The story was barely noticed last week, amid the orgy of coverage given to the fact that yes, Michael Jackson was indeed still dead, as he has been for more than a week now.
Yet there was far worse news for thousands of living Michigan adults who depend on Medicaid coverage. For them, this was the week their lives took a turn for the worse. This was spelled out in a letter they received last month from the governor's office.
"Dear Beneficiary," it began, "Due to Michigan's budget problems, the State cannot continue to pay for some Medicaid-covered services." What that meant was then spelled out:
n Starting July 1, Medicaid would no longer pay for any services whatsoever provided by a chiropractor or a podiatrist.
n The cash-strapped state also has stopped paying for most vision services. That includes routine eye exams, glasses, contacts.
n Dental services will now only be covered in emergencies, meaning severe pain or infection. That means no more routine dental exams, cleanings, fillings, dentures or other non-emergency work.
Canceling vision coverage struck Jamie Wierenga, of Kalamazoo, as the ultimate example of a penny-wise, pound-foolish philosophy. He is not on Medicaid himself, but he knows a lot about vision: He is a certified optician who practiced for a decade.
Most upsetting to him is the thought that people who need glasses won't be able to get them.
"I find it very disconcerting that folks who should be wearing medically necessary eyeglasses to drive are not going to be able to if they can't pay for the glasses out of their pocket. How are these people going to get to work?
"How can they function at work? Won't this change in coverage lead to more layoffs, if the worker can't see to perform their job duties? How can these people get off the Medicaid and welfare support if they cannot see?"
He worries that some of them will drive anyway, with potentially deadly results.
For Miriam Braunstein, now 33, the changes in Medicaid coverage hit even closer to home. A brilliant young writer, she has been fighting the slow ravages of mitochondrial disease most of her life -- and has done her best to refuse to give in to it.
She and her devoted partner Matthew Clark share a small, wheelchair-friendly house they are remodeling in an older Detroit suburb. The letter from the state came right when it was just becoming apparent that she was going to need a hearing aid, a step she had been reluctant to take. That galvanized them into action.
They scrambled to fill out and file the required forms. Fortunately, they got her hearing aid on June 30, the day before coverage ended. The next day it would have cost them $2,000 they don't have. That's not the end of their worries, however.
Dental coverage is a problem, though they are hoping she can get treated at a dental school clinic. Miriam, who has slowly lost muscle coordination and doesn't like to ask for help, has an acerbic, Dorothy Parker-style wit. She sometimes chips her teeth trying to open medicine bottles, etc. She thinks the state will end up paying more in the long run, not less.
"This is ridiculous," she said.
"So, they won't pay for a regular exam that might reveal if you have cavities, but they will pay the far greater cost if you end up having an abscessed tooth and a root canal? You can't get an eye exam, but they will pay to treat an eye infection? Brilliant policy."
She does understand that the state is running an enormous budget deficit, and that painful cuts have to be made. But the savings to the state from cutting these services is miniscule.
Currently, Michigan is projecting a budget deficit for the next fiscal year of something like $1.7 billion, a number that is constantly changing for the worse. The entire cost of the Medicaid dental program was a mere $2.9 million. Figures for the cost of the vision and hearing programs were harder to come by, but they were almost certainly less than what the state spent on dental services.
For contrast, Michigan has been spending about $2 billion a year on its prisons. Detroit pension fund trustees have been taking $56,000 trips to Singapore, and the governor and other state officials are frequently off on expensive junkets, allegedly to recruit jobs.
Someone's priorities seem to be out of whack in Michigan. Somehow, my guess is that it is not Miriam and Jamie's.
