This is a story, true story about a woman dying of cancer who has lost TennCare. Her story is not unique but the fact that this is happening tells me that ethics and “for the good of the people” are gone in government.
The woman is Beatrice, age 60 and she has terminal lung cancer. Beatrice has several health issues but for the moment, I will tell you why TennCare decided that she is no longer eligible for medical care.
All the reasons Beatrice lost her TennCare(this comes straight from TennCare Medicaid Rules):
Her cancer is not cervical cancer.
Her cancer is not breast cancer.
She is not a single mom with minor children.
She is not in a nursing home yet.
She is not a pregnant woman.
She is not a child under the age of 21.
She does not receive SSI from the Social Security Administration.
Now I will explain the rest of Beatrice illnesses. Beatrice has not mentally developed much past the maturity of a pre-teen (low IQ). She has delusions that started for her at age forty, which is treated with a medicine called Zyprexa. Currently there is safety Net for Mental Health, but no one can tell me when the safety net will end for her mental health treatment.
Who Cares?
TennCare is saying it does not care about Beatrice even if she is poor and dying of cancer. She is currently on a Safety Net program that will pay for only a certain number of Chemo treatments, but it will not pay for CAT scans to monitor progress of the treatments. Since the doctor is working blind without a CAT scan he is treating her symptoms, (but of course, he already knows she is dying of lung cancer). The doctor gives her a break from Chemo when she appears to be feeling all right at that moment. Recently she started coughing up blood so she is receiving Chemo treatments at this time (Feb. 2006).
TennCare Rules vs. Knoxville Legal Aid Rules vs. Health Department Rules
Once the Safety Net money runs out, Human Services has told Beatrice that one of the Knoxville Health Departments is offering Chemo to cancer patients. However, Beatrice may not be eligible because she lives with her daughter. Her daughter wonders if that means they want Beatrice to be homeless before they give her any medical services at the Health Department.
Although TennCare rules never considered the income of her daughter, the Health Departments do and the Knoxville Legal Aid does as well. This means that the Health Department will not help Beatrice with Medical and Knoxville Legal Aid will not help with any TennCare appeals. Someone at Knoxville Legal Aid said they do not fight TennCare cases where the eligibility requirements just do not fit the plaintiff. I can under stand them not wanting to fight a losing battle. I just do not understand why so many are losing something they so desperately need.
Sadly, all the resources given to Beatrice have referred her to other resources only to find out that she cannot qualify under the different rules of the different organizations. To add insult to injury the amount of money that her daughter makes over the limit for Knoxville Legal Aid was $400. If she took that $400 to a lawyer, would he represent Beatrice?
What is Wrong or Right?
Is it wrong ethically that you will help someone to get medical care then take it away while they are receiving it? Would a doctor do that? Would a government do that? I guess we know the answer to those questions, but can we accept that answer?
Do Not Feed Your Dying Mother and We Will Help Her?
Beatrice lives with her daughter because she has nowhere else to go. Her daughters’ family has six people now including Beatrice. Money is stretched very thin under these circumstances. Can her daughter pay for Cat Scans at $5000 each, or Chemo treatments (amount unknown), or medicines (over $400 last count)? The answer is No. Her daughter can only house her, and feed her. The health department suggested that if Beatrice did not eat with her daughters’ family, then Beatrice might be eligible for Food Stamps. Her daughter cooks for the whole family every day. They all live in the same house so, should Beatrice be told to not to sit at the table with everyone else? Beatrice’s daughter is now the caregiver and the transportation to doctor visits for Beatrice.
Encouragement from Human Services, Lack Of
After losing her TennCare Appeal, Beatrice was encouraged to re-apply for Medicaid. She did and at her Human Services appointment, Beatrice was told that she of course still does not qualify and that she would receive in the mail her denial letter. She was told to watch the news because the governor was talking about adding back some of the medically needy people. I have just learned that the rules for that category will also not let Beatrice qualify because her un-paid medical bills are over 90 days old. (One of the rules is that medical bills must be less than 90 days old). Other restrictions do not apply to Beatrice and her situation but do restrict eligibility of many other medical needy folks. In fact very little of the rules actually address the medical necessity of an individual. So, why is it called a Medically Needy category again?
The Pain
When the chemo has stopped, Beatrice will die a painful death. That is the only thing keeping the tumors down in size. When the tumors begin to grow, they will be painful as they take up the space inside her lungs. It will be harder for her to breath and her back will hurt her a great deal. She will cough up blood. Then she will die, in pain.
The pain for her family will be watching Beatrice suffer. Later the family will receive a hospital bill in an amount they know they can never pay. At that time, the words of Beatrice will haunt them. “Why are they taking my medicine away, don’t they know I will die sooner without them?” They do know this, and that is what I have had to tell my mom (Beatrice). She does not understand why someone would hurt her like this and I do not understand either.
