LePage should get a waiver for easier Mainecare access to bariatric surgery

There are subjects I’m tired of writing about. Governor LePage and Maine DHHS Commissioner Mary Mayhew’s perceptions of what constitutes welfare reform is top on that list. I don’t say that as a typical bleeding heart liberal.

I say that as someone who has received social services including SNAP benefits and as someone who has worked in the social service arena and has serious concerns about the need for reforms. Serious concerns about serious reforms.

What we get from the LePage administration are perceptions of reform that miss the mark and/or make problems worse.

Like cutting healthcare access in the middle of a public health crisis. The LePage administration has whittled away at the Mainecare program, literally yanking insurance away from people actively receiving treatment for addiction during an addiction epidemic. Now as overdose deaths have escalated to more than one a day in 2016, the administration wants to cut access even more. 

Did anyone tell LePage or Mayhew about the ripple effects of their previous cuts? Did Maine DHHS officials track any of the people who previously lost treatment access to evaluate a sampling of outcomes before championing more cuts? Did any of the people who lost their coverage die? Or land in jail? Or lose their children?  

Does anyone care enough about addicts and their kids to keep track?

Then there’s the other LePage administration favorite:  restricting SNAP purchases. Once again the LePage administration is requesting a waiver to restrict sugary drinks and candy from being purchased with SNAP benefits.

Never mind that most households receiving SNAP include the working poor who have earned the right to make their own food choices. It’s not the working poor’s fault wages have stagnated for decades.

Never mind that Maine is one of 12 states with a “statistically significantly higher household food insecurity” rate than the nation — nine on the list.

Never mind that professionals battling hunger in Maine attribute increased use of food banks to previous LePage administration policies. It makes perfect sense for the administration to be obsessing about making sure poor kids don’t get a chocolate bunny in their Easter basket. Or ginger ale when they’re nauseous. Or a candy bar when they ace a test.

Misplaced focus much?

To treat all SNAP recipients like they’re that guy so and so saw buying all that Red Bull is offensive. To pretend they’re aren’t complexities to the purchase choices and/or dietary issues of the poor is … well, in my view I’m sorry to say, ignorant.

Complexities range from the ones I mentioned already to things like medications that make people have intense food cravings. There’s the harsh reality that $2 of soda or Kool-Aid will go a lot farther quenching the thirst of an apartment full of children on a July afternoon than $2 of juice.

Forget the crap about let them drink tap water — long before Flint, I had concerns about lead solder in the old buildings we lived in and in Maine’s old water infrastructure. I bought spring water by the gallon, which is roughly the same as a two liter of soda, but my kids went through spring water way faster than they would have plowed through soda.

I was both fortunate and unfortunate in that my kids didn’t really like soda. I wouldn’t have indulged in soda purchases on a regular basis, but you’re darn right I would have bought a two liter during a really broke week, would my kids have tolerated such an act. You do what you have to do to survive.

I tended to opt for going hungry and having lived through those hard times, I’ll never support these kinds of restrictions. However, I’m sure Trump administration will be more amenable to these waivers than the Obama administration was.

If the waiver is granted, maybe the LePage administration can ride the success and ask for a waiver to make bariatric surgery more accessible to Mainecare recipients who may struggle with their weight in a similar fashion to LePage. I Googled whether such operations were covered under Medicaid law, and it turns out they are, but the requirements are pretty stringent.

Since the LePage administration is so concerned about obesity, I’m surprised such a waiver isn’t high on the list of priorities — especially considering adult obesity in Maine is a much bigger problem than childhood obesity.

And, if the restriction waiver is granted, at least I won’t have to blog about this particular subject anymore. The well of talking points is running pretty dry. The only thing left on my brainstorming list is “control issues —” meaning I think these kind of ideas are the manifestation of control issues.

Control—exerting influence over one’s environment or the actions or behaviors of another person—is sometimes used excessively by those who fear the unpredictable and ambiguous, feel they need to prove themselves, or fear losing control.

… The need for control drives people to turn to the external world in order to find things they can control. They may be compelled to micromanage and orchestrate the actions and behaviors of others, or maintain rigid rules regarding routine, diet, or cleanliness and order.   Excerpted from Control Issues — goodtherapy.org 

It would be a waste to write a blog about control issues being weak engines for driving public policy, though. The people who most need to hear the message are often the most likely to ignore it. They’e the ones who are sure that they don’t have control issues.

Patricia Callahan

About Patricia Callahan

Trish is a writer who lives in Augusta. She has worked professionally in education and social services.