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Native Intelligence
	Playing politics with people's lives (Published April 4, 2005) By DIANA WINTHROP

For the past couple of weeks I have received many e-mails and calls from D.C. residents who wanted to help pay for the medicine needed to keep Bill, the subject of my last column, alive. My previous column recounted the story of Bill’s dilemma as an extremely ill stroke and heat attack victim who has no health insurance, can't afford to pay for it and subsequently couldn’t afford the hundreds of dollars for medications to allow him to live. The government said Bill and his wife were not poor enough for help, even though her income is just a few thousand dollars over the federal poverty level. Bill’s health has been failing, and as I wrote, in the next few months he could die unless he receives the 11 prescriptions that cost almost $700 a month needed to keep him alive.

Readers who had attempted to navigate the health care system themselves or family members had some pretty creative ideas. One suggested that Bill’s wife ask her employer to pay her less money so Bill would qualify for Medicaid or the District’s health care system. The leftover money could be put aside in some kind of trust to be given to her later -- the reader wasn’t quite sure how that earned money would be returned to the family or even when. Most people were extremely generous by offering to donate money to help Bill. It amazes me how so many people who have limited income are always the first ones to step up to help anyone in need. But raising the annual $8,400 would be rough.

The good news is Bill’s problem is at least temporarily solved. Some official bent the rules just a little to help Bill. The bad news is Bill’s story is not rare. There are thousands of people like Bill who don’t receive help. What is even sadder are the hundreds of health care workers and advocates in the District who admit citizens are experiencing a health care Armageddon but act as if there is more than enough time to fix the system.

Sorry folks, we are already in a meltdown mode unless there are some changes before the end of the year.

One D.C. health care advocate says the mayor should be given kudos for the 50,000 residents and working poor who now have health care. He thinks residents should be pleased with the progress that has been made, though he wants to see more changes. I suggest he needs to visit George Washington University Hospital's emergency room any day of the week to see how the mayor’s efforts aren’t working.

Mayor Anthony Williams has not excelled as a leader on an important piece of legislation that some in his administration say he supports, while others find it unnecessary. It is legislation that would help citizens better navigate the health care system. The plan, according to Cheryl Fish-Parcham of Families USA, is the culmination of three years of work by a coalition of health care advocates. It creates an ombudsman whose sole job would be to assist residents in obtaining better access to health care. The office needs to be fully funded and operating by the end of this year, before President Bush’s prescription drug plan goes into effect on Jan. 1, 2006, advocates say.

Currently 20 states have ombudsman offices. If one had been in place in the District when Bill and his wife were trying to find help for paying for his prescriptions, Bill’s health might not have been compromised. People who are computer literate or have access to a computer have had a better chance of finding help. Most major drug companies offer free medications for many without health insurance and the working poor -- if you know how to find them online or through the companies' headquarters.

With an ombudsman, uninsured residents would have a central location to find information. While the D.C. City Council unanimously approved the bill, sponsored by At-Large Councilman Phil Mendelson, last December, the mayor’s administration has not been speaking with one voice.

Gregory McCarthy, the mayor's deputy chief of staff and policy guru, seemed genuinely surprised when I asked him why the funding for the office was not in the mayor’s proposed budget for fiscal 2006, which begins Oct. 1 of this year. If the mayor ever let it be known that he thought the measure was important, I suspect folks in his administration -- such as D.C. insurance commissioner Larry Mirel, who recently testified against it --wouldn’t publicly oppose the plan. Mirel has argued that the health department already has information lines to help residents, so he believes the ombudsman’s office is a duplication of services. If there is already a central place to find health care information, few people know it exists.

The federal government needs to take some of the blame, as well, for not eliminating the uniform poverty level. In Bill’s case, the government says $25,660 is the most a couple can make to be considered poor. Those who struggle daily in this city know full well the cost of living in Washington, like Boston and most major cities, is higher than in smaller communities. The government must rethink how it calculates poverty. To assume that people in the District, Kansas City, Des Moines or Fargo are suffering equally is ridiculous.

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Diana Winthrop is a native Washingtonian. Contact her at diana@thecommondenominator.com.

Copyright 2005 The Common Denominator