lasted five days.
Complications arose later, about two months later.
Two months later, I received a notice from MassHealth which told me that I needed to provide more information, specifically verification of citizenship, specifically a passport or birth certificate. My original certified copy of my birth certificate, the one my mommy got right after I was born, and also my passport had been destroyed years before, and I had no replacement for either in hand.
A photocopy of a birth certificate won't do for something like this. For purposes of legal proof of identity, one has to provide a certified copy, or "authorized" copy as they are sometimes called. To get such a thing by mail, I (or rather my true love, since I have no income) had to pay $17 (about two weeks' worth of food for a single poor person who eats a largely ramen diet -- yeah, been there more than once), get a proof of identity notarized (which was free at my bank but isn't if you're the kind of poor person who doesn't have a bank account -- yeah, been there, too), and wait.
The notice also said I would have to fill out something called a Disability Supplement which would be mailed later.
I received the Disability Supplement the same week. Remember how the website assures visitors that MassHealth has "tried to make the Medical Benefit Request easy for you to fill out"? Yeah, well, that was the Medical Benefit Request.
This is what the Disability Supplement looks like, front --
-- and side:
I started to go blind a little. I set the packet down and walked away.
For about a month.
A month later, classical music tinkling on the computer, herbal tea in hand, I sat down to actually read the packet. The cover letter read, inter alia, in boldface, just like this:
If you do not return the form to us within 60 days from the date shown at the top of this letter, we will not consider you to be disabled. This means we will determine you eligibility as if you are not disabled.
Longtime readers of this blog know that I have a problem calling myself "disabled." (See category entitled "Learning to be, uh, "disabled," I guess" for details.) As I have tried to explain many times, and in spite of accusations I have received to the contrary, my disinclination to use this word about myself does NOT come from any desire to distance myself from disabled people or the disability community. It comes from me not thinking it describes me, and from my profound desire to avoid taking resources away from people who need them more. I am not in chronic pain. I can walk in my working prosthetic. I can even look like a dork running, as opposed, for example, to people who can't even stand.
Because health care is considered a business not a right in this country, there are people getting nickle-and-dimed over things as basic as trach suction kits, yeah, simple maintenance supplies for the systems that let people with neuromuscular complications breathe reliably.
Yeah, really.
In a country like this, I feel very, very uncomfortable saying I'm disabled, taking -- or even being perceived as being interested in taking -- from the shallow pool of basic, life-sustaining resources doled out so very parsimoniously even to people who need them unquestionably.
I am also uncomfortable signing any declaration under penalty of perjury that I am disabled unless I can be sure what definition is being used. Legally, "disabled" here means "unable to work." (It says so somewhere in that sheaf of paper pictured above.) I am not unable to work.
I was perplexed as to why I got this packet. I turned back that loud first page, and this is what I read:
Yes, it says "You have indicated that you have a disability."
Huh. Don't remember doing that.
I turned the page.
The first section of the first page asked for "Information about person claiming a disability," stuff like name, address, etc.
The second section read, "We may need to schedule a medical exam for you. [emphasis in original, not just my head] What are the best days and times for you to go to an appointment? Please check two or more." Then there was a box full of tick-boxes labeled things like, "Monday A.M.," "Monday P.M.," "Tuesday A.M.," "Tuesday P.M.," etc.
It was at this point that I started to go blind again. Or something. Longtime readers of this blog may understand part of why, though they should bear in mind that they don't even know the whole story.
Here's the upshot: I do not go to doctors unless there is something specific very wrong with me that I think they can fix. No no no no no. No.
No.
I put the form down and didn't so much as touch it for another month, just about.
Come late June, and my 60-day deadline by which to send in my birth certificate and officially claim MassHealth benefits on the basis of legal disability loomed. I thought and thought about what to do. I really didn't remember claiming that I was disabled. And you know what? I hadn't, not specifically, even though the state had sent me a form assuring me I had.
Actually, what I'd said was that I had a chronic condition and/or a disability. That was the box I'd checked.
I read the rest of the form. I was paralyzed with fear. This is what PTSD over benefits is like. I could not answer a single question for fear I would answer wrong and be accused of lying or trying to get away with something, or that I would answer wrong and be denied benefits as a result of not guessing the exact right way to say something, because it's not like a law book comes with this form telling you what the range of right answers might be. I was afraid of being humiliated. I was afraid of going to jail. I was afraid I would be made so sick by my interactions with this new insuring agency that I would have to go to the doctor. All the time I was fearing all these things, every memory I have of dealing with bad insurance companies while working for Whole Foods and getting over having my leg cut off for cancer flooded every nook of my consciousness in minute detail and a solid flash at the same time.
Paralyzed.
I thought to myself, "This is a government service, one I have paid taxes to support in the past, and it exists to help me. I am going to bet that the people who work for it want to help me and that I can be reasonable with them and be dealt with by them on a reasonable basis. I can't really move forward without placing that bet, and so even though I don't completely believe this, even though no experience at any time in my existence has led me to believe this, I am going to operate on this assumption."
I decided that I would write a letter explaining my situation and enclosing a medical release form which would allow MassHealth to approach my oncologist, my surgeon, and my prosthetist for information regarding my case. They had enclosed an awful lot of release forms. I would just fill some out and mail them in with my $17 authorized copy of my birth certificate.
I wrote a draft. I wrote another draft. I was having trouble. I thought that I would just fill out the releases before doing another draft.
The releases all say they are from the MassHealth Disability Evaluation Service. The first sentence reads, "This MassHealth Medical Records Release Form is to get medical information from your health care provider so that the MassHealth Disability Evaluation Service (DES) can make a disability determination."
I didn't want the MassHealth Disability Evaluation Service (DES) to make a disability determination. I wanted the people reviewing my application to know that I had uncured metastatic melanoma and a prosthetic leg that needed to be maintained.
I thought about writing my own releases. I remembered what I went through with CNA, providers of temporary disability insurance for which Whole Foods employees must opt to pay extra out of their paychecks if they want to have this kind of coverage, which would pay 60% of their wages for a brief time in the event of physical illness or injury which would prevent them being able to work -- to begin immediately after a waiting period had elapsed, of course. When I hurt myself and had to make a claim against that coverage, I had to write my own release because CNA lied about what information it was required under HIPAA to demand a release for (helpful hints: NOT HIV status; NOT history of drug and alcohol abuse; NOT college transcripts; NOT for this kind of claim; MAYBE during discovery in litigation should any ever ensue). I was punished. There were huge delays in the start of my coverage, and I never did get the last few hundred dollars they still owe me, and after the one truly helpful person in my local HR team (such as it was) got promoted to a different department, partly on my enthusiastic recommendation, Whole Foods refused to go to bat for me and certainly wouldn't make it up to me. But I can't talk about that right now.
Let's just say that when I considered writing my own release now, a release which would have been both useful and valid but would not have included the word "disability," I encountered a little mental block.
I decided to think things over some more and put the project aside again. I think it was another week.
When I was ready, the project was just as I'd left it:
I had decided what to do. I sent the following letter:
Dear Sir/Madam:
In late April, after applying for MassHealth, I received two pieces of correspondence from you. One indicated that I needed to provide proof of citizenship in the form of a U. S. birth certificate issued before my fifth birthday, and the other sent me a big fat packet of forms entitled "MassHealth Adult Disability Supplement," which includes the assertion that I have indicated that I have a disability.
I enclose an authorized copy of my birth certificate from the County of Los Angeles Registrar-Recorder/County Clerk. I do not enclose the disability supplement.
I believe you were prompted to send me the disability supplement because I answered "yes" to a question on the initial application which reads, "Do you or any family member have an injury, illness, or disability that has lasted or is expected to last for at least 2 months?" I answered "yes" because I have had metastatic malignant melanoma for years, still do as far as I know, and as a result of this I am a right transfemoral amputee. However, I believe the legal definition of "disabled" is "unable to work." Neither of the conditions I have listed has ever in the past disabled me to the point of being unable to work for more than a period of months, nor do I expect them to in the future as long as the cancer doesn't flare up, my prosthetic leg doesn't break, and I don't encounter prejudice or some pretty severe ADA violations. Therefore, I do not claim to be legally disabled at this time.
I hope this is sufficient information to allow you to process my application. Should you require anything further, please do not hesitate to contact me.
Thank you for your time and consideration.
Regards,
It was the best I could do under the circumstances.
A few days later, I received an envelope. The address was handwritten, and there was no explanatory cover letter inside, only my $17 authorized copy of my birth certificate.
A few days later, my true love and I each received individually addressed postcards as described and quoted early on in this post.
A few days after that, I received the following note from MassHealth:
The MassHealth agency has received and approved your request for more time to get us the citizenship and identity information we need to make a decision about your eligibility for MassHealth.
If you are applying for MassHealth: you must send us all of the information we need by 08/28/2007. If you do not send us the information by 08/28/2007, your MassHealth benefits may be denied.
If you are currently getting other MassHealth Benefits: you must send us all of the information we need by 08/28/2007. If you do not send us the information by 08/28/2007, your benefit will end.
If you have any questions, call the phone number at the top of this section. [Emphasis in original.]
The next day, I called the number. I called too early and was told by a recorded voice when to call back, and that due to high call volume, a human would not answer this number after 3:00 p.m. because that was the time reserved for MassHealth employees to do paperwork. I called at a time that the voice had specified would be a good time, and spoke to a woman who didn't give her name.
"I don't understand this notice. I did not make a request for more time."
"Oh, that just means you didn't send us everything we need. That's the notice that gets sent out for everybody when they don't send us everything; it's automatic."
"I don't understand what else you need. I sent a letter explaining that I was not claiming disability and enclosing an authorized copy of my birth certificate that I spent $17 getting from the County Clerk in L.A. Then I got it mailed back to me with no explanation. Then I got this. What do you need me to do?"
"Well, let's just see who sent your birth certificate back to you, and we can ask them." She hunted around in her computer, then said, "Just a minute please," and put me on hold.
Or so I thought. I thought she was going to go talk to someone. Actually what she did was transfer me to the voice mail of someone named Esther. I left a message for Esther requesting further instructions. Her voice mail told me she would call me back if I left a message.
Of course she never called me back.
Today I received a notice which states, in pertinent part:
MassHealth has decided that the individual(s) listed below are eligible to enroll in a health plan from the Commonwealth Care Health Insurance Program.
[Name: Me / Coverage Type: Commonwealth Care]
Commonwealth Care is a program run by the Commonwealth Health Insurance Connector Authority (the Connector). Commonwealth Care is not a MassHealth program, but MassHealth determines who is eligible for the Commonwealth Care program on behalf of the Connector.
Commonwealth Care is an insurance program that offers health-care coverage through certain health plans.
The Connector helps Commonwealth Care members join a health plan and find providers that meet your health-care needs. Commonwealth Care offers services like preventive care, prescription drug coverage, and hospital and emergency room services.
Based on the information you gave us about your income, you do not have to pay a monthly premium to join Commonwealth Care.
[insert appropriate expressions of relief here]
You will soon be getting a package in the mail with information about
the Commonwealth Care health plans available to you. You do not need to wait for this package to sign up. You can enroll in Commonwealth Care now by calling the Commonwealth Care Customer Service Center [numbers and hours]. Customer Service can help you choose the right plan for you. You can also enroll right now at www.macommonwealthcare.com.Call Customer Service or go online now to select a health plan and join Commonwealth Care.
Before you enroll into Commonwealth Care, you may be able to get services from a hospital or community health center. These services may be paid for by the Uncompensated Care Pool. For more information, call [number].
...
The MassHealth Agency has decided that the following members of your family are not eligible for MassHealth for the following reasons:
[Name: Me]
Reason and Manual Citation
You do not work for a small business; you do not meet the definition for long term unemployment; you do not meet MassHealth disability rules; you are not under age 19; you are not pregnant or a parent of a child under 19; and you do not meet MassHealth Standard rules for the cervical or breast cancer treatment program. 130 CMR 505.002 505.005 505.006 501.001 [Emphasis in original.]
There's more, instructions on where to see the complete rules and how to appeal, with more forms.
I will try my damnedest to wait and see what wonders lie in store for me at the Commonwealth Care Customer Service Center website before I complain, and before I flip out. Really, this all sounds very good. Right? Good? It doesn't really matter that I'm not eligible for MassHealth even though I'm a one-legged cancer patient with no job, right? 'Cause they're giving me something else?
Breathing. Breathing.
Obtaining insurance coverage fulfills my promise to my true love. Not having to pay premiums at all suits my income. Now let's just see if it actually covers anything I need, like maintenance on my prosthetic, and what kind of deductible, out-of-pocket numbers, and personal autonomy to make meaningful medical decisions based on life goals and needs vs. state and insurance company budgetary considerations come with it.
I haven't ruled out the possibility that everything might go just fine, that this program is well designed to help me and others in exactly the best way for each person, and that the people working on it want to be of service to me, a taxpayer whenever I have an income. I'm not counting on it, but I haven't ruled it out.
Fingers crossed if you've got 'em, please.
AAAAAAAAAAAAAAAAAAAAAAHHHHHHHHH!
Sorry. Couldn't hold that in any longer.
I'd really like to go on a stretch here, and take that R rating of your blog right off into the sunset, but let me just say that reading something like this makes me embarrassed to be an American. I cannot and will not ever wrap my head around how this sh*t happens in the United freaking States.
Anyway, if you ever need any help/support filling out all that crap, or have questions on legal bullsh*t (and it's all bullsh*t) please don't hesitate to ask. I can't guarantee I'll know the answers, but I'll bring my best sailor vocabulary!
Btw, I deal with infuriating paperwork in the exact same way--I leave it in a pile and hope someone else will do it while I'm sleeping or otherwise not looking.
I need to start paying my damn elves more, apparently. They don't do dishes either.
Posted by: Michelle | Bleeding Espresso | July 20, 2007 at 09:53 AM
HA HA HA HA HA
Thank you for making me laugh. Yeah, my elves are slackers, too.
Now, as difficult as this was for me, imagine if instead of me I was a poor person without a high school diploma or a reasonably well-employed boyfriend supporting me while I do his laundry, cook his dinner, and develop my artistic career. I didn't post this story just to whine and think, though those motives were definitely in there. I also believe that those of us who have the ability to describe the process have the obligation to describe it, because until or unless one falls into the situation of needing these services, one doesn't know what obtaining them is really like, even when they are services we have paid for by choice (like conventional health insurance or optional disability insurance through work).
Imagine if health care were considered a human right. Imagine if we didn't have to prove we both needed and deserved to be able to go to the doctor when we were sick.
Oh, right, some countries have that already.
Posted by: Sara | July 20, 2007 at 10:26 AM
To us lot over here, of course, the right to basic healthcare is more basic than being able to vote. I have great sympathy and anger for you.
That being said, our form-filling and administrative crap? Exactly the same bloody thing. Those bureaucracies dealing with some of the most vulnerable people, in the most perilous circumstances, tend to be the most clunky and unyielding. They give you contrary bits of information, you get set standard irrelevant letters in reply to complex and specific queries. It is a headache, and inevitably you feel like your needs and worthiness are under scrutiny. It's plain nasty.
My top tip is to try and divorce yourself from the process as much as possible, remembering this is about systems and statistics, not about people, and certainly not about you personally. Easier said than done...
Fingers and toes crossed for you. :-)
Posted by: The Goldfish | July 20, 2007 at 11:42 AM
Thank you, Goldfish. That's good advice, and the ability to do it is what I long for most with regard to this situation.
It would sure beat throwing things on the floor and walking away, or so I expect. :)
Posted by: Sara | July 20, 2007 at 12:00 PM
Sara, remember I said I am a wheelchair user? Well, this means that I've had plenty of experience of this sort of thing, and I'd endorse unreservedly what The Goldfish said. These people do seem to be employed purely because they are inflexible, dogmatic and unimaginitive. If your case doesn't fall neatly into one of the boxes as defined by some overpaid Public Sector person in a suit, then you have to bludgeon away at their skulls until their usually feeble minds come to terms with the fact that not everybody is an ideal, model case.
However, I'd also agree that the Welfare State, for all its mismanagement by successive governments, and for all it's ridiculous reams of red tape, is a much better system than the "laissez-faire" ideas of the US. From here, it seems to me that the US is stuck in the politics of the time of the founding fathers, i.e. the idea of minimal Government intervention and hope that business will do the rest. I may not be proud of the way that the Welfare State is being handled, but I am proud of the principle of having it.
Posted by: Christopher Bell | July 20, 2007 at 04:13 PM
Thank you, Christopher. You're in England, also, right?
You know, I don't think that any of us who are advocating for universal coverage have any illusions that it will be perfect. The thing that kills me is when private insurance for which people pay extra money -- and feel as they do so that they are doing the correct and responsible thing, as opposed to all us slackers who need public aid because we are lazy or have failed disgracefully, obviously -- is less reliable than bureaucracy. And of course if we ever do get rid of private health insurance as our main source of medical care coverage, all those people who work in that industry, who are rewarded for incompetence that results in money saved for insurance companies because coming up against that wall of incompetence wears people out before they can bring suit, all those people will simply go to work for the government. We know this. But people are dying. We have to do something.
It's going to be a long, long road. We have difficulty even getting each other to understand why every government building (let alone private establishment) should be wheelchair accessible.
[insert loud sigh here]
Posted by: Sara | July 20, 2007 at 04:43 PM
Oh, Sara. I know. I know that feeling of paralysis over even TRYING to fill out this kind of paperwork, and the insane phone calls, and the lack of understanding or compassion ... and here you are, just trying to live your life as best you can.
I too have been unable to describe myself as "disabled" although I believe I am, legally. In my case, this means total paralysis when it comes time to fill out the application for a disabled hang tag for my car so I can park in the good parking places reserved for people with this tag.
Love the photo of the mass of paperwork.
Jeanne
Posted by: Jeanne | July 20, 2007 at 04:45 PM
Yes, I always laugh painfully, Jeanne, through tightly clenched teeth whenever you talk about how calling up the insurance company is something "cancer patients do for fun."
Yeah, fun. Big fun. Heh.
I lost my parking tag. Once I got a working leg, I lost the need for it, so I slipped it into some nook or cranny in the car for safekeeping and haven't seen it since. However, just for kicks, I recently became instantly ordained over the internet through the Universal Life Church, and apparently I can buy a parking placard from them that will do something or other but not take spaces away from wheelchair users.
To get a parking placard in MA, I had to wait until I had actually been amputated, and then I had to wait a few weeks while the card was being processed before I received it. Of course, I knew in advance that my leg was going to be amputated, and that the time immediately following my surgery would be the time when it was hardest for me to get about, and that I probably wouldn't need the placard once I healed from surgery, but the Commonwealth's policies do not allow for this. So after I had been out of hospital a week, I had to bring the form to my surgeon and have him fill it out, then send it in, then wait 'til I was a third or half of the way through my rehab before I could actually park in handicapped spaces.
The part I love best? Though amputation is considered legally "disabling" for this context, I actually have to apply to have the placard renewed periodically. I actually have to have my doctor declare under penalty of perjury that I am still "disabled."
hahahahahahahaha -- Take me, madhouse; I'm yours.
Posted by: Sara | July 20, 2007 at 05:10 PM
Yes, I'm in England, although the NHS and similar welfare schemes and bodies are UK-wide; ours is the Government of the UK, which is of course England, Scotland, Wales and Northern Ireland. A couple of years ago, laws were passed here to force all companies (shops, theatres, museums, cinemas and public-service buildings to take "reasonable steps" to mae buildings accessible. For some, this meant putting buzzers on the wall outside to call for help, but many had to adapt buildings to not have people take legal action.
Posted by: Christopher Bell | July 21, 2007 at 12:12 PM
Just to be clear, the NHS is funded by taxpayers through a deduction from wages/salaries called National Insurance (NI). However, the beauty is that anyone, NI-payer or not, gets care free at the point of use.
Posted by: Christopher Bell | July 23, 2007 at 12:32 PM
Thank you for the explanation, Christopher. When I do pay taxes -- which I have most of my life, incidentally -- I would certainly rather have my money go to something like that than horrible, unnecessary wars.
Posted by: Sara | July 24, 2007 at 09:29 AM
Well. So. I keep coming back to this post to commune with you about this crap, but leave again unable to adequately express my own frustration and solidarity.
Maybe "Ack! Gah! YES!!" would do it, but I am compelled to say more:
Where are those damn paperwork elves? I suspect they've been employed by the enemy, actually. The pay must be better.
I do believe there is a serious psychological component to the oppression of certain peoples that involves bureaucratic paperwork and the requirement to submit to the terminology and classifications involved. I haven't seen it talked about anywhere specifically, though Brownfemipower at Women of Color blog and kactus at Superbabymama have both hinted at it in their posts on the hoops poor folks have to jump through to get some aid. How much do you disadvantage people by requiring them to sign papers saying they are "disadvantaged," "poor" or "disabled," when those terms have specific legal/bureaucratic meanings basically signifying incompetence? It's a stunning process to subject yourself to.
Once, years ago, when I went to renew my driver's license, I declined to mark a box labeling myself as "disabled." I didn't understand the question in context of being certified to drive. The person at the window took a look at me in my wheelchair and told me I had to check that box, then when I did, informed me I was required to present a doctor's note that I was capable of driving. Because, you know, my doctor always rides with me and has an extensive knowledge of my competence with a motor vehicle. So, I had to check a box that I was incompetent (or had competency issues) and then get a note from a medical official who had never seen me outside of a clinic so that person could certify my abilities. Then, I was subjected to a driver's road test because of skepticism anyway. I don't have any real problem with that last, except this was all based on visual perception of the category "disabled." And the sum of the experience did rock my sense of my own skills.
Posted by: Kay | July 28, 2007 at 12:13 AM
Oh, Kay, thank you. This is brilliant. (Not the experience, but pointing out the syndrome.)
When I got my leg cut off, after I had healed enough to come back to work, I actually had to get a doctor's note certifying that it was safe for me to return to work as a grocery cashier. Not a high-wire walker. Not a roofer. I was furious and let everyone know that I thought it might be unconstitutional, that I did not need permission from other people to take risks. It was to cover Whole Foods' ass you understand. They worried about getting sued if anything went wrong.
I had to wait hours at my physiatrist's clinic at a local rehab hospital just to be seen for five minutes, observed walking on my new leg, and get this note.
I am going to be thinking about the concept of domination through required self-classification for a long time. There's more I have to say also about being forced to sign things, but my sister (whom I haven't seen in five years) is going to be here any minute. I will come back to this.
Meanwhile, I think I see something like this every time I go to Starbucks and am required to use its own proprietary marketing speak just to order a beverage. "I want large." "Venti?" "Large."
I think this syndrome is fairly pervasive, even beyond bureaucracy, and definitely worth examining.
Posted by: Sara | July 28, 2007 at 09:58 AM
Got this in the mail 9/1/07.....
Coverage End Date
09/03/2007
Reason and Manual Citation
You are already on MassHealth. 130 CMR 501.003
My wife and I applied for Commonwealth Care 3 months ago, and we're still waiting... Since she lost her Masshealth coverage for having it (actually for losing her SSI by marrying me), I've been on the phone several hours a week, and I think we'll finally be covered in November.
It's a nice idea, but nearly impossible for those who need it to get it.
A few tips for anyone trying to enroll:
1. Give them about 2 weeks to get your application, then start calling every week. Don't wait to receive paperwork... it's nonsensical. And don't waste your time dealing with a jerk/moron, they'll screw up your records! Tell them to "hold off", then call back!
2. Sara's right, you want Commonwealth Care even if you seem to be eligible for MassHealth... there are so many exceptions, you'll never qualify!
3. Know the laws & regulations, because most Masshealth employees don't. Those infamous CMR rules are (mostly) online at http://www.lawlib.state.ma.us/100-199cmr.html (130 CMR 5xx) For the missing ones, search for draft copies.
4. Call/write your legislator, senator, governor... they need to fix this, and may be able to help you in the meantime. And keep that backstabber Romney out of the White House!
Posted by: Tom | September 28, 2007 at 11:01 PM