There is an obvious answer to this piece by Chris Arnade: Don’t abuse drugs and the problem goes away. If that makes sense to you, read no further. If you care about the woman in the picture because she is a human being, read on . . .
Ted Cruz and Obamacare critics clearly don’t get it
Opponents of reform don’t see how lucky they are to have easy access to healthcare. For homeless addicts, it’s a different reality
Chris Arnade
The Guardian
Homeless drug addicts fall through the cracks in America’s healthcare system. Photograph: Chris ArnadeI arrived at 9am as planned, with $10 in my pocket and a sheet of phone numbers. Sonya was missing, her corner space now just a bed of cardboard, a bundle of dirty blankets, broken needles, and a Bible. Her kitten was gone, presumably given to a friend to watch, or maybe it fled, scared by the roar of semi-trucks only 10 meters away.
I walked the stretch of the Bruckner Expressway in the Bronx, New York, where she begs for money.
At 10am I found her leaning against a pole. She smiled, “I just need to get straight before I go”. I have learned the language of addicts. She was talking about one last hit of heroin before entering detox. The thought of being dope sick in a waiting room is just too much.
Nobody had drugs available this early; she had to call for a delivery that came an hour later.
Most of her veins are dry, shriveled from overuse. Except in her foot. She took off her shoes and asked for privacy:
My feet really stink, sorry, get all soggy in these shoes. Out here you can’t really wear heels.
I grabbed her small purse, once red but now black. Inside was her paperwork: an expired driver’s license from a happier time, a Medicaid letter crumpled and torn. I struggled to make out her information; maybe it was a letter E or an F on her Medicaid ID, maybe a three or an eight. I wrote down the different possibilities.
I waited in the car, calling different hospitals and inpatient programs that accept those who only have Medicaid. Most calls went to voicemail, doomed to become messages unreturned. Forty minutes of calling netted me three rejections, all the places were filled or needed proof of residence. I explained she slept under an overpass. They shrugged. Rules are rules.
Desperate, I called a place nearby, a place most addicts hate, a place with “nasty doctors and nurses who treat you like shit”.
“What is her Medicaid ID?” I repeated the numbers and letters. “What is her drug of choice and when was the last time she used?” I looked over at Sonya, still hidden in her corner, working on her foot. “Her drug is heroin and the last time is five minutes from now.”
They had a bed. She slept in the van as I drove, overpowered by a bar of Xanax she neglected to tell me about. She slept again in the drab detox intake room, filled with others desperate to be clean. The smell of urine and bleach was overpowering.
US Senator Ted CruzTwo college kids were giving a lecture on healthy eating, passing out flyers. They left one on Sonya’s lap.
After an hour of confusion, she was turned down. Her Medicaid coverage had expired. Renewal letters never reached her patch of dirt she calls home. Sonya returned to her spot, coiled on the cardboard and collapsed into the blankets, the Bible under her head.
I have tried about 15 times to take homeless addicts to detox. Only twice has it worked, and only after days of navigating misinformation and filling out paperwork.
One addict was turned down after eight hours of driving from clinic to clinic, because they were not in withdrawal at the time. I asked what in the hell I have to do to help get an addict clean. A doctor, angry at his time being taken, responded:
Just drop them off sick at the emergency room. They have to take them.
I did that once, waiting amongst families with ill children, families who are forced to use the ER as their primary care physician. We waited five hours. It ended with the addict running into the street to vomit, sick from withdrawal, his pants soiled.
After dropping Sonya off, I drove home. The radio news was filled with reports on Senator Ted Cruz’s 20-hour marathon rant against healthcare reform, which includes an expansion of Medicaid to cover an additional 21.3 million people.
Ted Cruz has access to wonderful healthcare coverage, available either through his government job or his wife’s job at Goldman Sachs.
I also have secure access to quality healthcare, because of my prior job on Wall Street. Unlike Sonya, when I was battling a penchant for beer, I had many luxurious options: weeks away in a country estate or a private suite that offered family visits. I never went that route, but it was always available to me and others as fortunate.
I understand now, after so many frustrations and failures dealing with one of America’s most neglected and at-risk populations, how lucky I am to have those choices.
Ted Cruz does not.
