| MAMIE JACKSON
MAMIE JACKSON has been working her way through the
bureaucratic red tape of private and public insurance
since her kidneys failed in 1990.
A federal law helped the Studio City woman, now 51,
qualify under Medicare for coverage of the dialysis
she needed for several years and for the kidney
transplant she received in 1996. "I'm not a senior,
but once you go into kidney failure, Medicare kicks
in," she says.
Kidney failure has been covered by Medicare since
1972, shortly after Shep Glazer, a kidney dialysis
patient, was wheeled on a gurney into the House of
Representatives where he testified before a committee
— while being dialyzed. Shocked that such care was
being denied to patients who could be saved, Congress
passed the End Stage Renal Disease amendment to the
Medicare Act, and kidney patients became the first
disabled people younger than 65 who could qualify for
Medicare. Today, 6.7 million disabled people, in
addition to 35.6 million elderly people, qualify for
Medicare, according to the Centers for Medicare and
Medicaid Services.
Before she had health problems, Jackson was upwardly
mobile, moving from Southern segregated poverty to the
world of academia. She has childhood memories of
marching for civil rights with her mother in Mobile,
Ala., facing off snarling dogs and meeting the Rev.
Martin Luther King Jr. Her mother worked as a domestic
employee after Jackson's father, a longshoreman, died
in a dock accident.
Jackson and her five siblings, pushed by their mother,
got good educations. "But I was the overachiever. I
got several degrees," she says, the last one being a
master's in organizational management from the
University of La Verne.
At the time her disease hit, she was a professor at
Cal State L.A. So in addition to Medicare for
treatment of kidney disease, she had health insurance
to cover the needed drugs.
But over the years, she got weaker and sicker,
eventually giving up full-time work for consulting and
buying her own health insurance. "The more ill I
became, the more they increased my premiums," she
says.
Finally, she could no longer afford coverage. She
began burning through her savings to pay for the
thousands of dollars worth of drugs she needs every
month to combat rejection of the transplanted kidney,
and to treat high blood pressure and diabetes.
What she did is known as spending down — literally
impoverishing oneself in order to qualify for
Medi-Cal, the state health insurance program for the
poor. A single person qualifies if monthly income
doesn't exceed $812 and assets total $2,000 or less.
With her medication bills, it wasn't hard to get to
that level.
"Once I no longer had the HMO, I was paying retail,"
she says. "I take 27 drugs a day. It just wiped me
out." Once she had nothing, Medi-Cal covered her
drugs.
The coverage worked pretty well — until the new
Medicare prescription drug benefit took effect Jan. 1.
It provides limited drug coverage for people on
Medicare. If those people previously qualified for
state Medicaid programs, called Medi-Cal in
California, they were switched to the federal drug
plan. A March 21 report by the California HealthCare
Foundation found that those people, called "dual
eligibles" in bureaucratic-speak, have access to a
narrower range of pharmaceuticals than they had
before.
Again, Jackson is back to studying her options.
She has taught, written, sung gospel and traveled
extensively before coming full circle back to poverty.
"I've adjusted my life to where I don't need a lot of
money," Jackson says. Along the way up and back down
the income scale, she's experienced just about every
configuration of healthcare coverage available in America.
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|
2006 National Organization For Renal
Disease.
