Gov. Paul LePage and DHHS Commissioner Mary Mayhew want a waiver to add more restrictions to MaineCare access. Thankfully, there is some talk about the cost of such proposals as evidenced in other states, and there were hearings this week for public comment.
I knew I should be writing a post about the proposal, but all I could think was:
I get it. I’m pretty sure most people following politics get it: LePage and Mayhew’s idea of stewardship when it comes to our social service safety net seems to fall under three categories: restrictions to access, cuts to spending, privatization.
Please don’t get me wrong — it’s not just a LePage/Mayhew thing. I wasn’t a fan of the previous administration’s handling of the department, either. Admittedly, the previous administration might have been more willing to spend on behalf our most vulnerable citizens.
However, I think an under-willingness to monitor that spending and resulting outcomes (or lack thereof) gave rise to the current ideology at the department. I even have personal theory that a prescription drug program developed back then laid some of the groundwork for our current addiction crisis, but that’s a digression from my point.
The point is, social service programs have been silo-ed by party ideology. The silo on the right loves cutting, the one on the left loves unmeasured spending. Meanwhile, our most vulnerable citizens are running around the farmyard waiting for policymakers and lawmakers to pay attention to the actual details of their lives.
To their actual health and social service needs in today’s social and economic climate.
But the ideologues in their silos can’t see those details through their silo walls.
Evidence? Look at the slow response to the addiction epidemic. Like I said before, policymakers’ and lawmakers’ response to it has been a tragic example of the cliche about the farmer fiddling with the barn doors after the cows are out.
Things can go pretty wrong around the barnyard when all the farmhands are hiding in silos.
One problem with all these restrictions and cuts coming from the silo on the right is the fundamental premise for such measures. That premise seems to be that all social service program recipients are somehow cheating the system and can afford to do more, or they have the resources to do better.
As a social service program recipient I know that premise is fundamentally untrue, no matter how many people “in the know” attest to its truth. Been there, done that personally and professionally.
I believe that a tiny sliver of recipients do cheat. A tiny, tiny, tiny sliver. When I look at the other small sliver of recipients that some people might perceive to be cheating, I see failed programming not addressing actual recipient needs.
It’s easier to blame the vulnerable themselves, but I’m inclined to think the folks with all the degrees and big salaries have some culpability when it comes to recipients failing to thrive.
Another thing people may not understand about all these restrictions and additional costs to accessing services — they create layers of bureaucracy that hinder access for all the folks in genuine need. Costly layers of bureaucracy that create more cracks that the majority non-cheaters can get lost in or even fall right through.
Not only are most recipients not cheating the system, some are actively trying to save the system money. For example, there’s this 70-something great grandmother I know. Like so many extended family members in Maine, she and one of her adult daughters are co-guardians to her great-granddaughter who lives with her.
I’ve wanted to blog about the story, but it’s one of those hot messes that wouldn’t necessarily benefit from public attention. It is, however, a hot mess that would benefit from a kinder, gentler Maine DHHS. A hot mess looking for less cumbersome process to access a meager TANF benefit and MaineCare for the sweet child who didn’t ask to be born into a hot mess.
And her relatives love her too much to want her to become one of the children stagnating on the foster child rolls.
But the folks in the silos aren’t asking for waivers to expedite and maximize benefits for retirees raising small children during a public health crisis.
They’re not creating a hullaballoo about expediting and maximizing mental health and addiction services for our jails and youth center.
They’re not making a big deal about finding funds to keep up with abuse and neglect reports.
There’s so much going on in the barnyard in need of attention that goes beyond simple spending or restricting measures. The question is, can we trust elected and government officials to see that from their silos?
Endnote: This post is about opposing the new proposed changes to MaineCare and about the problems that happen when ideology becomes more important than reality. As I wrap it up, though, I find myself thinking, it’s really more about supporting Asst. Minority Leader Nathan Libby’s proposal to create citizens oversight committee for some programming at DHHS.
The best way to be sure the folks in the silos are seeing what they need to see is to have citizens demanding that they do so.