August/September1999

Health care reality contradicts country's claims

Chicago-The word "reform" used in connection with the health care system in this country suggests that the system is undergoing important changes to better serve and assist the poor, sick and elderly. However, my own recent experience with the Department of Human Services (DHS) and the Medicaid program reveal another reality.

My mother is 84 years old. She lives alone in a senior citizens' building, and she pays $611 per month. She pays $85 per month in food and utilities. She must also pay $400 per month for prescription medicine to treat brain seizures, Parkinson's disease, hypertension, rheumatoid arthritis and diabetes. She has no savings and no assets. Her only source of income is $567 per month from social security.

Our family helps my mother meet her rent, food and utilities, but we cannot afford to pay for her medication. She does not qualify for Medicaid, because DHS ignores my mother's living expenses and requires her to use social security payments, her only source of income, to pay for her medications. She can submit the receipt to DHS. If her bills equal or exceed some magical number called a "spend down," she can receive a Medicaid card for a limited time, and then the process begins again. The issue is that, if my mother were able to pay for her medications before submitting her receipts to DHS, she would not need to come to DHS.

SOMETHING HORRIBLY WRONG

Now, I may not understand how the Medicaid system works. But I am a social ethicist, and I can tell you that there is something inherently and morally wrong in a country that claims to open its arms to the tired, the poor and the huddled masses yearning to be free. Because this country's health care system contradicts that very statement, and I don't know which tired, which poor and which huddled masses we are talking about.

My mother is tired, my mother is poor, and she is a Black woman who has given her time and service to the government and still yearns to be free from the racism, sexism and classism that is woven into the very fabric of American society. But this country has a system in place that provides her with only $500 per month to care for her living and medical expenses.

DHS, I have seen that your policies and procedures are not based on any genuine concern for the poor, the sick and the elderly. For you perceive that they are useless to American society. You perceive that they lack intelligence, moral strength and courage. You perceive that they have no purpose in life because of their skin color, gender and cultural background, and are, therefore, undeserving of living a healthy and productive life.

RESULTS OF NEGATIVE PERCEPTIONS

I see the results of your negative perceptions in the tired eyes of caseworkers overburdened with heavy caseloads and a desire to know and be of real service to their clients. I also see it in the attitudes of other caseworkers and supervisors who began their careers years ago caring for others, but have remained in your system much too long and have become as cynical as you, DHS.

I felt your negative perceptions when I was forced to take my mother to the Fantus Clinic of Cook County Hospital because she couldn't get a Medicaid card. I saw it in the face of the woman taking my mother's blood pressure who had a chain around her neck saying, "I love Jesus," but couldn't offer a smile or any measure of kindness to my mother. And I certainly felt your negative perceptions as I waited in line at the Fantus Clinic pharmacy.

I heard one male pharmacy clerk make very disparaging remarks to another clerk about the poor and sick who sat directly in front of his window while he dispensed medication. With just one wide brush stroke he assumed that everyone in that clinic on the other side of his window were nothing more than a bunch of illiterate people. When I got to his window and saw that I had been incorrectly directed to him by another clerk, this man's attitude and comments suggested once again that I was nothing more than just another stupid, poor Black woman.

But they were not just his remarks, DHS. They are your remarks, your attitude, your negative perceptions, which breed contempt everywhere within the health care system in this country.

Suffering is universal, joy is universal, and the desire for a meaningful life is universal. My mother wants happiness. She is a human being, and she wants to live a life of health and well-being. You need to change your negative perceptions, DHS, so that your policies, procedures and programs will be positive and will demonstrate genuine concern for the well-being of the people who need your services.

DHS, your negative perceptions hurt my mother, who must fight to stay alive each month without any assistance from you. As far as I am concerned, there is absolutely no truth in the words of the Statue of Liberty, who stands in New York Harbor saying give me your tired, your poor, your huddled masses yearning to be free. For your DHS health care policies and procedures, your total immoral, paternalistic and dehumanizing health care system, make that lady a liar.

-Dr. Amenti Sujai

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