美国国家公共电台 NPR--A Rhode Island woman's struggle to get her young daughter Medicaid coverage

A Rhode Island woman's struggle to get her young daughter Medicaid coverage¹

Transcript²

Faced with a lack of treatment providers and frequent insurance denials, many parents are considering desperate measures to qualify for public insurance like Medicaid to get treatment for their kids.

A MARTINEZ, HOST:

If you have children with mental health problems, one of the most reliable ways to get care is through government insurance such as Medicaid. But qualifying for it can require making some tough choices. That was the case for one Rhode Island woman who struggles with getting care for Rose, her 9-year-old. NPR's Yuki Noguchi has her story as part of our ongoing⁴ series on medical debt with Kaiser Health News.

YUKI NOGUCHI, BYLINE⁵: Rose is the youngest of Colleen O'Donnell's three children.

COLLEEN O'DONNELL: She's, like, really funny and beautiful and creative.

NOGUCHI: Several years ago, Rose started acting⁶ aggressively. It was a sign of a worsening mood disorder⁷.

O'DONNELL: I couldn't get her on the bus to go to school. That was a real struggle. And then what do you do when you have a kid that won't go to school that no one else can take care of because it's unsafe?

NOGUCHI: Rose had two forms of private insurance through each parent's job, but neither covered her care. Only Medicaid would pay for the care Rose needed. So O'Donnell, a single mother, quit her job as a school nurse to cut her income in order to qualify for public insurance.

O'DONNELL: Oh, my God. Having Medicaid has made everything easier. I don't have co-pays. I don't have to wait for the insurances to fight it out to see who's going to pay for what. I don't have to worry about getting collections notice. I don't - you know, the stress level of relief there is huge.

NOGUCHI: But it came at a serious cost. Without a job, O'Donnell took out a $22,000 second mortgage to pay for living expenses.

O'DONNELL: Qualifying for Medicaid means you live right around the poverty level, right? Which means that I'm also not generating any sort of wealth. I'm not contributing to my retirement⁸ because I'm barely able to, at that point, make ends meet.

NOGUCHI: Parents are making huge financial sacrifices to get care for their children. Meiram Bendat says this is a major trend. Bendat is both a psychotherapist and an attorney representing patients in insurance disputes. He says shortages of treatment providers, frequent coverage denials and a lack of enforcement of insurance laws are major barriers.

MEIRAM BENDAT: Debt, forgoing⁹ treatment and Medicaid tend to be the most common responses, particularly for getting services for kids and adolescents.

NOGUCHI: State and federal laws require insurers to pay for behavioral care on par³ with medical treatment. The insurance industry says it complies with those laws. But Bendat says violations¹⁰ are common and often go unenforced.

BENDAT: There are so many states that are just doing an awful, awful, awful job of ensuring access to care. Really, there are some states where you can't even get hold of a live person at the regulator's office.

NOGUCHI: California has some of the strictest mental health parity¹¹ laws in the country, yet it too is in crisis. Christine Stoner-Mertz is CEO of the California Alliance of Child and Family Services.

CHRISTINE STONER-MERTZ: One of our children's hospitals saw something like a 1,700% increase in emergency room visits because there just weren't other options for them.

NOGUCHI: Stoner-Mertz says some parents never pick their children up from the hospital in order to qualify for Medicaid. They just give up custody¹².

STONER-MERTZ: The only way to get those services is if that child becomes a dependent of the state and therefore is automatically eligible¹³ for specialty¹⁴ mental health.

NOGUCHI: That kind of desperation sounds familiar and understandable to Colleen O'Donnell.

O'DONNELL: It's something I contemplated¹⁵ a week ago.

NOGUCHI: She says the financial and emotional toll¹⁶ of caring for her mentally ill child has come at the expense of her own mental health.

O'DONNELL: I mean, even now with things better, it's her and I in the house alone. And at times I feel, like, suicidal. I feel absolutely hopeless. I have contemplated giving up my child to survive myself.

NOGUCHI: O'Donnell recently started working as a school nurse again for the money and for her sanity¹⁷. But she says she must ensure not to work so much that she loses eligibility¹⁸ for Medicaid. Yuki Noguchi, NPR News.

1 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

2 transcript   

n.抄本，誊本，副本，肄业证书

参考例句：

• A transcript of the tapes was presented as evidence in court.一份录音带的文字本作为证据被呈交法庭。
• They wouldn't let me have a transcript of the interview.他们拒绝给我一份采访的文字整理稿。

3 par   

n.标准，票面价值，平均数量；adj.票面的，平常的，标准的

参考例句：

• Sales of nylon have been below par in recent years.近年来尼龙织品的销售额一直不及以往。
• I don't think his ability is on a par with yours.我认为他的能力不能与你的能力相媲美。

4 ongoing   

adj.进行中的，前进的

参考例句：

• The problem is ongoing.这个问题尚未解决。
• The issues raised in the report relate directly to Age Concern's ongoing work in this area.报告中提出的问题与“关心老人”组织在这方面正在做的工作有直接的关系。

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 acting   

n.演戏，行为，假装；adj.代理的，临时的，演出用的

参考例句：

• Ignore her,she's just acting.别理她，她只是假装的。
• During the seventies,her acting career was in eclipse.在七十年代，她的表演生涯黯然失色。

7 disorder   

n.紊乱，混乱；骚动，骚乱；疾病，失调

参考例句：

• When returning back,he discovered the room to be in disorder.回家后，他发现屋子里乱七八糟。
• It contained a vast number of letters in great disorder.里面七零八落地装着许多信件。

8 retirement   

n.退休，退职

参考例句：

• She wanted to enjoy her retirement without being beset by financial worries.她想享受退休生活而不必为金钱担忧。
• I have to put everything away for my retirement.我必须把一切都积蓄起来以便退休后用。

9 forgoing   

v.没有也行，放弃( forgo的现在分词 )

参考例句：

• Everything, in short, is produced at the expense of forgoing something else. 总之，每一种东西的生产，都得以牺牲放弃某些其他东西为代价。 来自互联网
• These aren't the only ones forgoing the morning repast, of course. 当然，他们并不是放弃早餐的唯一几个。 来自互联网

10 violations   

违反( violation的名词复数 )； 冒犯； 违反（行为、事例）； 强奸

参考例句：

• This is one of the commonest traffic violations. 这是常见的违反交通规则之例。
• These violations of the code must cease forthwith. 这些违犯法规的行为必须立即停止。

11 parity   

n.平价，等价，比价，对等

参考例句：

• The two currencies have now reached parity.这两种货币现已达到同等价值。
• Women have yet to achieve wage or occupational parity in many fields.女性在很多领域还没能争取到薪金、职位方面的平等。

12 custody   

n.监护，照看，羁押，拘留

参考例句：

• He spent a week in custody on remand awaiting sentence.等候判决期间他被还押候审一个星期。
• He was taken into custody immediately after the robbery.抢劫案发生后，他立即被押了起来。

13 eligible   

adj.有条件被选中的；(尤指婚姻等)合适(意)的

参考例句：

• He is an eligible young man.他是一个合格的年轻人。
• Helen married an eligible bachelor.海伦嫁给了一个中意的单身汉。

14 specialty   

n.(speciality)特性，特质；专业，专长

参考例句：

• Shell carvings are a specialty of the town.贝雕是该城的特产。
• His specialty is English literature.他的专业是英国文学。

15 contemplated   

adj. 预期的 动词contemplate的过去分词形式

参考例句：

• The doctor contemplated the difficult operation he had to perform. 医生仔细地考虑他所要做的棘手的手术。
• The government has contemplated reforming the entire tax system. 政府打算改革整个税收体制。

16 toll   

n.过路(桥)费；损失，伤亡人数；v.敲(钟)

参考例句：

• The hailstone took a heavy toll of the crops in our village last night.昨晚那场冰雹损坏了我们村的庄稼。
• The war took a heavy toll of human life.这次战争夺去了许多人的生命。

17 sanity   

n.心智健全，神智正常，判断正确

参考例句：

• I doubt the sanity of such a plan.我怀疑这个计划是否明智。
• She managed to keep her sanity throughout the ordeal.在那场磨难中她始终保持神志正常。

18 eligibility   

n.合格，资格

参考例句：

• What are the eligibility requirements? 病人被选参加试验的要求是什么？ 来自英汉非文学 - 生命科学 - 回顾与展望
• Eligibility for HINARI access is based on gross national income (GNI). 进入HINARI获取计划是依据国民总收入来评定的。