Gimme Gimme Gimme

Do you have Abba in your head now? Good. You now have a modicum of the pain I have endured today thanks to California’s glorious state Medicaid fund, Medi-Cal.

If you are still a proponent of state run health care after this, I’m guessing you probably could not wait for ‘Survivor’ tonight, & you are really concerned about whether Paula regrets leaving ‘Idol’. Pat pat.

Anyhow…

As I have ranted before, Medi-Cal is the Three Stooges of all the state run health plans, and I am not sure how the Sovereign Dimension of California got it that way, but it must have been a magical process involving Shriners in those little cars, shrooms, that weird speech impaired kid down the street who kept saying he was gonna beat people up, and lemmings. Here is what got my hard earned goat today.

A few weeks ago, Medi-Cal discovered that one of our patients had Medicare primary. Our patient apparently did not know this, either, as she neglected to tell us. No matter, Medi-Cal, like all Medicaid programs, is supposed to cover the disabled & look out for them. How it does this from riding on the short bus itself is a mystery for the ages, but ya know. Medi-Cal, obviously by some administrative screw-up, had already paid our claim, so the letter telling us that the patient had Medicare primary was also requesting a refund.

What did we do, as a compliant practice? We cut an effing check, didn’t we? We sure did. We also mailed it immediately to the address indicated on the letter.

Yeah, so, today…we get the check back. WE GET THE CHECK BACK. With a letter. There was a lot of Medi-Calese on this letter, so I will translate for you what it said:

“You don’t get to give us money back, even when we ask you for it. Instead, we get to take it out of future payments, even though we won’t send you any future payments, as we send you maybe $47 out of the $14,789 you bill us a year.”

Yes, California, which is broke, is not accepting MONEY IT ASKS FOR.

Are you making the “I would so, could so kill a goat” face yet? (see psychotic photo below from the last #wtfwednesday)

Wait. It gets SO much better.

In addition to returning our check and then telling us they were not going to pay us for whatever the amount in the check was for however long it would take to make up the amount of the check, they also sent a form. “When Medicare pays you, complete the following form to retrieve your secondary payer funds.” REALLY? Really, Medi-Cal? Knowing full well that you nearly always allow 50% LESS than Medicare, you want us to fill out a freaking form that violates MMA & completely flies in the face of the simple act of sending the claim with the Medicare EOB attached like EVERY OTHER FUCKING SECONDARY PAYER IN THE COUNTRY??!!!”

REALLY?!! How stupid I are!

I advised our intrepid state plans gal to check the allowables and, should they teh sucks, kindly introduce that fucker to the shredder. Which was of course taken on with delirious glee. I’m pretty sure the whole rest of the office thinks billing is on drugs now.

Anywho. If this is the mentality of the people running the medical funding for persons who are the sickest, weakest, and most defenseless people in society, how in the hell are they going to treat the REST of us? Like one more bleedin’ pot hole, that’s how. Ignore, rinse, repeat.

What else is wrong with gimme gimme? It cripples us. Shut up. If you’ve even babysat a child, let alone raised one, you know what spoiling does. Sure, you can have a pop. Sure, you can have a lollie. Sure, you can have a Little Debbie. Sure, you can stay up and watch T2 on HBO while I talk on the phone with my boyfriend. Wait, why am I surrounded by children stained various shades of purple, wielding knives & crying? I can has headache! I can has fired!

Oh, but we’re not children! We can has thinkings! No, we cannot. Observe, my sweet little friend who believes in the inherent intrepidness of the human spirit <snicker>.

When I was feeling particularly martyr-y and decided to leave private practice to do hospital work, I at one point did a stint in customer service. Customer service plain blows everywhere, but customer service for sick & dying people that you just sent a $400k bill to is not anybody’s idea of a career high. Here’s one of the lows of that stint.

Girl calls me. She was about my age, which at the time was 25 I think. She is furious. “Why you guys keep sending me this $70k bill? I don’t got $70k.”

“I’m sorry, ma’am, let me check that for you.” After the unholy torment of trying to get her account number out of her (anybody who’s been on that side of the phone knows what I’m talking about), I finally find her account & within 3 seconds  of reading the notes, ask, “Ma’am, I show you probably qualify for Medicaid. Did you take your application in to the Social Security office?”

Big dramatic sigh. “Yah, I did, but there was a line. It was like a 5 hour wait. Can’t you just write it off?”

*aside: You pay your fucking credit card bills for your goddamned Nascar tickets, people, but somebody saves your LIFE, delivers your CHILD, and you want us to write it OFF? Pri-ori-fucking-ties!*

Anyhow.

I say to her, “Ma’am, I don’t understand. Why couldn’t you wait 5 hours to get free health care?” You could HEAR the blinking.

I continued. “Ma’am, I sit at this desk 50 hours a week, and it would take me something like 3 years to make $70k. I strongly suggest that you go to the Social Security office, wait the five hours or more if it takes that, and get the free health care. It will last you until you are able to get your own health care.”

She was approved within two weeks. It was paid two weeks after that. The bill had slid 120 days, though, so it was in danger of going to collection. REALLY?

So that’s part 1 of why Gimme Gimme fucks you over by turning you into a whiny child.

Part 2: The Plucky Pole. I am well known to folk in the Depeche Mode/Recoil online circle, as is The Plucky Pole. She is a dear girl, beautiful, vivacious, adorable, completely insane like most Depeche Mode fans (particularly the kind that glom on to Martin), and she appalled half the DM mailing list by announcing that Poland was better with Communism.

I defended her, stating that she grew up with everything being given to her, and it’s not her fault that at 18 she was now at an American university on scholarship, but having to buy her own concert tickets, food, $15k Gibson guitars…anyhow this did not go down well. She did not understand why we did not understand why she was not dropping to the floor in front of a tapestry of Reagan every day praising his name. Didn’t she like being able to say what she felt about the government?

“I always said what I felt about the government.The government was great.” *headdesk*

My immature 14 year old boy response is always to go “The Whatever is Your MOM” and in this case, it would have been appropriate to scream “THE GOVERNMENT IS YOUR MOM!” because it WAS. The government was her overburdened, highly stressed mom who had no dad in the house to help, way too many children, and had to lay down a strict code of behaviour or kill ’em all (as any sane mom would snap in that situation). The Plucky Pole didn’t know any better because Mom = love & that’s all she knew.

Cold, horrible, “You have to buy it” America was expecting her to pick her clothes up off the floor, do her own laundry, make her own lunch, and walk to school. As she had never done this, she was horrified. She was ill equipped to deal with the basics of survival. It was awful to read in her emails. Her priorities were, to put it mildly, whack.

Part 3: Overheard today: “Unemployment pays me more than a full time job at Starbucks would. Why would I go off unemployment?”

WHY INDEED?!

Sigh.

*kicks a puppy*