Sarah, I See Your Rant and Raise You an Anguished Cry For the Poor of Chicago

January 30, 2007 at 4:21 pm (Michael's Posts)

Sarah’s question in her previous post made me think of bureaucratic reform and at work at the clinic I am surrounded by the rumblings and turmoil of budget cuts. In other words, the gutting of the health system. So, I was just thinking about this crisis in light of bad bureaucracy. One of the biggest issues that i’ve heard mentioned around the campfire is that the county healthcare administration is bad at billing medicaid and medicare. As in they only get some tiny amount of the money that there is alloted for the care they offer. And that’s only for documented medicaid/medicare folks. There are thousands who qualify but who have not applied or been approved for one reason or another. Why is it not a chief priority in the clinics and hosiptals to get people signed up for these services?

A: It costs the feds money and there’s a conspiracy to prevent people signing up.
B: There’s no good reason.

I’m a down-to-earth guy (even though I am an economic radical of sorts) and I go with answer B. At least there’s no good reason the doctors I work with can think of. So it must be a failure of a bloated, inefficient bureaucracy. And since I don’t actually get paid by them and my volunteer job is not on the line, I feel free to say that. And if it be false, please, do let me know.

So it looks to me that there’s money and we’re not using it. Instead we’re contributing to the myth that there aren’t enough resources in America to go around (read: no one wants to take responsibility for the care of the poor). And this makes it look like it’s impossibly expensive to care for everyone in this country. How will we know if we don’t use the systems we have set up? We’re just going to give up on it like that? It’s a damn shame.

See also: Bureaucratic reform. (Sarah’s post on polio)

See also: public accountability. How do we make THAT work?? How can people who are as disenfranchised as the poor hold a machine as famous as the political system in Chicago accountable when it screws them over? Especially when it screws them by not charging the federal government for the medicaid and medicare it’s owed. Absurd. And if I’m totally off base with this accusation, someone set me straight). Any ideas from political type people on how to empower the poor to hold powerful government entities accountable? I know it’s a very uphill battle.


1 Comment

  1. misarita said,

    Michael, there has been a big step forwards here in terms of public accountability. One of the biggest issues that I face around here is seeing how little information people have about what their rights are, what their health care should be like and what services they deserve. In short, there is a huge gap between community expectations and services provided.

    But, in 2005, the Right to Information act was passed here, which basically gives people the right to demand and receive information (as defined by a long list) relating to “any private body which can be accessed by a public authority under any other law” ( There have been many publications, advertisements and lawsuits about this, but people are starting to use it. They are starting to demand accountability, ask for their health information, publish data on politicians, and the like. At leastin India, accessing that information is a large part of getting the public to be accountable.

    I wonder how much of that is also the case in the states. The information is there, but how much to people know about their right to gov’t subsidized healthcare? Do people know their options? A large part of community mobilization could well be giving folks the information about what their rights are in the first place. It probably isn’t as big a gap as in India, but it could be one direction that needs attention.

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