Cats and dentists

Two rather unsettling things happened yesterday.

First, the cat peed on a almost new puzzle that Julia and I had been working on.  Our kitchen table is still being refurbished and so, we had set up the puzzle pieces (all 500) on a board about 30” square.  The board was on the floor in the dining room and when I was in the kitchen yesterday morning, I heard the cat scratching at the pieces.  I thought he was just playing with them.  Latkah used to pick up puzzle pieces are carry them around the house or to her food bowl.  Muta would not be chased away from the puzzle and so I went into the room to physically remove him.  And there, I saw that he had peed on the pile of pieces and was trying to cover it.  Just as if he was using a litter box.  

Ugh!  The puzzle was thrown away and Julia was very disappointed to hear about it when she got home.  She wanted to wash the pieces and we a piece of cardboard in water to find out why we couldn’t do a wash job.  Julia wanted to put the cat in time out or punish him, but ya know, there is no way to punish a cat.  And I remember a time when there was no way to really “punish” Julia.  Julia has changed; I don’t expect such a change from the cat.

I am trying to believe that this was a mistake.

Thing Two: I called to make a dental appointment for Julia.  She goes to a pediatric dentist who I am not fond of and after yesterday, I feel only more so.  

Julia was on medical assistance for two years.  I pay retail for my health insurance these days and it was a great help after David died that she was eligible for medicaid because of the autism waiver slot she had.  I changed her health plan to my own in July so that she would get an additional year of intensive therapy, and so as she sees her health care providers now, they are changing over to my private plan.  For our primary care provider and at the psychiatric clinic that prescribes Julia’s ADHD meds, I see absolutely no difference in the way we are treated because she was on Medicaid or as she is now on my private plan.

But at this dentist, as a patient on Medicaid, I could not make an appointment 6 months ahead of time like I can for myself at my dentist.  I had to call one month ahead of her 6-month check up time, and by that time, of course, all the good times and everything a month out was taken.  I asked about this once, and was told that I was lucky that they even took medicaid patients and that it would not be easy to find another dentist with a kid with special needs and all.  I choked back some bile the day I was told that because I needed to work within the system and didn’t really know if any other dentist would take Julia.  But even that treatment was pretty awful.  It was plain and simple discrimination.  How could we, as a community, allow our most vulnerable kids to be treated that way?

But my plate was full at that time and I let it pass.

So, I called to make an appointment yesterday and was told that I could make an appointment in November and my choice was Tuesday or Wednesday from 10 to 11 in the morning.  I am trying very hard not to take Julia out of school, especially in the middle of the day -- the break and transition make it hard on her teachers and hard on her therapists at the end of a day.  So, I asked about December, but got the same answer.  I asked if another month would be better but the answer was the same.   I explained Julia’s situation, difficult transitions, etc., but the answer was the same.

So, from what I gathered, a Medicaid patient was not allowed to make check up appointments like other patients who can make it 6 months ahead of time.  Medicaid patients can call 6 months after their check ups and make an appointment for a month or two ahead.  This means that Medicaid patients are seen less often than patients who pay out of pocket or are insured by private insurance.  The newest wrinkle of difference is that Medicaid patients can only be seen on inconvenient weekdays during the school day.  I was offered the option of making a Tuesday appointment and then put on a cancelation list for last minutes appointments but at that point I was not offered any other day or time.  

I was flabbergasted for awhile as I shifted days and months.  Maybe I was not understanding them.  Surely, the dentist had some time in January . . . and then it dawned on me what was going on.  I told the receptionist that Julia was now covered by my private insurance.  She asked for that to be verified, and then I was able to make an appointment after school on Wednesday, October 24th.  I was also offered a cancelation appointment today if I could possibly make it since Julia was due for a check up immediately.  

The difference in treatment hurts my soul!  How can we, as a community, allow our most vulnerable kids to be treated that way?  If my kid was a typical Medicaid patient, I would probably be working a low paying job.  Those jobs are notorious for being inflexible and probably there are no personal or sick days.  I’d have to take time off from work, take my kid out of school, go the the appointment, bring the child back to school, and go back to work.  What if I didn’t have a car and had to rely on public transportation?  And, according to that office, there is no other time available.

I could rant, but I am very sad.  I contemplate my responsibility here.  Do I just change dentists as quickly as I can?  Should I do more?