The first thing wrong with the letter from Rural Metro was that it was post-marked June 20, 2003, but noted at the bottom that it had been revised July 8, 2003. Okay, we have just moved into the surreal world of Medicaid transportation where a letter can be revised after it’s sent. Either that or somebody’s lying or incompetent.
The second thing is the way they talk to poor people: “is not . . . do not . . . the ONLY person . . . will NOT BE REVIEWED and all transportation will be DENIED.” Can anyone explain to me why civil discourse does not apply to poor people? Why is it that we—remember, I’m a poor person—are continually yelled at and told what we cannot do?
My mother and I were a lot alike. We looked alike, sounded alike, and were both physically disabled, but my mom got treated like a queen for one reason: she had money. My dad had worked hard, invested wisely, and left my mom comfortably fixed when he died. She got please-and-thank-you-ma’am and I get is-not-do-not-will-not. Mother and daughter—the same moral code, but different treatment solely based on ability to pay.
Why is it that you all are so mean to us poor people?
Oh, maybe you’re not all mean to us. Maybe it’s that the good people are silent and the bad people speak so loudly. Syracuse.com, the web site where the Post-Standard is published on-line, is rife with comments from people who hate poor people. It hurts. They blame us for all their problems, and accuse us of being selfish, greedy liars who are poor because we are too lazy to work. Fact: the largest group of people receiving Medicaid in Onondaga County is single women with minor children. Irresponsible sexuality is leading to pregnancy and then one partner in the parenting is walking away from his responsibility. You want to appropriately direct your anger? Go after deadbeat dads.
Meanwhile, us poor folks—who are just as morally upright as you rich folks (maybe more so)—get the is-not-will-not-do-not shit from government agencies. Except Rural Metro is not a government agency; it is a subcontractor of the Dept. of Social Services (DSS), which is a government agency. So why is it okay with DSS for us to be talked to this way? Oh, maybe because that’s how DSS talks to us, too. I am financially poor, not morally corrupt. God knows, I deserve better than this.
The third problem with the Rural Metro letter is that “Your primary care physician is the ONLY person authorized . . .” When and why did physicians decide to become the gatekeepers to social services? Doctors are always complaining to me about how much time they spend filling out paperwork for Medicare and Medicaid; why did they ever start to do it? Why is there this collusion between the government and the medical profession to control patients? Why don’t physicians get themselves organized and refuse to do this gatekeeper stuff?
Did you know that if Medicare and Medicaid—that would be you, my neighbors—buy an electric wheelchair for a person who is disabled then getting it repaired requires a physician’s order? I am not shitting you on this. If you need new tires for your car, do you have to ask your doctor’s permission? If I need new tires for my chair, I do. A good doctor will let you phone in the request and then will fax the order to the wheelchair supplier.
However, let me tell you about Dr. Robert Friedman, who used to be the medical director of St. Joseph’s Hospital. He quit the hospital and went back to private practice and I accidentally became his patient. I say “accidentally” because if I’d realized he was the ex-medical director then I would not have gone to him. (He and I had already gone one round, but that’s another story.)
So I’m Dr. Friedman’s patient and I need wheelchair repair. I call it into the office and they tell me that I have to come in and be seen. For what? I’m not sick; my wheelchair is. This guy went to medical school, not BOCES. What’s he going to do, put a stethoscope on my left motor and diagnose that it needs to be replaced? Hell, even Mel from the warehouse of my wheelchair supplier can diagnose that over the phone without a visit.
For me to go to the doctor’s office will require, first, a trip by Medicaid wheelchair van that will cost you, my neighbors, about $50. Then Dr. Friedman will charge Medicare—you, my neighbors—between $50 and $100 for the appointment with him. Can you think of one good reason why Dr. Friedman is requiring this office visit in order to write a prescription for wheelchair repair?
Don’t, for God’s sake, blame poor people.
The most important thing about the letter from Rural Metro was buried at the bottom in the return address. I missed it, and I’m sure you did, too: “Rural Metro Medical Services, C/O: MAS Transportation.” Who or what is MAS Transportation?