Archive for the ‘Medicaid’ Category

Sorry, Wrong Number…Many, Many Times

My Dad used to smile when telling his story about the young fellow who had just seen the classic 1962 World War II movie – The Longest Day – about the D-Day invasion of France in 1944 and was, in turn, telling his own father about the film.

The old man listens patiently and then off-handedly tells his son, “I haven’t seen the movie, but I was there for the play.”

In the same spirit as that old story, I have not seen the 1948 Barbara Stanwyck/Burt Lancaster movie – Sorry, Wrong Number – but I have definitely been living the play. My play is called: Trying to Reach Health and Welfare? Sorry, Wrong Number.

There is nothing special or particularly unique about my telephone number except that the first seven digits of my number match the first seven digits of a toll-free, helpline number – Medicaid Automated Customer Service – managed by the Idaho Department of Health and Welfare. I know this rather obscure fact because I have been averaging two or three “Health and Welfare calls” every weekday for the last two years or so. I long ago lost track of the number of calls, but it beyond hundreds and into the thousands. Thankfully, callers with questions about their Medicaid benefits must assume no state employee works on the weekend, so my phone tends to get the weekend off, as well.

Months ago I thought I had identified the answer to all these wayward calls, but alas it was a fix without a cure. On the state government website that promotes the toll-free number the “1″ before the toll-free number had been, inexplicably, left off the rest of the number. So an unsuspecting caller, say from Weiser or Bonners Ferry – I’ve had calls from every corner of the big state of Idaho – would just dial the number shown (minus the “1″) and get me. I called a helpful state agent and asked if maybe, just maybe they could add the “1″ and solve the problem of the call from Mrs. Jones from Caldwell, she needs to talk about her niece’s Medicaid needs, ending up on my voice mail. Problem solved, right? Not so fast. The wrong numbers declined a bit, but did not end. I have to assume regular callers to the toll-free number have made a note of the non-”1″ toll-free number and were still calling, blissfully unaware that some public affairs consultant and part-time blogger was fielding their calls. The voice mail messages on my phone seemed to continue unabated.

So, believing that information is power, I changed the greeting on my phone. No longer was it, “You have reached me and I can’t take your call right now…” My message became much more Medicaid-centric: “If you are trying to reach the Department of Health and Welfare, you haven’t…hang up and dial a “1″ before you call this number.” That’ll fix it, I happily proclaimed, as I began answering questions from people who were really trying to reach me and wondering why I had a Health and Welfare related message on my phone. You can inform some of the people some of the time, but…the calls continue.

I have genuine sympathy for my callers. They need answers to real questions. Judging by some of the hundreds of messages that have been left on my voice mail, many of the callers are confused and uncertain about benefits and responsibilities. If you have ever tried dialing into a government agency you know what an intimidating experience it can be. Imagine getting the wrong number and ending up in some civilian’s voice mail, while you worry and wait for a call back. It would be easy to conclude that government just doesn’t work.

My standard procedure now is to try and intercept as many of these calls as I can and re-direct them to a number that begins with that essential “1,” but it is not always possible. And, while I admit that I’ve been annoyed and frustrated by the calls that I get, wasted effort that doesn’t do the callers any good, the “sorry, wrong number” play I’ve been living has given me an entirely new appreciation of what one little glitch in a vast government program can do to create problems and frustrate users.

As Idaho contemplates a major expansion of Medicaid services under the Affordable Care Act – one estimate holds that 100,000 more Idahoans could be covered – and the state’s for profit Medicaid contractor continues to try to make the system work, here’s hoping, and not just for my sake, that they attend to all the details, small and large, involved in an expansion.

And, just for the record, I have equal amounts of sympathy for the state workers who, without much fanfare or appreciation, labor to make an essential program of our society work for people who really need the help. This is a vastly complicated government program, wrapped in layers of regulation and requiring immense levels of accountability. One little digit – that pesky “1″ – can frustrate even the most essential government program.

And, yes, I could get a new phone number, but have ruled that out. If Barbara Stanwyck and Burt Lancaster can handle a wayward call, so can I. But, for future reference, do remember that “1″ in front of a toll-free number. Given the vast proliferation of telephones these days, it is a given that someone has the number that is toll-free with a “1″ and just some schmuck’s voice mail without.

 

 

The Moral Test

medicaidHard Cases

“The moral test of government is how that government treats those who are in the dawn of life; the children, those who are in the twilight of life; the elderly, and those who are in the shadows of life, the sick, the needy and the handicapped.”

The quote is most often attributed to the liberal icon Hubert Humphrey and dates to a time when there was a broad consensus in American life that government had a very precise role to play in trying to improve the plight of those fellow citizens “in the shadows of life.” The lingering Great Recession more than ever has called that role of government into question and, at the same time, made Hubert’s eloquent quote more relevant than ever.

A massive human hurt is unfolding in nearly every state as governors and state legislators contemplate unprecedented reductions in spending on various services paid for at the state level by Medicaid. In states like Idaho, all the easy stuff has been cut. Now the real pain begins, as illustrated by the estimated 1,000 Idahoans who showed up on Friday, some in wheelchairs, to show state legislators, more eloquently than words ever could, just what the American social safety net really means to real people.

With the 50 states collectively facing a budget gap estimated at $125 billion, the New York Times reports today that Medicaid is “ripe for the slashing” from New York to California, from Idaho to Texas. The times are tough – very tough – but I doubt that even tough-minded, fiscally conservative legislators can live with the implications of ending services for a guy in a wheelchair or an 8th grader with autism.

In Idaho, 20 lawmakers, the members of the powerful Joint Finance-Appropriations Committee (JFAC), make most every spending decision for the rest of the 85 members of the legislature. It is an awesome power and responsibility. The committee has co-chairs, Sen. Dean Cameron and Rep. Maxine Bell, and no one has ever credibly accused these experienced lawmakers of being big spenders. They run a tidy ship and one has to be impressed with the diligence they and their committee have lavished on the hard choices the state faces with both Medicaid and education. Cameron and Bell deserve a lot of praise for showing the political courage to open up the committee to those thousand people who came calling on Friday. It had to have been a sobering experience for anyone paying attention.

Here’s a fearless prediction. Arguably the most conservative legislature in the nation won’t be able to make the $25 million in Medicaid cuts that Idaho’s governor has proposed. It will take a while yet for the reality to sink in, its still early in the legislative process, but Friday was an important day. Not only did the thousand show up, but the budget numbers that have been in dispute since the first day of the 2011 session just gained some clarity and not in a good way.

All this will eventually lead to a frantic search for some barely acceptable source of new revenue to help plug the budget holes. The legislature will come to embrace, in tried and true fashion, the method of patch and scratch tax policy making. Some how, some way, Idaho’s very conservative legislature will “find” some new revenue to avoid these awful choices.

It won’t be easy, and people elected never to raise taxes will anguish over the choices, but it will happen I think. Idaho’s lawmakers have come face-to-face with their fellow citizens who really do, through no fault of their own, live in the shadows. In the end, it will not really be much of a political test. No one is likely to lose an election by making a vote to preserve home care services for an elderly, wheelchair bound neighbor. It will be quite a moral test, however, for lawmakers who infrequently see so clearly the impact of their votes.