Money Makes the World Go Round.

About 3 years ago I sat down with the COO of a private insurance detox/rehab facility. I asked him why it was not possible for that facility to accept Medicaid-reliant patients who carry the same diagnosis. He helped me understand the basic issue involved. 

It boils down to money:

Private insurance pays (in round numbers) $800 to  $1,000 per day for professional services. Medicaid pays $150 to $200 per day for the same. That is a staggering difference in reimbursement. There is no way for a private insurance facility to provide proper services as per its philosophy on what those services should be at the Medicaid rate of reimbursement.

Money Makes the World Go Round.

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As I shared with you in a previous blog, one Medicaid reliant couple who I've been getting to know in recent weeks shared with me how much money it takes to purchase the drugs that they feel they need.  They must spend $500 in a 24-hour cycle.  That's $250.00 for each of them 24 hours each day, 365 days each year including all holidays.

For every 24 hours that this young couple is in active substance use, she as the female in this deeply committed heterosexual relationship must earn $500 by doing ‘dates’ with random men who pick her up.[1]

Think about that and now think about this…

At the Medicaid rate of reimbursement, these two individuals[2] are earning more money in any 24-hour cycle through prostitution[3] to support their addiction than is being paid through Medicaid to provide healing to them from their addiction. 

Money Makes the World Go Round.

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The males who provide the funding for sexual 'services' are often referred to a 'Jawns.'

Collectively, Jawn[4] reimburses for sexual 'services' women in addiction on the streets of Kensington at a substantially higher rate than does Medicaid provide for professional healing services to this same population.

If Medicaid paid more than 'Jawn' we just might see more healing.

Money Makes the World Go Round.

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[1] Additional perspective: If each 'date' earns her an average of $50.00, that is ten 'dates' that she must perform in every 24 hour period.  It's not 9-5 or 3-11 or 11-7.  It's every 24 hours around the clock.

[2] who very much would like to be healed from the active use phase of their substance use disorder

[3] and all the hazards thereof

[4] Sometimes used as a first name of sorts when referring to one.

The Christmas Eve Steady Beat of the Little Drummer Boy at the Corner of 'This and That'…

As I sat at the street intersection of "This and That Streets" on this Christmas Eve, the steady beat of the Little Drummer Boy continued with its all too well-known rhythm of life on the streets of Kensington.

There was an increase in the desire for connection through conversation on this night in which the world of the healthy celebrates the Birth of the Lord.  

This is the world of patients with Substance Use Disorder who are forced into prostitution by a Medicaid reliant medical system that knows not or cares not how to bring healing to its patients. 

One woman of mid-twenty years whose appearance is that of an 11th-grade girl waiting for her school bus sat on the back bumper of my opened trunk car with me as if it were a park bench at her bus stop or in McPherson Square.  She shared with me the resentment that she feels in being the sole income provider for her and her long-time boyfriend.  As the woman in their heterosexual deeply committed relationship, it is her systematically understood role to make herself available to random jawns[1] for their own selfish sexual purposes for a price so as to provide funds for her and her lover's medicinal needs.

A very short time later in this evening, this evening otherwise awaiting the Birth of the Christ, I watched as she entered two cars within one hour on this Holy Night.  She can't take a break for this night or any night, afternoon or morning because she must raise about $500 per twenty-four-hour cycle so as to support the untreated addiction that she and her lover would rather not have that lives on and thrives on within them both.

It is her long-time lover's systematically understood role in this ongoing rhythm to allow her to be rented for her sexual 'services' to unknown jawns.  In a separate conversation with him on a different night not long ago near the same intersection, I told him as his back was deliberately turned away from her so as not to see her leave on her rented rounds that "She just got into a dark-colored Ford pickup truck with a New Jersey tag."  His response with a noticeable sense of sad relief was "Oh good.  He's a regular."

At the same intersection, as she and I sat and chatted, another woman paced and paced with the goal of renting herself.  Jawns are slower to pick her up for reasons that go beyond the point of this blog.  As she paced and paced, I asked her at one point if she would like my typical handouts of a banana and water.  She said 'Yes.' 

On this Night of Holy Anticipation, I asked her if she would like to read about the Birth of Jesus from the atypical 'song sheet' that I was sharing on this night.  Her response while she was pacing in the 'Rent me.' lane at the intersection of "This and That" was a surprisingly sparkle-filled "Oh.  Yes.  Please." 

She gladly took the sheet of paper to be read later.  For now, however, she needed to negotiate a price for service with the driver of the car who had just pulled over to check her out as if she were a piece of meat on display at Outback Steak House.  She got in and off she went with a random 'jawn' to her left in his driver's seat and a deliberate chapter 2 of the Gospel of Luke to her right in her pocket.

The Christmas Eve Steady Beat of the Little Drummer Boy at the Corner of 'This and That'…

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[1] The term used by these women when discussing these males

Isn't there a better approach?

Over 5 years ago, I truly believe that God led me to the streets of Kensington.  Two totally unrelated storylines in my life got me there.

In this time I've come to know and love so many people who call the streets home.

Some have found healing and moved on in amazing, new, and revitalized lives of their own.

Others have died by overdose or medical situations secondary to their drug use.

And then there is a third category of loved ones who rips my heart to shreds…

These are the men and women who are growing increasingly physically debilitated and emaciated.  Whatever degree of healthy weight they may have had at one point has reduced itself to a living and breathing skeleton of their former self.  Some are riddled with abscesses while others are on the verge of losing one or more extremities.  Teeth are falling out or totally gone.  

And I'm supposed to just sit back and not say anything directly to them because people tell me that would be rude.

It's extremely painful to watch a loved one or multiple loved ones seemingly run and run hard toward their own casket.

Isn't there a better approach for loved ones than to just sit back and wait for that phone call informing me that the run is done?