A voice in the wilderness

I can't seem to find out anything personal on this blog, so I guess it's safe to continue.

Poverty doesn't just happen in the urban areas or the mountains of Appalachia. It's in the areas that one female politician said is the "real America."

Without giving too much away, let's just say that my "welfare" work takes place in a county of a little over 20,000 people and a town of about 7,000. We are the biggest town in our county. The next biggest town is about 1,500. We have several smaller towns ranging from a population of 4 all the way up to 500.

We have 2 towns over 15,000 people each about 30 miles away in different counties, a city of over 50,000 about 45 miles away (different county) and a metropolis of over 1 million about 80 miles away (also a different county).

I mention these boring stats because the state government in the metropolis often makes laws regarding public assistance programs that look great and may even make sense to white, middleclass urbanites, but have a determental effect in the more rural areas.

Case in point: Emma is on the Medicaid program (the government paid health "insurance" for people in poverty) (yes, we do have the government involved in health care already). She is 80 years old and lives by herself. She can't drive so she relies on an Aging program that provides volunteer drivers to take people to and from medical appointments. Medicaid will reimburse the Aging program so many cents per mile for this service, which they in turn pass on to their volunteers. Some legislator at the state or maybe the feds, I don't really know or care which, has decided that it's a "cost savings" to only pay for "loaded" miles. All the other policy makers agree. After all, in the mega city it's only a couple blocks or miles from the volunteer's starting point to the "patient's "house so what's the big deal if they don't get reimbursed for those few miles.

Emma meanwhile lives on the farmstead 20 miles from the town the nearest volunteer driver lives in. Oh sure, there is another town closer to Emma, but with a population of 90 there's hasn't been anyone who is jumping at the chance to drive sick people to their appointments. So Fred, who has been a volunteer driver for years must drive 20 miles to pick Emma up. From there they go 45 mile (farther away from Fred's starting point) to the nearest specialist. The specialist decides Emma needs to be admitted to the hospital next to his clinic for further tests. Fred now has to travel 65 miles back to his home. So for all Fred's time and gas he will get reimbursed for the 45 miles that Emma was in the car with him, but not for the 20 miles to pick her up or the 65 miles back from the hospital. Fred decides that it's not worth the wear and tear on his car, the cleaning up after Emma had an accident or the near miss with the deer. Another rural volunteer driver is lost to the wisdom of the urban lawmaker.