Tag: Washington DC

Vince Gray’s election on Tuesday night as mayor of Washington, DC, was met with a curiously nonchalant response among city residents.  No one seemed much inclined to celebrate.  A city that is famously buttoned-up and all business, all the time, was precisely that.  The prior mayor, Adrian Fenty, was widely seen as a temperamental prima donna, but this election was less a vote about specific District issues as it was a referendum on his leadership.  The results, a decided victory for Gray, were a backlash among many towards Fenty’s perceived stance in favor of more affluent parts of town, particularly those in the Northwest quadrant of the District.  This is far from an uncommon phenomenon.    

Since I moved to Washington, DC, I have obtained piece by piece of a massive jigsaw puzzle.  No one bothered to explain the rules, or what the picture is supposed to look like when you’re finished with it, but that’s just not how things work here.  Because I don’t believe that truth ought to be granted on a need-to-know basis, I have written about what I’ve uncovered.  Perhaps enough of us will chip away at the Sphinx long enough to find the answers to the riddles it holds close to the vest.  What follows is another one recently explained.

Across the board frustration at Washington, DC, will characterize this November’s elections.  The question on the minds of many is why, despite the promises to the contrary, nothing gets done and the situation gets worse and worse with every passing year.  To answer this question, one first needs to examine Washington culture in detail.  To begin, it is insular, frequently secretive, and suspicious of outsiders.  Capitol Hill dictates a more or less common mindset among everyone who lives here.  And, in all fairness, one really needs to get involved on the inside to totally understand its riddles.  I firmly believe that reform is possible, but, on the difficult matter of a solution, the analogy I always use is that of the Gordian Knot of Greek mythology.  This was an impossibly entwined knot that was eventually undone by a bold stroke of the sword, rather than through a probably hopeless desire to devote hour upon hour in the hopes of eventually untying it.    

Generation after generation of politicians running as Washington outsiders have railed against the established system.  Lambasting corruption and inherent evil has been an effective populist message for a long while.  We saw it from one party in 2006 and 2008 and now, in 2010, we observe it in another.  Every generation appears to have been sold the same basic message. But after each wave of reformers finds the going perilous and true change difficult, we engage in an equally long-running tradition, that of demanding why.  Why is this institution so resistant to change and so stubbornly ingrained?  Where does one even begin?

Today I scheduled an appointment with a GP for my yearly checkup. I’m not physically sick or injured at the moment, but I figured it would be worthwhile setting up an appointment anyway. While on Medicaid here in the District, an insured person is required to establish a particular primary case physician.  This PCP is based at a specific location and is, of course, the person one sees in the event of a serious illness.  I had meant to do this long before now and finally got around to it.

Last night, voters rejected the Washington, DC, establishment, signaling an electorate eager to take out its anger on political insiders of both parties.  Channeling dissatisfaction with the nation’s capital has long been the meal ticket for candidates espousing a strong populist streak.  Such is the nature of this election cycle.  Having established that, I thought I might try to add my own perspective as to why Washington runs the way it does.  Close to a year spent here has given me ample opportunity to observe many of its idiosyncrasies and quirks.  While I have certainly not been privy to the private world of the federal government, I have experienced a multitude of other meetings, gatherings, and functions which have inadvertently or deliberately mirrored that of the seat of power.

Nine months spent in Washington, DC, has provided valuable insight.  Beltway insiders and area professions are their own breed.  As I’ve gotten my sea legs, more and more of their world makes sense to me.  Once I arrived here that I was immediately given some particularly infuriating advice, namely that other people were just as smart as I was, if not smarter, and that I ought to get used to it.  I think he assumed I was just like everyone else—the latest newcomer eager to play the game in a town with more than its share of naked ambition and power plays.  Perhaps he was the latest candidate for burnout, having recognized that institutional idealism is often an exercise in minutia.  Though my background and my academic career may be relatively humble, I am no stranger to elitism when I see it, and I am just as repulsed by it now as I ever was.

Last night I attended a Happy Hour/meet up pitched by an outreach advocacy group called Women, Action, and the Media. The organization’s stated object is to combat the still-shockingly vast degree of gender inequality that exists in the field and in so doing move towards complete parity. Moreover, the gathering was designed in particular to network, as the group itself notes, media makers, activists, academics, and fundraisers. I agree very strongly with the sentiment, so I decided to attend in order to see what other people had to say.  My hope was that I might have some interesting, enlightening conversations.  Suffice it to say that I was not disappointed.  Yet, I nonetheless began to get a greater picture of the challenges facing not just women’s rights but also those of all those who are a part of the media to some degree or another.  Many of these pitfalls standing in our way have nothing to do at all with sexism and or even the Old Boy’s club of the mainstream media.

Welcome to Washington, DC, a world of think tanks, non-profits, and journalistic enterprises.  One could also call it paradise for the Type A personality, the person who enjoys regimenting his or her life with military precision.  It is heaven for those who enjoy having each and every hour in the day filled with something and who learns to divide his or her attention between the task at hand and glancing down at a Blackberry. In this town, it often seems like everyone meets someone for a drink after work, but only for an hour or so, since there’s always something else terribly important to do after that. Many of the movers and shakers present were very much indebted to that sort of lifestyle, the basis of which I have frequently been critical because it seems designed to produce inevitable burn out, if not a heart attack.  But I digress.

To qualify, my skepticism is not directed towards those whose energetically articulated vision was to change the world, which was true with just about everyone I encountered. We need more people who love what they do and are enthusiastic about it. Instead, my reservations focus squarely upon organizational structure.  These sorts of outfits build whole galaxies of worthy initiatives, training seminars, and important-sounding programs that manage to exist in complete isolation, totally unknown, to the other 5,000 similar organizations covering much the same ground. True networking does not involve finding ways to achieve a higher paying job or padding one’s nest. Rather, it takes into account the idea that by combining forces and getting on the same page with those covering the same relative territory, gender justice can proceed forward and efforts to encourage it might become a reality.

These days I am not easily impressed when someone rattles off for me the particulars of whatever they’re working on right now.  I know they’re not trying to impress me, of course, and I know they really do believe that their initiative to say, encourage media participation for women in third-world countries is going to make a huge impact.  On a very limited basis, it will do good, but unless paired with other forces, the plan will be a mere drop in the bucket.  Unless serious efforts are made to reach out and build bridges of communication, whatever gets set forth and put into action is just another dot in a sea of similarity.  DC, after all, reflects the nature of Congress, whose own esoteria and minutia often end up submerging worthy bills and legislation under the deluge of statutes, procedural measures, and utterly useless proposals.

Sometimes I think the biblical story of the Tower of Babel is meant to illustrate the point. These organizations, like the Tower itself, grow taller and taller and taller, but they don’t grow outward that much, and in so doing don’t easily reach out to others. Instead, they are in love with their own language, just as much as those in the story used their own lingua fresca to serve as a common basis for organization. The Tower of Babel was not built for the worship and praise of a higher purpose but was instead dedicated to the glory of humanity, to “make a name” for the builders.  I don’t believe that that DC organizations put forth their agendas with malicious intent, but they nonetheless mirror the way things have always been in Washington, a course of action which has proved to be not especially effective in the long run, a viewpoint currently shared by a majority of Americans.  One can work purely to climb the ladder or work to advance humanity’s understanding.

I took liberty with one other issue.  Some in attendance last night were well-connected employees for Mainstream Media outlets.  They talked excitedly about the ways that newspapers had adopted New Media tactics and as such were hiring lots of bloggers to keep pace with changing times.  Again, do pardon my skepticism.  I myself have never seen any of these jobs posted anywhere and the few somewhat like it that are advertised are quickly snapped up by those who have impressive credentials.  As it is with so much, these sorts of positions are the domain of the well-connected and often the well-heeled, further casting doubt on a system supposedly predicated on the idea of meritocracy.  One mustn’t forget that blogs sprung up in opposition to attitudes such as these and for a very good reason.

The system itself is flawed in lots of ways, from the Old Boy Network, to hiring practices which insist a person have exacting credentials to even be considered, to tactics which feign to introduce citizen journalists into the picture while more or less keeping the status quo intact.  The intersectionality which we seek within our own movements must be that of both action and intellect, else our own hard work and idealism produce frustratingly minimal results.

But he, knowing their thoughts, said to them, Every kingdom divided against itself is brought to desolation; and a house divided against a house falls.

The circular firing squad over the defeat of Martha Coakley and what this means for the Democratic Party and Health Care Reform got underway a couple days ago.  I’ve said my bit, and have nothing further to add, but I’d rather address the potential challenges facing reform aside from the loss of a seemingly filibuster-proof majority.  It is now absolutely imperative we push forward and bring a bill to President Obama’s desk.  Our backs may be against the wall, but perhaps it will take abject panic and fear to rouse our complacent, weak-kneed Democratic legislators towards the goal.  If it takes the shock and dismay of a humiliating defeat to break the logjam, then so be it.  I’m not concerned with speculating as to how we got here; I am instead consumed with what we learned from it and how we will use this tough lesson to think of others and their needs rather than ourselves.  

What I have noticed in my own struggles to obtain low-income health insurance is how class and race ensure that government subsidized plans are underfunded and often dysfunctional, but money (or the lack of it) seems to be the most powerful determinant of all.  What many have noted is that basic selfishness is what threatens to derail any efforts towards changing the existing system—namely that people who have always had sufficient coverage do not understand the limitations faced by those who do not.  We can call that privilege if we wish, but that term has always seemed accusatory to no good end to me, and my intent is not to chastise anyone but to make many aware of the challenges in front of us that never get much in the way of attention.  In my own life, I can say that I have now seen how the other half lives for the first time ever, and I noted that they live lives severely impeded by the tremendous limitations and senseless complications of the existing system.

I have been unemployed or at least severely underemployed for several months.  As a result, I had no choice but to file for government assistance.  When I was finally granted food stamps I signed up as well for a local DC funded health insurance plan.  What I have discovered in the process is that since the Recession hit, social service agencies in DC have been swamped by new applications for every existing option currently offered.  According to one worker with whom I spoke, claims have tripled since the bottom began to fall out of the economy.  The system was barely able to manage the number of filings in more stable times, and now it has in large part ground to a halt if not slowed to a trickle.  New claims are supposed to be processed in no more then 30 days from approval, and I was forced to make several time-consuming, additional calls to the proper department to even get the coverage activated.  Those without the time or without the persistence likely will be granted nothing at all and this simply should not happen.  

My great point is that without the infrastructure in place, it doesn’t matter how many people to whom we grant coverage.  Ensuring that everyone can get their teeth cleaned, fillings filled, broken bones set, flu-like symptoms properly treated, diabetes regulated, or depression adequately under control is the ultimate goal, but we must also be sure to build a sufficient number of clinics, medical centers, doctor’s offices, dental hygiene practices, well-stocked pharmacies and all the rest.  They must be built in proper proportion to need and since humankind has never been able to curtail its zeal for making money at the expense of the health of the financial system, we need to devise strategies to build these things for both good times and bad.

In DC, the low-income, government-funded system forces the poor and/or disabled to a handful of centers scattered across the District itself.  Visiting a private doctor or specialist is not an option, since coverage is only granted to those who use these designated centers.  Likewise, pharmacies and medication dispensation function under the same parameters.  Using Walgreens, CVS, Rite Aid, or other commercial medication fillers is not allowed under the plan.  Though there are a score of specific pharmacies which take the DC plan, in my case, there is only one pharmacy in the entire District that fills psychiatric medication, and for me it is a 35 minute trip, one-way via public transportation and then by foot.  The pharmacy itself is attached to a Mental Health services clinic which is the sole site whereby psychiatric care is provided for a city of roughly 600,000 people.

Without enough workers to process claims, grant coverage, manage medical records, or attend to even the most basic of needs the system is essentially worthless or at least incredibly inefficient.  Without enough revenue allocated by governments from taxation or other means, it doesn’t matter how snazzy or up-to-date is any system designed to speed up or modernize the system.  Window dressing is window dressing.  Without the money to properly stock a pharmacy, medications will be obtained on a priority system and as such, meds that are rarely prescribed or are very expensive will rarely be on hand when needed.  For example, one of my medications, Parnate, is an MAOI inhibitor.  Parnate is a very powerful anti-depressant that is infrequently prescribed because with it comes potentially dangerous, even deadly side effects if I do not take care to abstain from eating certain foods.  As you might expect, it is not one of the more common prescriptions, but it is essential to my lasting health and quality of life.  A commercial pharmacy usually has it in stock, or if it does not, it can be quickly ordered or is certainly in stock at some other store in the immediate area.  With the government-subsidized pharmacy I must use, if that particular drug is available at all it is due purely to chance and luck, and if it needs to be ordered, it may be a week or more before they have it in stock.      

Regarding visits with a GP, specialist, or other specific health practitioner, some clinics and centers accept walk-ins or schedule appointments within a reasonable time frame.  Some do not.  For those who need surgical procedures or more invasive treatment, one might be expected to wait months.  When I still lived in Alabama, there was approximately one Medicaid-accepting clinic for the entire state that performed the procedure, and as such when it came time for me to have a very routine, non-invasive treatment, I was booked four whole months in advance.  In more affluent, usually blue cities and states, the wait time is often less, but it can still be a bit on the lengthy side.  As for me, I found to my utter dismay that my coverage was terminated before the procedure could be even performed after the clinic filed and billed Medicaid for the cost of the preliminary screening.  Someone must have realized that to save cost I was not what they deemed a “high-priority” need and thus I could be safely removed from the rolls to save money in what was a system already in danger of being completely depleted of funds.    

An important distinction needs to be drawn here.  The DC-based coverage I have been talking about is different from Medicaid or, for that matter, Medicare.  This coverage augments or seeks to provide coverage to those who either have Medicaid/Medicare or cannot get approved for it.  This is why the rules, parameters, and hoops to jump through are more severe.  Medicaid usually allows a person to pursue more orthodox means of seeking treatment.  Though some medical practitioners do not accept it because it usually pays out less than a gold standard coverage plan through a private insurer, many do.  Again, money is a big factor at play.  If Medicaid were capable of paying out at a sufficient rate, everyone would take it.  If it wasn’t at times forced to pay out much later than a private carrier or even being forced to issue IOU’s when monetary shortfalls and partisan bickering delayed enactment of a satisfactory state budget, then it certainly would be on par with usually employer-based coverage.

Yet, it is very disingenuous at best for those who oppose health care reform to stubbornly dig in their heels and express haughty indignation that they are NOT going to have “the government” take away their right to choose their doctor.  The only way this would ever happen for most is if they lost their insurance altogether, lost all their personal savings, and lost the ability to come up with the money to see a well-compensated physician and/or specialist.  Their worst-case-scenarios and numerous reservations are true only for those living in abject poverty, or at or below the poverty line.  The wealthier among us have any number of lifelines, be they family, co-workers, friends, fellow members of a particular group or club, or other sufficient means.  Those at the bottom have none of this upon which to rely.  Friends, family, and others are just as impoverished and less fortunate as they are, and they have no choice but to take and use what they can get.  And taking what they can get means dealing with a system that is convoluted, needlessly complex, inconvenient at best, and regimented to such an authoritarian degree that even obtaining the minimum often is an exercise in debasement.

If ever we had a need for revolutionary reform and change, now would be it.  Decades after a declared War on Poverty, we still have many battles ahead of us.  We haven’t really given this matter anything more than perfunctory attention, and we haven’t really allocated resources of any significant means to this very pertinent cause.  Doing so would require us to understand exactly how fortunate we are to have been granted, by complete luck and chance, the socio-economic status of which we were born.  For some quirk of God, fate, or nature we do not get the right to choose our parents or to choose our upbringing.  But we do have the obligation to see to it that those for whom daily adversity is not an abstraction have the same rights that we frequently take for granted.  I am not seeking to lecture, nor to hector anyone, but rather to strongly emphasize that our continued success as a people, a party, and a movement demands that we seek to assist the poor and the less fortunate.  Our wallets, billfolds, and bank accounts couldn’t open fast enough to provide aid to suffering Haitians.  If only this were possible for our own poverty-stricken citizens, many of whom struggle through conditions not that dissimilar to those we now view through heart-wrenching news reports and graphic photographs.  After all, it might be you someday who faces the disquieting realization that our health care system is designed for the wealthy, by the wealthy, and in so doing realizes just how much you took it for granted.

A few weeks back, I wrote about my trials, travails, and tribulations achieving food stamps.  I am pleased to report that due to my own persistence and the fantastic support of an advocacy agency, I was granted an EBT card.  Earlier today I trudged through areas of town which have not seen much in the way of a plow or a shovel.  I literally did have to walk a half a mile uphill in the snow both ways to arrive at the proper place, though I’ll save that lecture for another time.  Since I have joined the ranks of the unemployed, I’ve had to swallow quite a bit of pride, which isn’t always a bad thing, all told.  The complications that went into obtaining food stamps were easily explained, once I met with the proper person, and with resolution I have no further griping to share on that matter.  

A well-designed website imploring those wishing to apply for food stamps to submit their claim by mail, after, of course, entering pertinent information and printing out several pages of a lengthy form sounds attractive enough.  However, I learned that while the mechanism may exist, budget shortfalls prevented the DC government from being able to hire the workers needed to process internet-based claims.  It would not be much of a stretch to deem this situation an glaring example of an unfunded mandate.  Reform cannot proceed without the allocation of funds and while we often are curtly dismissive of throwing money at a problem, granting low income citizens the ability to feed themselves somehow doesn’t seem to be on par with all of these anti-underclass talking points that find their way into the mouths of Republicans and Republican politicians.

If one considers Maslow’s famous hierarchy of needs, then food falls right down there at the bottom of the pyramid.  Without the literal requirements for human survival, it’s tough to be a Welfare Queen or milker of the system.  According to Maslow, it’s only after our base needs for survival are met that anyone could ever even entertain the notion to willfully freeload.

With their physical needs relatively satisfied, the individual’s safety needs take precedence and dominate behavior. These needs have to do with people’s yearning for a predictable, orderly world in which injustice and inconsistency are under control, the familiar frequent and the unfamiliar rare. In the world of work, these safety needs manifest themselves in such things as a preference for job security, grievance procedures for protecting the individual from unilateral authority, savings accounts, insurance policies, and the like.

But until one has the security of knowing he or she will be fed on a daily basis without having to worry about potential financial famine, safety is not a concern.

As for my own situation, my packet of information sat on a desk for over a month, unprocessed.  Because a meeting with a claims associate regarding whether or not food stamps will be granted or denied must, by rule, be granted and scheduled within 30 days, once I was approved I was given a month and one week’s worth of groceries I should have received earlier had everything proceeded in a timely fashion.  Though I received only $200 a month in food stamps, which is approximately half of what my grocery bill is for the same period, I am not about to look a gift horse in the mouth.  In all fairness to the DC Food Stamp program, it has won awards for how promptly and effectively it processes claims and while my situation is uncommon, it is hardly unusual when one considers the food stamp programs in other states.  In a fairer society, I would have had my entire food budget subsidized, saving me from having to rob Peter to pay Paul as so many of us have to do these days, but perhaps someday we will learn that though we have a tremendous amount of financial resources in this country to go round, even in times of recession, we spread them around unequally and in so doing shortchange the least among us.          

Part of the problem is the stigma and the misinformation that still persists regarding accepting government aid of any kind, food stamps being merely one example.  One would think that welfare cheats salivate at the very idea of eating from the public trough, if you’d believe the stereotype.  DC Hunger Solutions, the advocacy agency who so kindly went to bat for me and got my situation resolved, corrects many of the myths and stigmas surrounding food stamps.  

Only 83% of eligible District residents, and 36% of eligible low-income working families, receive food stamps. Every $1 of food stamps spent in the community generates $1.85 in local economic activity. D.C. would gain millions in federal funds by signing up eligible households – funds that would stimulate the local economy. People who work sometimes assume they are not eligible for food stamps, or that time-off from work is required to apply. This is not true. A family of 3 with a minimum wage earner could be eligible for over $3,000 annually in benefits, and working families can complete phone interviews rather than go to the food stamp office in-person.

The true impact of the Economic Stimulus Package has become a political football of sorts, in part because what it promised could not be easily measured or highlighted in concrete detail.  If, however, we shifted at least some of the focus towards fully funding both the programs that provide food to the poor and the monies necessary to provide more assistance, then these would be highly visible symbols of what good government is capable of if it puts its mind to it and does not get distracted with superficial squabbling or red tape disasters.  When close to two dollars worth of gain comes as a result of every one dollar spent, one cannot overlook the overall benefit.  We often believe that reform of any sort ought to be an awe inspiring and highly complicated matter, when sometimes the simplest solutions are the best.  Blessed are those who hunger and thirst for righteousness, for they will be filled.