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Tuesday, July 19, 2011

Dispatches from the north

It’s hot in Central Falls, where I live in a high-rise for seniors and the disabled.   Residents are sitting in the community room or outside, where amidst the conversations about family and gossip about each other there is an undercurrent of fear.  They have read or heard the news reports about the stalemate in Washington. They are well aware that some politicians have claimed that if the U.S. doesn’t raise the debt ceiling on August 2, August Social Security payments could be interrupted, though they don’t understand why.

They worry they won’t be able to do their food shopping, or go to the dollar store for essentials.  They worry, too, about not being able to get their hair done or play bingo, a major source of entertainment here.  They worry about being dependent on their children and grandchildren for the things they need.  Many think that Medicare payments to their doctors will stop if the government defaults, and they won’t receive the health care they need.

Most importantly, they fear that they won’t be able to pay their rent.  If they don’t pay their rent, they worry that they could be turned out of their apartments and sent to live with relatives or, in the case of my friend Jean, shipped to a nursing home or even left on the street—at 90 she has no living relatives.  My reassurances don’t matter-- the Central Falls Housing Authority is likely well aware of the situation, and it’s unlikely that anyone would lose their home that quickly. 

Probably 90% of those living here rely on Social Security for their sole income, and most don’t have much in savings.  I am only guessing, of course, as it’s not proper to enquire into people’s finances.   I try again to reassure them that the default won’t happen, that it’s only politicians doing their thing, and that Social Security (and Medicare) will be safe. 

Privately, I worry too.  I myself depend on Social Security Disability Insurance for my monthly income.  My payments were only approved last October, after over 30 years in the workforce.  As an employee, I was fortunate to have good health insurance that paid for my treatments and therapy, insurance that ended on May 31.  As a new SSDI recipient, I must wait until October 2012 to become eligible for Medicare, a relatively new twist in the law.  As such, people with disabilities who depend upon medical and/or psychiatric care must wait for help in paying for their treatment.  

Further adding to the absurdity, Rhode Island’s only insurance program for those with pre-existing conditions like myself, run by Blue Cross Blue Shield, requires that applicants be without health insurance for six months before becoming eligible to even apply for coverage.  When/if I do qualify (after completing a 10 page application and have my treatment providers complete various forms), I can look forward to the prospect of paying $439 in premiums, excluding co-pays.  I also have a $1000 deductible.

 I’ve calculated that after paying rent, premiums, and other bills, I would have about $200 maximum left over for the month to pay for co-pays for medication and doctor visits, food, over the counter meds, toothpaste, and toilet paper, and maybe a Coolatta. 

Medicaid and Food Stamps aren’t an option either. A single person like me must have an income at or below the poverty line of $10,890. Preferably below.  Ironically, my years of working at a decent job have kept me from qualifying for any sort of public assistance as my SSDI payments are too high.  But they’re not high enough to make the prospect of living without health insurance for 18 more months any more palatable. 

Then there’s the problem of paying for prescriptions for my medical conditions.  One drug alone costs over $250 monthly without insurance at the cheapest place I can find, Costco.  I plan to apply for assistance from its manufacturer, but that’s by no means certain.  And simply filling out the form requires a visit to my physician (another $110 for an office visit) so that he can discuss it with me and sign it.  That’s the company’s requirement, not mine.

An option for many is the Rhode Island Free Clinic.  But, once again, I make too much money—by about $75.  There are clinics at Rhode Island Hospital and Memorial Hospital which may be available to me.  I have not yet checked them out, and I confess that I am reluctant to leave clinicians who have treated me well for years.   But I may have little choice. 

I am well aware that I am fortunate in many ways.  I do receive Social Security where there are many disabled people who have not qualified.   And there are too many who live in real poverty, people who are homeless, people with no income.  I find it ironic, though, that they are eligible for programs that I cannot access, even though I am considered to be “very low income” by HUD.  And I’m resentful that my years of paying into the “system” haven’t entitled me to more assistance, especially Medicare. 

Unfortunately, that’s the way it is.  And so I will continue my adventures as I navigate the world of the uninsured for the foreseeable future.  It should be interesting.

Guest post by Lin Collette

* Disclosure: Lin is Will Collette's younger sister. She worked at Brown University for decades and has lived in Pawtucket and Central Falls her whole life.