Calling ALL Bulldozers! It's time to Plow Down Medicaid Mountain!

In my role as a driver for RCA[1], I have had the privilege of bringing in one person at a time for the beginnings of their detox/rehab experience and to be relieved of their often years-long relationship with their drug of choice.  Very often, they did not know when they woke up that morning that they would be concluding their day at RCA.  It took one decision to call 1-800-RECOVERY to get the proverbial ball rolling.  Within a very few hours of making that call, I pick this person up in a fully loaded black Ford Explorer.  Upon arrival at RCA, this person is receiving the care that they deserve and in an environment of dignity and respect.

Recently, as I was preparing to go get one of these people, I was hearing by way of Facebook messenger, from a person I've known for a couple of years who lives on the streets of Kensington.  They had been admitted to the Temple Episcopal Hospital Emergency Room for withdrawal-related seizures.[2]  Once the seizure issue was resolved, this person was discharged with instructions to go to the NET or Hall Mercer, two different crisis centers that serve Medicaid reliant Substance Use Disorder patients.

Let's look at this incident more closely:

This homeless person, a woman reliant on ‘dating’ to raise funds for anything and everything, was discharged to walk ‘home’  - a piece of sidewalk on Kensington Avenue - and/or make her way by foot having recovered from seizures and still experiencing dope sickness - to one of two places many blocks away. 

Here's a visual of her three options:

It's an hour and 3 minutes
for a strong and healthy person to make this walk.

It's an hour and 20 minutes
for a strong and healthy person to make this walk.

Even walking at half speed due to dope sickness,
it's a 16-minute walk to find a 'date' and relief.

Once at either of these crisis centers, if she was to arrive there at all, she would be required to go through the same experience that 'George' did in this blog that I wrote contrasting Substance Use Disorder health care providers depending on your insurance: private or Medicaid.[3]

Now put yourself in her shoes for a moment:  She's convinced after all these years that she's a worthless piece of garbage, not even worth the breath she breathes.  Nothing matters and death in inconsequential.  Which is easier:  

1. Dope sick and potential seizure filled walking an hour and 20 minutes to reach Hall-Mercer or
2. the same walking an hour and 4 minutes to reach the Net so as to wait at either place for many more hours and MAYBE be admitted for her much needed services or 
3. walking 8 to 16 minutes so as to be in the general area where she can find a guy or two with whom to provide some degree of sexual service so as to 'earn' the very few dollars[4] that are needed to buy the 'medicine' that she must have to relieve her dope sickness?

Each person I bring to RCA is a human being made in the image of God and is worthy of dignity, honor, respect, and love.  They receive the care they need and deserve.

My friend from the streets of Kensington who is also a human being made in the image of God and worthy of dignity, honor, respect, and love, upon discharge from that emergency room is probably doing a dope sick date to raise funds for her next dose of ‘medicine.’

RCA is doing everything right and nothing wrong in providing high-quality care to their private insurance patients of Substance Use Disorder.

Temple Episcopal Hospital committed a grave error in violation of each medical professional's Hippocratic oath by discharging a Medicaid reliant patient in their care to the streets, an error that could very well send this person who is equally worthy of and in the need of care to their premature grave.

It's time to Plow Down Medicaid Mountain! << Click to read more.

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[1] Recovery Centers of America in Devon PA.

[2] Withdraw related symptoms on the street occur in two basic ways.  The person has either not been able to get the 'medicine' they need or they are trying to self-detox.  This second choice is extremely uncomfortable and dangerous.  What I know of this particular person, I believe that they were trying to self-detox since she had been told by Hall-Mercer a couple weeks ago to leave since there were no beds available.

[3] If you've not already read that blog, I encourage you to do so.  'George' is a fictitious man.  The description of the crisis center that he goes to is Hall-Mercer.

[4] If she's paid at all, it may be $5.00 to $20.00 per "customer."  One bag of 'medicine' is $5.00 and this is all it will take to relieve her of her dope sickness (and potentially kill her).

Hippocratic Oath: Modern Version

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.