the reality tunnel

Procrastinating as usual, I went to change my voter registration address today, the last possible day to do it.  I asked what would have happened if I hadn’t changed my address and the answer was that, at least in Monroe County, you are allowed to vote once at your previous polling location.  The challenge is that, with redistricting, your previous district’s polling location may now be the polling location for a new district.  So, in that case, one would most likely have to wait in line, only to be sent to a new location.  In any case, I was told that having different addresses wouldn’t keep you from voting, but could delay voting.  Info about this was mailed out to registered voters, but in a community like Bloomington where, for students, and many of my peers, housing situations change a lot, it’s easy to not get the info.  So, for those who moved, but didn’t change their voter registration address, I would just call the local election office and find out where the polling place is for the address under which you’re registered.  If you go there, you should be able to vote.

Healthcare and the State continued

There are few feelings better than knowing that someone’s got your back, or at least is looking out for you, or at the very, very least is holding up their end of being accountable to you.  So, I was really excited when my primary medical provider’s office called me and told me that, while the surgeon I had originally been scheduled to see didn’t accept the Healthy Indiana Plan insurance, they had scheduled an appointment with another surgeon.  They couldn’t find a dermatologist who accepted the HIP in Bloomington, but I could see one about the wart on my hand in Indy, in December.

Today I went to see the surgeon.  I had to wait an long time, or what seemed like a long time, but the receptionist was friendly and clear.  Being fairly healthy, and fairly irresponsible, I haven’t used healthcare services in a long time.  So, I feel like I have few points of reference to evaluate the quality of care that I’m receiving.  I think this is a common problem with folks who haven’t been able to see healthcare providers in a long time - you don’t know what to expect, so it’s hard to hold doctors, insurance providers, and paramedical staff accountable.  The surgeon was to the point, but moved through what he wanted to tell me really fast.  He was glad I didn’t smoke (it saved him a lecture), I had a sebacious cyst which was the result of a natural glogging of the sebacious glands, since it seemed inflamed and was on my neck where infection could easily spread to dangerous places like the spine it should be removed, I could choose to have it removed under local anesthetic at the office or by going under at the hospital.  The first option would be faster and cheaper, but bad if I had a low pain tolerance or an aversion to shots.  The doctor paused only briefly to allow me to make my decision. I chose the local anasthetic because I didn’t want to spend my day at the hospital, and, as I understand it, I am only covered for up to $1100 in healthcare expenses, so I need to watch costs.  The doctor prescribed some generic antibiotics (covered by the HIP, but they would have only cost me $4 out-of-pocket) to get rid of any infection of the cyst and scheduled a date for the surgery.
All in all, I’m happy with how things are going so far, but would be really nervous if I had to deal with more serious or complex medical issues.  I get this sense that I’m being herded through a big system, as efficiently as possible, and that I’d have to really struggle to make my concerns known and have my questions answered.

Decarcerate Monroe County/Critical Resistance Fundraiser “Vegan Dessert Party!”

–Saturday, September 13th.
–2pm-8pm
–110 N Maple Street

Support local jail resistance and help us get to CR10 in Oakland, CA!! Decarcerate Monroe County(DMC) is a Bloomington-based coalition resisting jail expansion and working toward meaningful alternatives to incarceration. CR10 is the tenth anniversary conference of Critical Resistance, a national grassroots organization working against the prison industrial complex- DMC will be hosting a panel of local anti-jail campaigns at CR10!! Please join us for a dessert party. The cost is only $5, and the food is served buffet style, so you can try whatever you like. There will be a number of different items, from cakes to pies, cookies to breads. All of the items are vegan and many will be wheat-free. Refreshments (tea, coffee, etc) will also be served. Please stop by, have a bite to eat, and support DMC. To donate $$ directly over the internet, please visit: http://criticalresist.live.radicaldesigns.org/article.php?id=55 Just click on the orange “donate now” button at the bottom of the page, and please specify that you want your donation to go into the CR10 travel fund, on behalf of Bloomington, IN.

The book group I’m facilitating at the county jail met again this past week, interrupting an Uno game going on in the common area of the cell block.  I had just played a game of Uno that afternoon, sprawled out across a post-picnic blanket on a grassy patch just above the lake.  Kids splashed below in the warm water, teenage girls lounged allofly in inflatable furniture, and in the distance, people careened back and forth across the wake of motorboats.  This is one of the things that is the most difficult about going into the jail - things that are completely familiar to me, like the Uno game, in a context that is completely different to my everyday reality.  Actually going into the jail has made me realize the boundary between solidarity and being in the same boat.  I think everything that I’ve encountered about jails and prisons firmly establish where you stand.  You are a guard, you are incarcerated, you are incarcerated and in the “therepeutic” block, you are in solitary, you are in the general population, you are a family member or friend here for visiting hours, you are a volunteer.  The roles, the mobility associated with each, and the expectations of each group by the others seem hard and rigid, ruts torn deeper and deeper with all the inertia of the prison industrial complex.  I want to just think that I’m just down, but even going in with the interest of supporting incarcerated folks is mediated by the fact, told bluntly by the corrections officer who did the volunteer training, that my ability to go in is largely based on the realization that programming in the jail tends to placate the incarcerated population there.

The reading group happens in the block and has a variable number of participants.  This is affected by what people have going on at the moment and the fact that people are constantly coming in and out of the jail, coming from a DOC facility for court or returning to a DOC facility after court.  This week, only 4 folks sat down at the table, with only 1 of them having read the book to be discussed.  The book might have been part of the problem.  A few weeks ago we had decided to read A Walk in the Woods by Bill Bryson, a travel account of two middle-aged men who decide to hike part of the Appalachian Trail.  It was funny enough, and met the criteria that was established by those initially interested in the group, of having a subject that seemed to be far, far from the reality of incarceration and didn’t have the self-help twelve-steppy overtones that mark some of the other programming they participate in.  Still, a few folks expressed that they couldn’t get into the book.  My favorite response to the book that I heard was one word - “quitters”, as the protagonists seemed to spend as many nights sleeping in hotels and eating at diners as they did in the woods.  As I read through the book myself, I was a little worried that the book centered on this activity that represented an idleness and mobility; to spend weeks just hiking without worrying about jobs, families, or the things that a lot of the things that people in the jail talk to me about as concerns; that it would seem just insensitive.  Still, it’s unfair and just not true to make assumptions about people’s situations or their reactions in the context of their lives.

So what is my place here in the jail?  Reading, for all the reasons that anyone loves it, with the additional weight of it being an activity that can happen, relatively unhindered, even within the constraints of incarceration, seems to be an important part of people’s lives at the jail.  People talk about the books that they read, and pass them around.  I remember a conversation starting with “Remember that Marilyn Manson biography …”, the book having apparenly made its rounds through the block.  There’s no question that books are important to people in jail.  Having someone come in to facilitate a discussion group about books seems of more questionable value. For the men in the cell block where the programming happens, their days are filled with different groups, many of them focussed around rehabilitation, I think that one more structured activity that involves a group and a discussion just doesn’t seem that appealing.  Volunteering in the jail, there seems to be such an impasse between what corrections officials and non-profits think people who are incacerated need and what people who are incarcerated say they need.  I think that more than anything, people need to not be incarcerated, because dealing with all the other things in life become frustratingly cumbersome to impossible.  Beyond that I think the concerns of incarcerated people are the same as a lot of people that I know, obviously with varying degrees of severity: economic security, a safe, comfortable place to live, help sorting out relationships and family.  Those are such large, ambiguous things, but it’s the way I can most accurately express it.

I like going into the jail because it has made me have to reevaluate how I think about other people and about prison issues as “issues”.  But, even though I feel like I’m getting something out of my volunteer work, the exchange doesn’t exactly seem equal.  One of the men interested in the reading group said he would talk to others in the block to guage the actual interest and to get some input about what format would be best.  We talked about two things that would be an improvement - meeting once a month instead of biweekly and reading shorter works of fiction.  One thing that seems like something that I can really offer is just giving people access to books.  The Monroe County Public Library has a sweet jail library program, but the men I work with said that while they used to get to go to the library once every two weeks, they now can only go once every 4 or 5 weeks.

I’ve also sporadically tutoring math in the jail, and had been working with someone who just passed his GED exams.  Working in this capacity seems like I can offer people something of myself that seems more useful, but it’s still hard.  The person who just passed his GED said that one of the reasons he wanted to get his GED was so he could go into the armed forces when he was released.  I don’t want to see anyone join the armed forces, but I’m afraid that, facing the realities of the current economy, and the additional challenges that someone with a criminal record faces getting a job, the options are limited.  It’s so frustrating that I, and the things I believe in, can’t offer an alternative.  This makes me feel like I’m not in a position to do what people really need.  I can give people books, or some tricks to solving math problems, but I can’t give people jobs or build houses.  It makes me feel like I’m not doing the right thing. Everyone, and I mean everyone everyone and not just incarceration people, need inspiration and tools, to be sure, but it seems really narrow sighted to think that they’re enough.

Working a lot with computers, acronyms have become second nature - lately it’s been SIP and DID and PBX and a slew of other ones.  Somehow though, I’m surprised when I realize that they don’t just exist in the realm of computer technology.  I’m more surprised when, in these other contexts, they no longer seem like par for the course, this arcane language that one can take pride in navigating, but instead a frustrating impediment, a needlessly oblique interface to tasks that should be simple and painless for everyone.

Getting healthcare for the first time on my own and not through school or family health insurance and getting it through the state subsidized Healthy Indiana Plan has introduced me to an entirely new set of acronyms.  A primary medical provider, that is a family doctor, is a PMP, and your recipient ID number is a RID.  And while cold, technical terms for the participants in a network are fine when we’re talking about computers, when I think about it, it’s a little uncomfortable being reduced to a “recipient”.  Even without the acronyms, the language to describe getting healthcare quickly becomes unintuitive.

After having to change my doctor, or should I say PMP, twice because both my assigned doctor and one I picked from a list of doctors with an “active” status in the MDWise system were not accepting new patients, I ended up just calling most of the doctors on the list provided by MDWise and asking if they were accepting new patients.  It was hard to figure out what to say.  I tried using the PMP term, since that is what was used on the MDWise website, but it just seemed to confuse the seceretaries.  More confusing was when I asked if any doctors in their office were accepting patients.  Most of the doctors that are available through the HIP, with MDWise, in Bloomington are part of a large organization called Internal Medical Associates (IMA) that seems to have around 5 locations and, at least according to their on-hold message, around 60 physicians.

So, it was difficult to figure out which doctors were connected with which location and which phone number corresponded to the office of which doctor.  When I was told that a particular set of doctors wasn’t accepting patients, I was often transferred to another location without really knowing where my call was going.  One location asked me if I had to see a doctor, or if a nurse practitioner (a nurse with at least a master’s degree in nursing) would be okay.  I said either and was able to schedule an appointment with a nurse practitioner  only to then find out from MDWise that only appointments with doctors are covered.

Eventually, I found a doctor who was accepting patients, though not until September, and was able to schedule a physical.  I called MDWise and switched to this doctor and was told I would receive a new insurance card in the mail.  When I told the person on the phone that I had never received my original card, she said that there had been some delays, but that I should expect my new card shortly.  This whole process made me feel happy that I have a job that is flexible enough that I can take the time to make a bunch of phone calls during business hours.  It also made me hope that I will never have to fully master all the acronyms associated with getting healthcare in the U.S., particularly state provided healthcare.  It seems that those who have finally figured out how to navigate the system, to whom the acronyms are second nature, have done so only after a dire struggle to get themselves or their loved ones the care that they need.  I hope that I can stay healthy enough that the frustrations of figuring out how to get health care are an occasional occurence and not a constant reality.  Still, it is important to remember that people already facing the challenges of a state of health that requires more consistent care shouldn’t have to have the additional burden of wading through a bog of acronyms, redirected phone calls, and confusing or unknown information.  I can better understand why some people work jobs just for healthcare.  The idea of being able to get the care you want, when you need it, and to be treated with respect and dignity as you work through the process of that care now seems so amazing, almost luxurious.

I don’t think quality health care should be a luxury.  Perhaps I am naive enough about the logistics of providing health care to expect that everyone could have personal attention, respect, and advocacy for working out problems or questions, but I feel strongly that this should at least be the goal, the benchmark by which the heated issue of healthcare is measured.  I don’t think this is the case right now.  A friend recently made the observation, correctly I think, that the Healthy Indiana Plan is, in fact, a rather conservative proposal.  It seems designed, with it’s coverage of preventative medicine, to reduce the costs of the state from uninsured people using the emergency room and not being able to pay for it.  While it’s certainly true that using the emergency room as one’s primary medical care is not in the best interest of the patient either, my experience with the Healthy Indiana Plan suggests an ultimate goal of cost reduction and not of a positive and healthy experience for the patient.

I’ll continue to write here about my experience with healthcare, with the hope that others in Indiana can share their experiences and together we can identify problems and propose solutions to the state’s healthcare approach. Perhaps we can help share ways that we’ve been able to better navigate the system.  Finally, I want to express the way in which the idea of healthcare has become real for me and not just a topic of presidential debates or news stories.

After being told that the physician to which I was assigned by MDWise under the HIP was no longer accepting patients, and that the person I switched to after that (being told by MDWise that their system listed them as ‘active’ or accepting patients) was also no longer accepting patients, I called another practice.  I asked if they were accepting patients and they asked if I needed to see a doctor or if a nurse practitioner would be okay.  I told them that it didn’t really matter because I just wanted to establish care with someone, get a general physical, and have the sebacious cyst on the back of my neck re-examined.  They took my information, and were able to look some of it up based on my MDWise RID, and then scheduled me an appointment for next week with a nurse practitioner.

I called MDWise to tell them this and they said that care with a nurse practitioner wouldn’t be covered, it had to be a doctor. I called the office back, canceled my appointment and tried to see if any of the doctors at that office were accepting new patients.  They weren’t accepting new patients, so I continued down the list of results from the MDWise web site.  Of the people on the list that I have called so far, 10 out of 20 are not accepting new patients.  Right now I am stalled at waiting to get a call back from one of the doctor’s offices who I was told was accepting patients.

One of the biggest confusions that I have encountered is the fact that many of the doctors on the list that MDWise provided are part of very large practices (the on-hold message at one of the practices said they had over 60 physicians) at the same location with diffrent offices and phone numbers.    It’s very hard to figure out who I’ve talked to already, especially since I’ve been transferred to different offices via the phone system.  The thing that has cleared things up the best for me has been to ask the seceretary “Which doctors do you schedule appointments for? Are any of them accepting new patients?”

I have been pretty frustrated by this process so far.  Last month, I went to a forum about the FSSA privatization and how it has affected people receiving food stamp beverages.  WFHB covered the event and its worth a listen just to see how messed up the program is and how many people have been treated unfairly or just had to jump through a bunch of needless hoops just to get their benefits.  At least there was a general consensus, even by the FSSA rep there that things needed to change.  A lot of people who did get their situations resolved did so with support from their state representatives or senators.  I would really recommend that if you’re having problems with the HIP, that you contact your Indiana rep. as many actually have social workers working for their office who might be able to help you navigate the crazy HIP system.  You can look up your representatives at the state’s Who’s Your Legistator page.

I have gotten my information packet from MDWise but I had to call to get my RID number and assigned physician. Today I got my second POWER account bill from MDWise, but it said I didn’t owe anything. I tried to call my physician to schedule a physical and they said that the doctor was no longer accepting additional patients and that I would need to call MDWise to work that out. So far, my experience with the HIP has been one of a lack of communication, clarity, and knowledge by the people I’ve talked to both on the FSSA side and the MDWise side.

Update:  I called MDWise and was able to speak with someone pretty promptly.  She told me that I would have to pick another doctor and pointed me to the list (actually a search) on the MDWise web site.   She had some trouble pronouncing the doctors names which wasn’t a problem because I had the web page in front of me, but would have been really confusing if I was just on the phone.   She had to list the names because not all of the doctors were accepting patients.  She said that I should pick a doctor and call MDWise back.  She said it would take 3-5 business days to make the switch and notify the doctor’s office and that I couldn’t call the doctor I chose to make an appointment until after that.

I’m trying to be better about posting what I’ve been doing lately.  Last night, the book group I’m facilitating through Pages and New Leaf New Life in the “therapeutic” block of the local jail met for the second time and we picked the book that we’re going to read, A Walk in the Woods by Bill Bryson.  We did a rough vote and there wasn’t an overwhelming consensus so I’m going to bring in a few copies of the other books that I brought up as options including Me Talk Pretty One Day by David Sedaris, Oryx and Crake by Margaret Atwood, and The Golden Compass by Phillip Pullman.

Doing the group is challenging.  Some people are extroverted and seem to love to talk about themselves and their experiences.  Some are the exact opposite.  I feel like we’re also fighting the difficult dynamic of being a “group” amidst a lot of other mandatory groups that the men have to go through all day.  I think, at the end of the day, some just aren’t feeling another group.  People in the block are respectful and quiet, but the whole jail is noisy.  There are lots of interruptions like meds and the church group that comes in to provide worship services without notices.  I’m still getting my balance as a facilitator and trying to make it more clear why I’m there and what I’m doing and try to get past the reasonable distrust that some of the guys have for people like me.

In spite of all the challenges, we had a short discussion about a piece of writing titled The Best Time in My Life and many shared a memory or description of places and eras that they had seen pass.  For some it was rock quarries in southern Indiana, for another being towed around on an old car hood in his tiny hometown, and for another it was the closure of a vital youth center in his Chicago neighborhood.

I still haven’t gotten my introductory literature from my health provider (MDWise) or my second month’s bill for my POWER account.  I called MDWise and they said they were behind on sending them but that I should receive them “soon”.  The rep also said that I shouldn’t worry about being late on my POWER account payment because of the delay in sending out the bills.  Finally, I was able to get the name and # of my assigned doctor and my Recipient ID (RID) number so I can go and receive healthcare.  So, if anyone else has the HIP and hasn’t heard from them, call MDWise or Anthem and see if you can get your info.  You can call Anthem at 1-800-553-2019 and MDWise at  1-877-822-7196 or 317-822-7196 if you are in the Indianapolis area.

ART OPENING.

FRIDAY JUNE 27th!

7-10 PM:

WORKS BY SWAMPDONKEY (SAN DIEGO/SANTA CRUZ)

at sweet hickory!

(317 east 3rd in bloomington)

drawings and mixed media work by california based graffiti artist “swampdonkey”

for more information call 812 369 5284