Posted by: dharmabeachbum | October 31, 2013

Medicaid inadequacies widespread, harmful to the downtrodden

Charles Bukowski was a prolific underground writer who used prose and poetry to champion the rights of the downtrodden in American society. His writing was influenced by the social, cultural and economic ambience of Los Angeles, his home city. He drank a poor man’s beer while bringing to light the plight of the poor. Many, many writers have tried to follow in his footsteps, but that’s hard to do without walking in them. Without having his immense talent.

I’m taking a few baby steps in his large and influential shadow in writing this piece.

Charles Bukowski

Charles Bukowski

Five months ago, the South Carolina Department of Health and Human Services cut off my Medicaid benefits on the grounds that I didn’t return my recertification papers. I didn’t know that until eight or nine weeks ago when I called the Medicaid office in Conway. I received neither the recertification papers nor notification that my benefits were being cut off. The agency had the wrong address for me in its computer system.

If this were the first time it happened, I may have let it slide. It’s not. Long before I moved into my latest pad, I drove my recertification papers out to the Medicaid office in Conway and handed them across the counter. Two weeks later, I received notification that my benefits were in danger of being cut off for failure to return the paperwork. Office personnel denied that I had been there.

Medicaid has systematic flaws. There are more than a few people working in that system who are obnoxiously condescending. Medicaid recipients deserve better. Taxpayers deserve better. How can Medicaid recipients be expected to make better lives for themselves if they can’t get the help they need from The Man? If they’re constantly being told by society, the so-called civilized people, and by a government-funded agency that they aren’t worthy?

As a result of their latest series of blunders, $100 has been deducted from my social security check for Medicare coverage since July. I thought little of it at first. I was amidst a personal crisis and my mind was muddled, even more so than usual. I mistakenly thought the deduction from my check had something to do with Obamacare. As of Nov. 1, that’s $500 taken away from someone who already lives on very little. Social Security will most likely reimburse me $300 of that. I’ve been told that’s the limit.

Long ago I was diagnosed with bipolar disorder and that personal crisis about which I just wrote had exacerbated the mood swings and symptoms with which sufferers of mental illness must live 24 hours a day. I’d recently made peace with myself regarding the situation. The Medicaid debacle has wounded my psyche immensely. Set me back substantially. But I’ll rise above it eventually.

When I first called the Conway office, the caseworker with whom I spoke acknowledged that they had an incorrect address and assured me that she would send me a new application. My street address is 6501. They had 6504. Since I’d received paperwork from their office before, I found that strange.

Over two weeks passed and I still hadn’t received the application. I called again and explained very clearly that the situation was creating havoc for me. She said they still had my address as 6504. That annoyed me and I let her know as politely as I could under the circumstances. She said something that implied that this situation was all my fault and I reminded her that it was her office that couldn’t get my address straight.

“Yeah, but…” She caught herself and moved forward with the conversation. “Yeah, but…” was the last time anyone in that agency took any responsiblity for this fiasco through its resolution in late October.

In the meantime, my anxiety shot through the roof and I suffered the first two panic attacks that I had had in a quite awhile. Years. I’d conquered them with the help of medication and meditation. Two nights in a row I awoke with my heart racing, numbness in my hands and numbness in the left side of my face. I recognized the racing heart and hand numbness as symptoms of overwhelming anxiety. The slight numbness in the left side of my face was new to me. Dazed and confused, I spent the better part of the next two hours wondering if I just had a stroke. The mind is a powerful thing. When overworked, it orders a gland to release adrenaline in self-defense. Voila! Panic attack. And that adrenaline shoots through your body in waves. Months and months of sleeping four or five hours a night short circuits your brain and it fights back. It’s difficult to sleep when your mind won’t stop and the tension in your back, shoulder and neck muscles borders on being physically painful.

Nearly three weeks into October — well over a month after I’d first called the Medicaid office in Conway — I still didn’t have that new application in hand. My thoughts were bogged down in mire and I was wallowing in a sty of misery. I mistakenly called the wrong agency, bypassed the normal channels and left messages with a supervisor at that office. Irvin Smith, a kind and professional gentleman working with the Department of Social Services, called me a few days later and redirected me to the proper agency. One with which I was all too familiar.

I spoke with another caseworker upon calling. She chastized me for raising my voice when speaking to her. I was so angry I was fixin’ to cuss her out, but I’m not one for using profanities. Swearing only reveals that one’s vocabulary is limited. Again, I was told that they still had the 6504 address in their computer system. She said she changed it and told me that the papers were on the way.

Extremely frustrated. I called the state Medicaid office to complain and to see if they could fix this calamity. Part of their recorded message stated the obvious. “It’s a great day in South Carolina.” Many times when you call government offices you are told that all employees are busy and it is suggested that you call back. At this point, I was running out of fingers and toes on which to count the number of times I’d heard the “South Carolina” message. As it played, complete with many options for continuing, I screamed, “It’s always a great day in South Carolina! The problem is that your agency is causing me nearly all my stress!”

When I finally got a human being on the line, I told her of my dilemma: the month was coming to a close and I needed to get my Medicaid reestablished before Social Security deducted another $100 for Medicare. She told me all she could do was file my complaint. She also told me that I could print an application, fill it out and send it via fax. I thanked her and told her she had done more for me in five minutes than the local office had in five months. I walked five miles one way to Chapin Memorial Library, filled out the computer application, faxed it and called the Medicaid office in Conway to see if they had received it. Nada. My mind was muddled. I’d sent the fax to the wrong number. My mistake. My responsibility.

The next day I made the same ten-mile round trip to and from the library. I had $1.60 in change in my pocket so I only faxed the pages that applied to me. I called the Medicaid office in Conway and was told that I needed to fax all 12 pages of the application, half of which were completely irrelevant to my case. One would think a competent caseworker could connect the dots, considering I had previous applications and recertifications on file — i.e. I’m still a Caucasian male and I haven’t had any babies. I haven’t evolved into a Native American and I haven’t devolved into a felon.

Nevertheless, I’ll take responsiblity. My mistake. I was still on the verge of going ballistic. At some point in that conversation I said, “Good thing I’m a writer.” The caseworker scoffed. I think I know what she was thinking, but I wonder if she’ll be thinking the same thing after she reads my little rant.

I made the same trek to Chapin Memorial Library again the next morning and walked back up the beach. I called the Conway office again and was greeted with that now-irritating message.

“It’s a great day in South Carolina.”

Yes, I know. Twenty some times over. Being a dharma beach bum, one of many along our coasts, really, I already kiss the sand every morning and thank a higher power for blessing me with some sort of energy that I don’t fully understand.

Nearly four hours after sending the fax from the library, I asked the same caseworker if she had received it. She said, “Yes.” I asked her if everything in my paperwork was okay. “As far as I can see?”

As far as… What? How much more vague could she be given what I’d been through over the past five months? During our conversations, I would have been more likely to trust Mr. Magoo’s eyesight and to have more faith in him to admit his inadequacies.

I asked her if she would give my application priority in what was left of the afternoon.

“It’s being processed. You’ll receive something in the mail.”

Well, that’s reassuring. Are you sure you have my correct address?

I asked her another question about my paperwork. She repeated herself verbatim. Does Polly want a cracker?

Two days later the application from Medicaid-Conway was delivered to my mailbox. Four days after it was postmarked. Wow! It takes four days for a letter to get from Conway to Myrtle Beach. Bring back the Pony Express. Y’all know I have my differences with The Man, but I’m not griping about the United States Postal Service. I’m just glad it hasn’t been privatized. If that were the case, the postal service would be even more corrupted than it is now.

Individuals can be corrupt, too. We’re human. Fallible. I suspect the problems that I encountered with Medicaid are widespread.

When somebody is getting something from the government at the taxpayers expense — taxes that I used to pay and taxes that I hope to pay again in the near future — that person can’t complain much on his or her own behalf. But I’m still a journalist at heart and I can do so on behalf of my fellow Medicaid recipients. For their children.

Charlie. Mr. Bukowski. I’m hoisting a Schlitz and toasting you. May your beautiful soul rest in peace.

Bum raps: For those of you too young to remember, The Apple Dumpling Gang is a 1975 Disney film that stars Tim Conway, Don Knotts and Bill Bixby. Bixby plays a gambler and Knotts and Conway play bumbling hold up men. I’ve lower-cased the movie’s title in my blog because I’m using it as a descriptive phrase. In no way am I calling anyone at the Horry County Medicaid office a thief. But I’ve definitely been held up. For five months of a life that I treasure. Bob Dylan, “Positively 4th Street,” 1965 single, quote: “You’ve got a lot of nerve to say you are my friend. When I was down, you just stood there grinning.” Interesting trivia: The earliest reference to, “Does Polly want a cracker?” was in “Bunkum Flag-Staf and Independent Echo,”a satirical newspaper published in The Knickerbocker (or, New York Monthly) in 1849. Satire? I dig it.


  1. This is horrible, but I’m not surprised in the least bit. Every day I see the mediocre attempt by people to do their job. Doing just enough to get by and all the while laying blame on others for their inadequacies.

    • Exactly, Miss Cindy. I worked for the county (Snyder County, PA) when I was about 18 and 19, doing some microfilm (old school) work on the third floor of the county courthouse. Also, one of my best friends in PA worked at the Welfare office in Selinsgrove, PA, and what I’m about to write doesn’t apply to him. People at these places were lucky to work a half day. They spent most of their time socializing, snacking (the apple dumpling gang) and eating lunch. The three women who worked with me in microfilming were very, very nice to me, but they spent half the day cooking (a lot of crock pot believe it or not), playing board games and playing cards. Most of the time I kept working and they blamed me for “working us out of a job.” It was the same way in most of the other courthouse offices. What a waste of taxpayers money. The people at Medicaid treated me as if I were just another person leeching off society. Like I’m homeless or something. I’m neither, thank God. When I wrote this blog, I knew exactly what goes on out there. It’s obvious. You put it succinctly. They, like many others in our society, are very mediocre at what they do and they obviously put in as little effort as possible. They don’t care about many well-meaning parents out there who need Medicaid’s help desperately so they can try raising their children properly and tend to them better. That makes me sick. I’m sending this blog to the Medicaid-Horry County executive director on Friday morning. Hopefully she’ll read your comment and this comment, too. If you are in a position that it would be harmful to you for someone like that to see what you said, let me know. I can delete it and leave this here. Nice to know someone else cares. Peace.

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