Well, Medicare isn't free, that's for sure. However, some people who receive Medicare are also in a lower income bracket that also qualifies them for subsidies from the state. In some cases, the state regulated Medicaid pays their Medicare premium, their prescription drug coverage, and all of their co-pays. Others in a higher but yet still low income bracket may not get ALL of those things paid but will get a portion of them paid.
IMO- and personal experience with pts, I came to the conclusion that bot Medicare and Medicaid superficially make those that "have" feel they are doing something while going to $25,000 a plate parties!
There is an inverted deal here. It is true the more acute the illiness, the resouces go up a little, while completely ignoring the realities of the more acute.
Makes many feel society is not throwing the metally ill off a cliff. But as a society we do.
Its great to say there meds will be covered. Totally forgetting that , the very acute, cant work, dont have a car, dont have the reality orientation to either remeber to take their meds, to remeber to get med checks, remebmer to pick them up.
There are all kinds of "porgrams" out there. I worked with the disenfrached youth. Its awesome go to anger management class. Well how does that happen. Mom is working at Mcdonalds full time, and KFC 10 hours a week.
How is mom gonna get him /her to the class? There are fees for the classes. There is gas money / tolls that she does not have. She frequently gets fired over and over cause if the car will start , and there is gas in the car, and she asked for some time off (unpaid) she make it once or twice.
Then employers fire her cause she is requesting time off regualily (the anger management is usually 1x week)
mom then gets reported as non compliant with anger management order. She has to go to court for non compliance. She has no job, no money, her car battery needs to be replaced, how is she suppossed to go to court? She cant go job hunting becasue her car is out, she needs to be in court.
So she makes it to one psyc appointment in and is given RX for her child. So now she is supposedly to go job hunting, make court, have to meet with the probation officer,go stand in line for a free month of electricty.
When and how does our society expect an individual in that situation to "comply" . I forgot to tell you there are three siblings, one of them is running a fever of 102, she asks her brother to give her a ride to the free clinic , which has a 5 hour wait. Brother has to go to work, so now she is waiting in a clinic with no way home, so she ends up stuck there until her sister can come get them.
During all this time the other siblings are alone, a neighbor reports it now social services is involved and comes for a visit unannounced. The power has yet to be resumed, so now mom is charged with endangering her children.
With social services now involved there are a whole bunch of new court records. She still has probation involved, and they like pop ins- if she is not there that is a violation.
So single mom is - through our "helpful" programs that help expects one :
Be able to get the cild to the anger management class on time everytime,meet with the social worker as ordered or in surprise visits, get to the therapist 1 x per week. get med eval every 30 days, work full time, supervise her children when school lets out.
With all the stress in the one bedroom apt the 5 live in another sibling starts acting out in school. Teacher who has no clue about moms realities, requests a conferance which mom cant make which is reported to social angency.
He continues to act out and gets suspended for 10 days. Now we have a 10 year old with no school, no adult supervison , he gets into mischef at home and the police are called, and find a unsupervised ten year old and makes another report to social services.
They then began to try to take her parential rights away. She cant read but is given a 45 page legel thing on her pariental rights and what she needs to do.
Her first court hearing regarding losing her babies from her is in 2 weeks , the day before her tire went flat and she misses court.
Social services pops in the house and finds it in disarray.
Mom gets a DUi- so now mom needs to find bail, make it to court, go to drug classes, pay fines, pay court court costs.
There are only so many hours in a day guys........
The "haves" think there are resources out there for folks who need it -- it is a completly ineffective undoable sitution
Medicaid here, horrible they would mess my pts Rx , not get authorzation which means the person is thrown off there meds, and the caretaker has to make another trip to Rx.
Services for Adults are just as un doable - its sad for such an industilized nation
I am not writing fiction, I lived it with my folks, and slowly discovered that the system is actually escalating things.
My dream would be ( if we took all the money this would actualy be cheaper).
Make like campus - where the beneficary would be given place to live, school on campus for kids and adults, therapy services on campus. In exchange they work 40 hours in exchange and must be going to adult tech school. There can be no law invovment or criminal stuff or you are removed form the program. Child care is there as well where the kids are doing structured activities.
Pharmacy on campus, medical center there. Just think of the millions that could be saved just in paperwork - they get a card on campus, like a debit card and it is used all over campas for all the same servies we claim we give folks, on one account imagine the costs saved while providing doable upward mobility for the less fornuate
As a socieety we are throwing money at all these needs already - centrilize them, cost effective and 'doable"
Sounds like a fantasy , but at least our social programs would be doable, be providing opportuties for forward movement
