La Medicaid Transportation: Fill & Download for Free

Harvard Economics Professor Greg Mankiw (his is the most widely used textbook in college Econ intro courses) did a series on this question at the time when healthcare reform was being debated. Mankiw: Beyond Those Health Care Numbers/ Life Expectancy as a Gauge of HealthcareHe pointed out that life expectancy in the US is more dependent on societal factors than healthcare systems. There are societal factors that no healthcare system can solve unique to the US.The US has the highest obesity rate in the developed world. No other country comes close. Obesity leads to higher diseases including diabetes, heart disease and cancer. Treating these illnesses is expensive.The US has had the highest rate of teen pregnancies in the developed world. That is improved over the past decade but teen pregnancies lead to premature births. Premies have a high risk of not surviving. In the US, a premature baby who dies is considered a live birth and counted in the longevity statistics. In many countries, they are excluded. Apples and oranges depending on country.The US has over 30,000 deaths due to motor vehicle accidents. In a large country with many rural areas, public transportation doesn’t exist. These deaths are not 85 year old people. The victims are typically young and skew the statistics negatively.Now, the US is in the grip of a national opioid crisis. More than 70,000 largely very young individuals die from overdose a year.That is why survival numbers are lower. Now to the costs. Half of all the funds spent for healthcare in the US are used by 5% of the population.American healthcare costs are so high in part because as a society, we don’t withhold care and medical care in the last 6 months of life is very expensive. This includes cancer treatments given that are either not available for wide restricted elsewhere including the UK and Canada, dialysis of very elderly individuals and months spent in the intensive care unit. How We Spend $3,400,000,000,000About $200 billion per year is estimated to be wasted on the practice of defensive medicine as physicians order countless extra tests to avoid malpractice lawsuits. Americans waste $200 billion every year on medical tests they don't need, experts sayThere is estimated to be $100 billion in Medicare and Medicaid fraud yearly. The $272 billion swindleMedicare for All isn’t going to impact this, absent drastic rationing of care at the end of life, major malpractice reform a la the Canadian model and restrictions on access to expensive but marginal treatments.Only one third of Americans favor Medicare for All when its revealed that they will be paying higher taxes and lose their employer sponsored health plan according to recent Kaiser poll.

One reason - which is NOT popular to mention - is pure and simple selfishness on the part of the homeless person’s family, or rather, the dominating members of the family who are the ones that have the money/good jobs/status that call the shots for everyone else.In an answer to a post asking if any “normal and respectable people” ever became homeless, I gave a good example of that from my own lived experience as someone who was orphaned at 12 and left homeless and then trafficked - in that order.Now, my uncle in question from my linked post has been dead for several years. But before he died, I found out quite serendipitously that I was not the first and only family member he threw under the bus, abandoning to die from poverty and homelessness (or die from being trafficked - which could have very easily happened to me as a child sex trafficking victim).I learned from a retired (unsure if he’s even still living) police officer from the area where my late uncle used to live, that on one very bitter cold winter night with temps dipping well below zero, police were trying to help as many homeless get into the local shelter as possible (room permitting). I found out about another relative that my uncle refused to lift a finger to help (besides me): A deaf, elderly World War 2 vet who was a decorated war hero that was found huddled on a steam grate, trying to NOT freeze to death.That man was my uncle’s uncle.I never even knew about this incident until many years later, long after I had met and married my husband in a different part of the state. And at the time the incident happened, I was not even able to support myself and get myself stably employed and housed (for reasons I described in detail in my post linked above).Anyway, long story made short: The police contacted my uncle (the same jerk who let me go homeless and end up trafficked upon being orphaned as a 12 year old kid) and asked him if he could please take ‘Uncle Rodney’ in for a few days until other arrangements could be made so this deaf elderly vet (who was a decorated war hero) wouldn’t literally freeze to death as the homeless shelter was filling up fast. My uncle’s response was to firmly deny being any relation to him! He straight-up LIED to the cops, saying this man was no relation to him and had no idea what the police officer was talking about - even though he certainly did know who he was, so much that he had included his birth and war service records in the family tree genealogy he worked on before this incident transpired.There are several other people I know in the human trafficking survivor community who ended up in the situations they were in because of abuse and narcissism in the family. There is no shortage of shitty, selfish, dysfunctional families out there.One case that is particularly heartbreaking that I have permission to share since the person in question already went public in HuffPost with his story, is that of Nicholas Al-Khadra.Nick was born white and male to upper-middle class parents from Chicago’s prestiguous North Shore area. He is someone that most people would think that the system, and society in general, favors. Except there was one problem. Nick was born gay.His father abused him for several years, in an attempt to “beat the gay out of him.” He was thrown out of the family home as a young teen because he couldn’t un-gay himself and being gay in a very ultra-conservative Greek Orthodox family was a major no-no.Within 48 hours of being thrown out of the house with no money and nowhere to go, and unable to “just get a job”, he was aquired by a trafficker. He was brutally raped (in the survivor community, we call this “seasoning” or “breaking in”) by a room full of this trafficker’s “customers” (i.e. ‘johns’) - one of them deliberately forced unprotected sex on Nick, knowingly infecting him with HIV/AIDS, and laughed in Nick’s face about it!Just recently, Nick developed severe health complications from a toxic combination of a black mold infestation that his landlord failed to rectify which comounded his HIV-related health difficulties by an order of magnitude, and California Medicaid ceasing to pay for his HIV meds causing him to go into ARC (and then into full-blown AIDS).As a result, Nick became too ill to continue his advanced education to earn his PhD in Psychology/Counseling so he could provide counseling and emotional support to other human trafficking survivors. He was also too ill to continue working at his part-time counselor job for ProjectAIDS-LA. This caused him to lose his grad school student stipend and his part-time job’s paycheck, leaving him without any income to pay the rent - for an apartment with black mold that the landlord either couldn’t or woudln’t fix. The result: Nick got evicted and was once again left homeless.Every survivor-leader in the trafficking survivor community scrambled trying to marshall resources to help Nick, even those of us like myself who don’t have any incomes (not even a paltry $700/mo SSI check, which isn’t enough to live on anywhere in the US) who are also struggling to survive in deep poverty.We started asking where all the help was for trafficking survivors because none of these well-heeled, well-funded big anti-trafficking NGO’s claiming to “help poor trafficking victims” had any help for any of us, including Nick, that was remotely feasible.Did they help by trying to compel the landlord to fix the black mold issue or re-house Nick somewhere else at their expense? No.Did they offer Nick any sort of economic stabilization so he wouldn’t be faced with homelessness out on the streets while dying from AIDS? No.They referred Nick to a list of resources that are really cash-strapped, budget-slashed public social service agencies that pointed to only one place that might be able to help him. And the “help” he was finally offered by that one place was to be placed on a waiting list for a bed to become available at a hospice for AIDS patients located in one of Los Angeles’s rough neighborhoods. But until then, Nick had nowhere to go. That’s the “help” he got. That’s what our “safety net” amounts to.And did Nick’s wealthy parents offer to at least send their son enough money each month to contribute to his basic survival needs of housing and food and transportation costs to medical appointments so he doesn’t die from AIDS out on the streets? No. They flatly refused and stated they don’t care what happens to him.Nick is one of many destitute human trafficking survivors whose life is imperiled by the elimination/shredding of what remained of the social safety net with impending loss of Medicaid courtesy of Congress’s recent vote on the “Tax Reform Bill” - which is really a Murder By Proxy bill aimed deliberately at the poorest, weakest, least-able and most vulnerable and disadvantaged members of this society.This is why I am a firm believer in enforcing filial responsibility laws in the states that have them in post-Welfare Reform, pro-“family values” America, since society will not bring itself to institute and implement any kind of a real social and economic safety net for those who are unable to economically provide for themselves and/or for those whose families decided to discard them because they were either unwanted since birth and/or because taking care of destitute family members for whom the job market is inaccessible for a multitude of reasons (disability, health issues, age/sex/race discrimination, etc.) is “inconvenient.”If anyone thinks I’m being too hard-nosed about this issue, maybe they should consider that before having kids that might, however unintentionally, “disappoint” them that they will end up discarding for embarrassing them by being born gay, or accidentally getting pregnant at 16 by Cousin Rapey at the family reunion, or being born with a learning disability or other intellectual impairment that makes it impossible to succeed in today’s hyper-competitive society where you have to be a “rock star” just to get a job (even as a contractor on freelancing platforms in the “gig” economy).

Public hospitals have to take anyone who walks in the door because they subsist on government funding and grants etc. Private hospitals can be more selective and can refuse to serve anyone. If the person doesn't have insurance they have to stabilize them for transport. I found this out first hand. If you have Medicare or Medicaid the private ones will turn you away.My ambulance had to be rerouted to a state funded hospital when I had the audacity to get injured. Have your cards available because even though I told them what I had, the ambulance still took me to the wrong hospital.