Wednesday, December 28, 2005

Squirrels and Other Rodents

I have this Camellia I’ve pampered all year, it has dark green foliage and huge deep red flowers with yellow stamens. I have it in a pot in front of the living room window. I repotted it, fertilized it and loved it all year; it has huge buds, which promise to bloom in late winter early spring. The other day I looked out the living room window and the red of the petals had started to show. A squirrel ran down the Oak tree and up the camellia it pulled off a flower bud like it was picking an apple and sat on the edge of the terra cotta pot and took a huge bite. I started waving my hands and stomping my feet in the window. The squirrel turned his head slowly toward me and stuck up his middle finger.

So what about the medical center’s favorite fury friend, Dave Kears? Dave runs the Alameda County Healthcare Services Agency. So complex and confusing are the county’s budget battles and bureaucratic labyrinths that those charged with serving the county’s poor spend most of their time serving Dave Kears and fighting other organizations they should be working with, for cash and turf. Sure we have some great services but they all operate in a vacuum instead of cooperating to provide the best care. Closing the medical center and looting Measure “A” funds are top priorities for the secret squirrel: he needs more cash for brain-dead billboards, consultants and committees.

With winter here and the new executives distracted by operational issues and settling labor contracts, opportunity knocks. Kears can’t take money outright but he can attack the medical center’s credibility and bottom line. It’s a shell game; Alameda County Healthcare Services Agency makes consultants rich, gives fat contracts to political suck ups and leaves the poor, sick and confused. For years the agency has been trying and failing to get county residents enrolled in Healthy Families, a program which gives low-income families MediCal (state paid health insurance.) Tons of county residents qualify but don’t get the services because of the daunting and bureaucratic application process, and the complete and total ineptitude of Alameda County’s Health Care Service Agency.

So of course Healthy Families has flopped but Kears knows how to turn personal failure into opportunity! Kears has now mandated the cumbersome and overwhelming state application, the 1-E-Application for financial eligibility, be used at the medical center. This electronic application can then go directly to the state’s computer, decreasing the time needed to get MediCal. They haven’t worked out the technical details like software compatibility with the state, necessary middleware or how to convert all archived paper applications to the new electronic format, but in theory it’s a great idea. In practice in order for the medical center to get the MediCal a patient desperately needs and deserves, the medical center must get detailed information about the whole family. So Highland’s overworked, underpaid and under resourced eligibility clerks now have to get a translator to explain to the patient that they need their mother’s bank account records for the medical center to get them the coverage they need to get dialysis.

Imposing this application on the medical center increases the time and complexity of each financial screen and because of the huge amount of information required, it decreases the success rate for the same reason. Kears is no dummy he conceded this might be difficult so he threw the medical center some “chump change” for a couple extra, temporary, non-union clerks. See Dave’s not looking for success, he doesn’t care about the county’s poor or sick; he cares about his beloved bureaucracy. Kears plans to shift blame for Alameda County’s failure to get families the state health coverage they deserve, onto the medical center.

1 comment:

Anonymous said...

I love your comments, humor, sincerity, and pathos. Your skewering of our "leaders" is right on and wicked. The love and care you have for the sick and powerless is, is...just marvelous. Keep it up!