(And oh, by the way, I have recently instituted a new personal policy that I will never keep a driver waiting for more than fifteen minutes. My salvation is in Christ, not American medicine, and if the doctor is late, I walk out of the office. I now realize that doctors and transport drivers are worthy of equal respect. If I schedule a return time, I keep it. I will wait for a driver for fifteen minutes without complaining, and I expect the driver to do the same for me. Also, I think that any time a customer is not ready for transport within fifteen minutes, pickup or return, then the driver should leave and when he has to go back, the carrier should get paid for two trips.)
Sixth, your employees also are not transmitting destination information. When I go into a medical complex, I send specific information on where the driver can find me, and your employees are not sending that information to the carrier. Transport drivers are human beings, not bloodhounds who can put their nose to the ground and follow a scent. (This is a particular problem when senile people are sent out alone from residential institutions to medical facilities—a practice that I consider contemptible.)
I used to live at the Bernardine, a 216-unit apartment building in which the administrator has eliminated both the receptionist and the lobby directory. Drivers complain constantly about the time wasted hunting for their customers. If I send you my apartment number, your employees need to put it on the order to the carrier.
Seventh, after using Medicaid transportation for more than three years, I have only this week learned that I can avoid a lot of this grief by putting in a standing order for some rides. Medicaid, you and the transport companies know how the system works, but the customers are never told. We have to learn by trial and error and error and error. I would be glad to work with you all to compose a simple pamphlet that would instruct the customer on how to use the system to the best effect for all concerned. Centro Call-a-Bus has such a pamphlet.
The problem, of course, is that the government has gotten in the way. If this were between the transport companies and me, we could work it out, but poor people get government insurance—called Medicaid. Consequently, the medical system has become riddled with people who think they only have to meet government standards, not please the customer. The staff of the Bernardine is a classic example. They don’t give a damn about the residents because they know the government will pay them regardless of how they treat the residents. Line workers no longer worry about losing their jobs because of dissatisfied customers. As long as they please their employers and their employers get paid by Medicaid, there is neither incentive nor motivation to accommodate the customer. Medicaid has not equalized society; it has stratified it.
If I had my druthers—and appropriate technology—all ride requests would be posted on a central site and then carriers would bid the rides. The best carriers would be chosen first by the best customers. The competition would be for good customers, whether “good” is defined as short trips, out-of-town trips, standing orders, people who are always on time, or little old ladies who bring home-baked cookies. Likewise, customers would seize the opportunity to ride with the safest, most respectful and timely companies. One benefit would be that bad customers—those with driveways into which you can’t get a van, or who are consistently late, or have nasty relatives—would find that they have to change their behavior if they want to ride with the good carriers.
Competition can be a wonderful thing. Please do your part to ensure that the government—which, in this case, is you—isn’t biasing which carriers get the rides.
We can do this thing nicely if we all work together and treat each other with respect. Let’s try it, okay?
Anne C Woodlen
So a couple days later I come home, press the button on my answering machine and get a message from Wayne Freeman. Who the heck is Wayne Freeman? His message said that “vendors” were refusing to carry me. I was in an absolute panic. I was very sick and being referred to doctors all over the place, and now I’m being told that nobody will take me to the doctors’ appointments? I had just entered Wayne’s world, where intimidation was the first response. Scare the bejesus out of the Medicaid recipient, why don’t you, and then she’ll do what you tell her to do.
But when I returned Wayne’s call and questioned him closely, I found that only one vendor was refusing my rides. (I had previously refused to place all my ride orders with the vendor in question, and he was offended.)
Wayne told me that Mike Addario had given him my letter, and it was confusing. I asked him what he didn’t understand, and he told me he didn’t understand any of it. It was a remarkably clear, logical letter in which I recommended policy changes that would improve the service; nevertheless, Wayne chose to treat it as a personal complaint. He said that henceforth all my rides would go through either him or his first assistant.
Because I had written a letter, trying to be helpful and point out ways in which Rural Metro could improve its service, I was now going to be treated to “special” service.