This should apply to every American citizen, regardless of age.
I’ve been out of the workforce since 2010. Don’t get me wrong. I see the value of good work and the pride that ought to come with it, but I’m simply too ill and impaired to hold down a job. Despite what Republicans and conservatives say, I’m not asking for a handout, but a hand up would be nice. Some weeks ago, I learned that my ridiculously small monthly check, paid directly from the Federal Treasury, has never been increased since the Nixon Administration. For years, I made do with a little under $700 a month and used food stamps without even once feeling guilty about it. Some time later, my check was increased to a little under $1200 a month, but Social Security’s Disability Determination Service overpaid me around $13,000.
Not having been told that the money was somehow not mine to spend, I decided I’d be a good liberal Christian capitalist and amateur philanthropist. I gave money to my Meeting (Quakers often use the term “Meeting” rather than “church”). Seeking also to be seen as a good male ally, I donated freely to a program that offered destitute women access at no charge to pads and tampons that they could have never afforded on their own. And I was prepared to take on new causes, with what I assumed was my money to spend, but one day I received a depressing and disturbing letter in the mail from Social Security.
Even though it had never been my fault, I was nevertheless paying for someone’s incompetence. I was highly fortunate to have done my research, whereby I quickly understood the particulars of a very complicated system, using tactics that delayed, for almost four years, having my entire check garnished until the debt was finally paid down. One would think that only taking a small portion of my monthly check would be a fair solution, but that’s not how Social Security Disability chose to see it. As of June 2021, my entire $1200 has been taken away and, sad to say, it will not return until April of next year. Thank God I had the foresight to deposit all of my unspent stimulus checks in a savings account. That is literally what I am living off of these days.
I’ve never had much money in my life and I suppose one can’t miss what one has never possessed. As the old saying goes, I know very well how to squeeze blood out of a turnip. Fortunately for me, even though I have literally zero income for the next eight months, my Medicare health insurance is still active. This is where I’d like to focus most of my attention this post, so that I might shed some light on what Medicare for All would be like, should this country adopt it.
My hospital bills are covered 100%. I have a Medicare Advantage PPO plan that covers up to $1000 a year in dental care. Prior to switching to Cigna, I had to pay $99 completely out of pocket for every clean and check. I also had to fork out, on the installment plan, around $1000 in totality for a crown. When I lived in DC, Medicaid covered everything. I benefitted from what was called the “wrap around plan”. In laymen’s terms, whatever Medicare didn’t cover, Medicaid picked up. That might not be a bad idea to adopt nationwide. Now that I have returned to this red state, Republican politicians claim they simply don’t have the money to extend these same benefits to the people who need it most.
To my reckoning, Medicare Part D is an example of a good government program. Due to how little I receive in income, the most I pay for generic medications is $3.70 per prescription. One of my medications retains its patent and costs, without insurance, about $10,000 for a thirty day supply. President Biden campaigned on the promise that he would make Big Pharma stop charging obscene prices like these. I’m waiting, with bated breath, to see if he can pull it off.
I’m grateful my script is covered and can more than afford the $9.60 co-pay. Upon my last visit to the pharmacy, I found that I had entered a period called “catastrophic coverage”, which means that I will have zero co-pays for the rest of the calendar year. This is a great relief to me, because at last count I take about eight different medications, and the cumulative effect begins to add up when one doesn’t receive that much income in the first place. But the other side of it only shows how much my health has deteriorated over time. I wish I didn’t have to be in catastrophic coverage. Would you?
What I resent most is the way the system is structured. If I was paid what I was truly due in 2021 dollars, I could be more independent. Instead, I find myself heavily dependent on others. That doesn’t sound very American to me. We’re supposedly a nation of rugged individuals, pulling ourselves up by our proverbial bootstraps. The way the laws and statutes are applied essentially tells all of us on disability that we don’t deserve a living wage, but God forbid we get sick and die on their watch. That would not be received well. To cite one other depressing example, dental fees in the District of Columbia used to not be covered at all by Medicaid, but that all changed when a child from an impoverished background died due to an untreated abscessed tooth. I don’t want to speculate, but I wouldn’t be surprised if the deceased child was Black or Brown.
As for my own situation, legal firms claim I have no case. Writing to one of my Senators, who is retiring in two years at the tender age of 86, has produced no results. To them, I’m simply another number. I’ll have to make do on savings and cut back drastically on what I spend. I have not received confirmation from Social Security beyond one single letter. It is legally obligated to give me notice of every significant change in payment in paper form. They have not followed up with their own stated protocols.
Nor have I been given the opportunity to go before an ALJ (Administrative Law Judge), which is my right. Before the pandemic, there was an 18 month delay before my case could even be seen. Now, with COVID, it may take three to four YEARS before my case is placed on a docket. With luck, I might win my case and with it the $13,000 that should have never been taken from me in the first place. Apparently, all the ALJs are on strike at the moment, at the worst possible time.
In part, the reason I am writing this post is to speak to many well-meaning people who want to extend Medicare to everyone. It’s a good idea, but Medicare desperately needs reforms that have never truly been addressed since it was passed into law in the mid-Sixties. It would be great, as I said earlier, if I was granted a living wage. It would be even better if Medicare and Medicaid provided the same rates of reimbursement that private carriers do. Instead, they pay out lower rates, which means mental health providers often refuse to accept patients who don’t have high paying insurance or the providers choose to simply not take any insurance at all.
A psychiatrist who treated me got busted in the recent past for committing acts of Medicare and Medicaid fraud.
Baltimore, Maryland – M. Wagdi Attia, M.D., a physician who until April 1, 2018 had a medical practice in Gaithersburg, Maryland, has agreed to pay the United States $400,000 to resolve allegations that from January 1, 2013 through May 31, 2017, Dr. Attia fraudulently billed Medicare and Medicaid for services not rendered.
Dr. Attia’s defense was a strong one. He literally never turned a patient down. When other psychiatrists and psychologists in the DC area refused to take Medicare and Medicaid patients, he did. His waiting room was always packed to the gills and I admit that I had to wait two hours or more to be seen, but I felt that his quality of care was more than sufficient. He also served as one of the primary doctors who was assigned to Sibley Memorial Hospital in The Palisades, a swank, treelined section of the upper Northwest part of the District. Now he can no longer practice medicine anywhere.
Many people who suffer from chronic illness, as I do, desperately cling to jobs they cannot handle because they recognize full well that they simply cannot survive on disability alone. They really have no business working, but those who have toiled in servitude for long enough hold out hope that they can combine a pension with disability payments and make something of a living for themselves.
Before we demand Medicare for All, we must ensure that the system can be functional for years to come. Other countries with socialized health care pay high taxes. When I could work, I paid into the system, same as everyone else. I have no issue with paying more in tax, which I suppose sets me apart from much of the country, the same patriotic Americans who are refusing to wear masks or are spreading false rumors on social media that COVID is a hoax.
I’m reminded of what led to former President and Arkansas Governor Bill Clinton’s first substantial setback in state politics. It had nothing to do with his sexual proclivities. Clinton's increase in the cost of automobile registration tags was very unpopular and arguably led to his defeat. Red State America has been conditioned to think in such terms. But to be completely fair, the American Revolution began when a group of dissatisfied colonists refused to take on additional taxes without being given the opportunity to have their own voice in the British House of Commons.
Pocketbook politics is as old as our country itself. But in recent times, the cynicism of rank and file Americans, particularly as regards their government, has morphed into the realm of alternative facts and counter-narratives. This degree of mistrust is somehow lifted up as proof of great wisdom, not fear of the unknown. I happen to believe that it can be regained, but that it won’t happen overnight. And while you’re at it, Nancy, Chuck, and Joe, will you please increase my disability check, or at least turn it back on? I’ll be glad to show you a detailed, itemized list of charges the American people have been paying to keep me at least semi-functional for years. Maybe then you’ll get it. I hope so.
