At times our conversations and debates concerning public policy leave us "stuck" in abstractions and theoretical concerns. After all, most of us here have the luxury of conversation about what are, for millions of other people, matters of life and death, literally.
Just this week I received a comprehensive report from the Children's Defense Fund of Texas (CDF) on how Medicaid and the Children's Health Insurance Program (CHIP) work or, in far too many cases, don't work in Texas ("In Harm's Way: True Stories of Uninsured Texas Children").
The format of CDF's report is brilliant.
Woven among the typical statistical analysis provided by such reports are the stories of real life people--men, women, children and families. These stories make the report "live."
Issues addressed include matters of recertification, income limits, delays in the process, impact of the value of owned vehicles, etc. Basically, the report educates us about what consumers of these insurance products already know all too well: they are not set up to serve the most in the best manner. Attepmts to contain costs by erecting barriers to useage can prove to be deadly.
The report is dedicated to the memory of Devante Johnson.
Here's his story as told by the CDF report:
Thirteen-year-old Devante Johnson had advanced kidney cancer and could not afford to be without health care coverage. But last year, that is exactly what happened, when Devante spent four desperate months uninsured while his mother tried to renew his Medicaid coverage.
For years, Devante and his two younger brothers were covered by Medicaid. Texas families who qualify for Medicaid or CHIP are required to renew their coverage every six months, and Devante's mother, Tamika, had tired to get a head start by sending in her paperwork two months before Medicaid was set to expire.
The application sat for six weeks until it was processed and transferred to CHIP, because an employee believed their family no longer qualified for Medicaid. At that point the paperwork got lost in the system. Tamika grew more and more desperate as she watched her son get worse. "I did everything I possibly could," Tamika said. "I would literally get off the phone in tears, crying because they [CHIP employees] frustrated me so much."
For four months, Devante went without health insurance as employees unsuccessfully attempted to reinstate his coverage. As a result, he could no longer receive regular treatment and had to rely on clinical trials for care. Meanwhile, his tumors grew. Time was running out.
It wasn't until a state representative intervened that Devante's coverage was immediately reinstated. Two days later, Devante was able to start a promising new treatment. But, it was too late.
Devante Johnson died on March 1, 2007.
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The "bottom line" of the CDF report on Texas is very simple and straightforward. Every child in the state who is uninsured should be enrolled in either Medicaid or CHIP today. Making this policy decision is smart for children and for every Texas taxpayer.
Beyond being smart, such a strategy is the right, just and compassionate thing to do.
[Read and/or download the full report at: http://www.childrensdefense.org/site/
DocServer/InHarmsWay.pdf?docID=3961.]
6 comments:
Larry, my name is Walter Taylor. I am the youth pastor at Metro Church of Christ where Dr. Kenneth Greene is the pastor. I was at the Mayoral prayer breakfast this morning. I had to leave but I am now listening to the webcast of the program. I work in Tarrant county as an outreach worker dealing with Medicaid and CHIP. The story about Devante saddens me because I have children, I have a son. It also saddens me because I believe Devante's death was so unnecessary. Medicaid and Chip are good programs, but more needs to be done to broaden their coverage (increase in the income limits and exlusion of the asset test) and to make more efficient and people-focused the administration and delivery of these important public assistance programs. I hope to one day be in a position to work directly on policies that make these programs work better. I am praying for your work and I hope to meet you personally in the near future. God Bless.
Following along that same line, what could be done, right here, right now, while the legislature is still in session till the end of May - to get the whole thing fixed? Is it possible? Has any other state done it, or come closest to laying a model?
Walter and Tim, thanks for the thoughtful posts.
Tim, I believe that Walter's experience contains the solution: make Medicaid and CHIP easier to navigate for both consumer and administrator. Relax the means testing, lengthen the certification period so that parents only need to re-enroll or better, confirm annually that they are still enrolled with the state. Upgrading IT would not hurt either. The solution is to operate out of a determined policy to enroll as many as possible, rather than from the current paradigm which seems to be "block as many as possible."
Upon reading this posting, I grieve for Devante's mother, and her other children. It is a tragic story, ending in the untimely death of a boy who may have had a chance for surviving his illness with the proper treatment. But the politics of state policy failed somehow, even though the boys' mother did what was required of her to obtain aid in a timely manner. As the mother of twin boys, age 13, who would not be here if not for the assistance of Medicaid, I find myself very disgusted by and disappointed in the system. I feel that though absolutely nothing can take the place of a child lost, Devante's family should be compensated. I hope they will find peace in the embrace of God and one another.
Larry, I have to completely agree with you on the situation at hand with CHIP. The government is doing everything in their power to ensure that as little children are being insured through Medicaid as possible. I myself was kicked off of Medicaid when I was living at home with my parents before I started school. I am in school currently and am still without insurance because I can not afford it. I pray that the same does not happen to my younger brother and sisters. Immediate action needs to take place in order to ensure that our children have proper health care. Legislation needs to be passed in order to ensure that these policies are changed.
Devante's mother was attempting to follow all the rules so she could help provide for her children and even following the rules couldn’t help her. It saddens me that it was too late for Devante, but it angers me that it took a Rep. to make progress for this family. Think about all the families that do not have help from her higher-ups. Making this Medicaid process easier for recipients is an urgent need, but making it feasible for employees to help is just as essential. This story is awakening, but I doubt awakening enough to really start any change.
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