Two weeks ago, while dropping in on Margi Tripani at CIDNY to discuss some upcoming events I was told about a upcoming roundtable discussion on the efficency of the ADA as it pertains to the implications of healthcare for the disabled in NY. As we know, much to the chagrin of our Republican brethren we are now putting into place the Affordable Care Act, AKA Obamacare. One part of the Affordable Care Act is that each state much put in place a healthcare exchange. This is a 21st Century version the old market bizarre. In short, around the outside we have every medical insurance provider (e.g Blue Cross, Blue Shield, Oxford etc) and the front runner to be the healthcare provider of choice for low income citizens is the NY State Empire Insurance as is used by city workers.The providers around the market place allows you the purchaser to see without pressure all your choices and make the right and affordable purchase. The problem has been come to light that even though the ADA act is 20 years old, and NYFAHC, is 15. At the same time that NYFAHC was formulated an addendum was added to the ADA. The addendum readers that not only all healthcare providers but the healthcare insurers (major HMOs themselves) must not only be complient with the ADA (cannot refuse coverage and care to a person with a disability if at that time it was illegal to do so), but at their own cost they must also train all staff in the sections of the ADA, its meaning and implication to their jobs as pertaining to dealing with and providing healthcare to the disabled.
Well folks, as we know and I have stated before in this blog, it is my opinion and no one in officialdom as yet to prove me wrong, that the ADA is next to only the civil rights policies of the 60’s is the mot underenforced federal laws in existence. If you wanted to argue this point to me you should have been at the meeting yesterday when letters from the various health insurance providers in the US were presented claiming that 15 years was just not long enough to come into compliance with the ADA. Really folks? How much longer do they need, and if it wasn’t bad enough that privately owned corporations who exist purely for profit (insurance companies) refuse compliance, it is a long standing well kept secret amongst the advocates for the disabled that the worst offenders are the state health departments themselves.
Fifteen years ago when these laws were put in place someone with an ounce of intelligence said that we couldn’t count on insurance companies to govern themselves when it came to complaints about their non-complience. The federal government ordered that the health department in each state set up independent phone hotlines (pre-computer days) and ordered that all staff running these hotlines be brought up to speed on all aspects of the ADA that applied to healthcare provisions but that they also have training in social work and mediation. The reality of this system was that it went to a central phone bank where the same person dealing with your insurance company refusing to cover surgery due to a life threatening illness had just put down the phone dealing with rats in a slum. They were not even trained, the phone was not even answered in such a way to identify that you had reached a special place. Now before you jump on me, and say but Mia, come on, you dialed the number and know you got the right place. Remember statistically, that its equally as possible the caller is intellectually disabled and not physically. So your expecting a person who is on benefits due to possibly diminished faculties due to accident or birth, to understand that someone that picks up the phone and says Health Department, not ADA hotline that they have the right place. Because of this problem in the early days, it is believed that over 50% of complaints went unrecorded. Then the workers cried aloud “this is too hard,” and their cries coincided with the introduction of computers in the workplace. One would think that this would make life easier. Go online, there is a space provided for an email to be sent to the right dept where you might be required to answer a few basic questions and leave a small statement about the nature of your issue. After all that is what an intelligent person who knows the nature of the people complaining would invent? No, the health dept decided they would come up with 4 complete pages of over 100 questions which when reviewed yesterday with a half dozen PhD and an attorney at the table, could not be worked out clearly and yet the health dept expects the intellectually disabled to master it. Lets not even talk about if English is your second language. So after you have hopefully managed to complete this form which is about as easy as taking pi to the hundredth decimal point, you just press send right? No, that would be too easy, too intelligent, caring and compassionate. No, after all that you are required to print out 3 copies and snail mail them. Now if that isn’t stupid enough that is assuming that a person living with severe physically and financially draining disability (46% of all bankrupties where medically based), now you are also assuming that someone who is financially distraugt to the point where they have to seek assistance with medical insurance (my own in-laws had to sell the family home and move into a studio to pay for medical expenses) has not already sold all luxury items for funds to relieve the financial burden (computers, printers etc).
In closing, does it surprise anybody that a panel empowered to understand better the financial strains on medical insurance had not thought an actual disabled person until I rolled into the offices of CIDNY to say hello. I mean after all, they threw the only women off of a federal panel deciding whether women should be allowed abortions and birth control because her voice wasn’t necessary but the catholic priest, retired generals must know better, but don’t worry, now they have me. I’m not going anywhere and I have your back. Common sense will prevail.