Audio By Carbonatix
A small misunderstanding about Medicaid and Medicare coverage touched off a crisis in Ofelia Garcia’s world. The money involved (less than $100 per month) would have elicited no more than a shrug from some people. But it was cause for alarm for this 74-year-old Little Havana resident, who scrimps by on Social Security and suffers from diabetes and a host of other ailments. That is why on a Tuesday evening in August, Garcia was sitting alertly in a second-row pew inside Holy Comforter Episcopal Church at NW First Street and Thirteenth Avenue in Little Havana. Minutes earlier, completing her outfit of pink blouse, gray slacks, and leather sandals, she had clipped on some small hoop earrings, checked her short gray-and-black hair, and walked across the parking lot that lies between the three-story Holy Comforter senior residence and the sanctuary. She joined about 60 mostly Spanish-speaking adults and children who had come to hear representatives of the Jackson Health System (JHS) describe its network of clinics and hospitals that specialize in serving the poor.
About one-third of Miami’s elderly population (age 65 or older) is living in poverty, according to the 2000 U.S. Census. Garcia is one of the city’s 17,683 residents who fall into that afflicted category. The health-care presentations wore on for a half-hour, but they were not addressing Garcia’s specific problem. A doctor diagnosed her with diabetes about a year ago. It is not severe enough to require insulin shots, but she must take pills when necessary, often twice a day.
As she listened, Garcia’s fingers nervously gripped a small set of instructions for One Touch Sure Step glucose monitoring strips. She uses them up to three times daily. After pricking herself with disposable lancing devices, she puts a drop of blood onto a strip and inserts it into a palm-size meter that reads blood-sugar level. If the number on the digital display is too high, she takes a diabetes pill.
Until a few months ago Garcia obtained the strips from the cramped and crowded Navarro drugstore on SW Eighth Street near SW Twelfth Avenue. She would make the short drive from Holy Comforter in her 1987 Chevrolet, navigate past the customers and boxes in the aisles, and often endure a long wait at the pharmacy in back. Until this past June she could leave with a box of strips and the pharmacy would bill Medicaid, the national health-care assistance program for the poor. But one day not long ago her pharmacists informed her that, because of a change in federal regulations, Medicaid would no longer pay for the strips. She asked how much a month’s supply would cost her. They said $99. Garcia left in a panic. She also left without a vital piece of information: This past June, Medicare, the federal health insurance program for the elderly, began paying for the strips.
So it was that several weeks later, with her supply of strips dwindling, she had come to the JHS meeting hoping to find a way out of this looming crisis. In Garcia’s budget, $99 would be a lot of money. Each month she receives $350 in Social Security plus another $221 in Supplemental Security Income, for a total of $571. As she is an elderly SSI recipient, whose annual income of $6852 is well below the poverty line, Medicaid pays for her prescription drugs. Medicare picks up the tab for doctor’s visits and other medical supplies, including the aerosol device she uses to treat her asthma. The government also covers the $100-per-month lease for the oxygen tank she breathes from at night to counteract her sleep apnea. She also takes medicine for high blood pressure, high cholesterol, and heart problems. “I practically have a pharmacy set up here,” Garcia chuckles in Spanish, her only language, while sitting in her living room. (In addition to requesting that her real name not be used in this story, Garcia declined to be photographed.)
In addition, under Florida state rules she qualifies for about ten dollars per week in food stamps, she notes. “They make up a life story for you,” Garcia offers, referring to the Department of Children and Families administrators who take applications for food stamps. “What’s your income, what are your expenses, whether you received a gift, whether you received an inheritance — this, that, and the other thing. You have to report it all and bring evidence of everything. Ten thousand things.”
But for the grace of the Episcopal Church and the federal government’s housing subsidies for the poor, her budget would be ten times tighter. After retiring from a factory job in 1989, she applied for a subsidized apartment and received one of the 43 units at the Holy Comforter’s senior residence. Today she feels lucky indeed, if not blessed by the Lord. “Oh! That waiting list is long,” Garcia exclaims. “If only one or two vacancies come up a year, when will that list ever be covered? Imagine!” Not only is her rent just $155 a month, but Holy Comforter is one block from San Juan Bosco’s Catholic Church, where Garcia attends mass every Sunday.
Still, after paying rent she is left with $426 per month — about $106 per week — for other basics such as food, over-the-counter drugs, gasoline, or heaven forbid, a new pair of slippers. Garcia must also stretch that monthly balance to cover her annual $774 insurance bill for her car. To save money, she buys a lot of vegetables. “We live with a lot of restrictions,” she says. And if she had more financial freedom? “I would have liked to have a car that was a little better. Not a new one, but a car that was in better condition, that wasn’t as old and ugly as me,” she jokes. “I would go see some plays that I like or to the cinema. I would have traveled more, gotten to know some other states. With more money I would live, you know, a little more comfortably. But no, all that has to remain in dreams.”
Garcia is one of the 125,000 Cubans who came to Miami in 1980 during the Mariel boatlift. She and her husband were shuttled across the Florida Straits in a small vessel arranged by their daughter, who had left Havana at age sixteen a decade earlier, along with Garcia’s sister and brother-in-law. She is still disgusted that the Castro government “cleaned out the jails” and allowed criminals to join the exodus.
Soon Garcia found a minimum-wage job sewing tennis shoes at the La Suave factory in Hialeah, and stayed there five years until the plant shut down. Then she took a packaging job at the Sweet’N Low factory, also in Hialeah. She had been there about a year when her husband, a heavy cigarette smoker, died of emphysema in 1986. Garcia labored on at Sweet’N Low until retiring in 1989 at age 61. At the time she lived in a small apartment building several blocks from her current residence.
After leaving Sweet’N Low, Garcia worked part-time at the Holy Comforter day-care center for six years, then four more at a center for the blind, until a severe case of asthma forced her to seek extensive treatment and stop working altogether.
Although she is a decade into retirement, she doesn’t expect financial help from her son or daughter. Her daughter, who is a secretary for the Miami-Dade Police Department and mother of two kids in their twenties, has her own family to worry about, Garcia says. Similarly her son, who left Cuba in 1990, supports a wife and two young daughters on the ten-dollar-per-hour wage he earns at a Miami-Dade paper factory. She thinks her son’s wife made the right decision in opting to be a stay-at-home mom. “Child care is going to cost almost as much as she’s going to make working in a factory,” Garcia notes. “When both kids are in school, then she’ll get a job.” Garcia adds ironically that her daughter-in-law has occasionally worked part-time as a house cleaner even though she has a pharmacy degree from a Colombian university.
Garcia loves her children and grandchildren, but she also likes her independence. When she stays with her son’s family in North Dade every two or three months, she insists on driving her carcacha, as she calls her Chevy. (Carcacha is Mexican slang for an old, beat-up car, she explains.) If she lets her son pick her up, she has trouble returning home when she wants to. “What happens is that they don’t want to bring me back,” she says. “They say, ‘No, what’s your hurry? Play with the puppy. Stay a few more days. Why are you leaving now?’ And the girls cry trying to make me stay. So when I go in my carcacha, the day I want to leave I wake up, close my suitcase, and say, ‘I’m leaving.’ Because I have things to take care of — medical visits, medicine I need to look for, groceries to order. I can’t spend a lot of time with them.”
She also has other people to see, such as her sister, the one who left Cuba in 1970 and now lives with her husband in an apartment a block from Holy Comforter. Their situation is even bleaker than hers. After expenses (including a $300 monthly mortgage) they end up with about $110 per week, nearly the same amount as Garcia, but it must support two people, not one. Moreover her sister has had diabetes for years. “The poor thing,” Garcia says. “The doctor told her that her kidneys are now very bad. She also has arthritis and the pain drives her crazy. It’s all combined with high blood pressure and anemia. Yesterday she had a dizzy spell and fell in a little store nearby. She’s very weak. She’s fallen several times.”
Garcia never got an answer to her question at the JHS meeting that Tuesday night. After about 45 minutes she rose from the pew and headed back to her apartment as the JHS representatives fielded questions and comments from the audience. At home she pondered how she would obtain the test strips. “I thought and thought and I said, ‘How can this be solved?'” Garcia recounts. “Because they are expensive and I don’t have the resources for that. Do you think with the income of $570 that I have I can spend a hundred dollars on that? Impossible!”
Then she found a toll-free number on the back of the instruction booklet that came with her blood-sugar meter. But when she dialed it, she reached a factory that manufactures the strips. Someone there gave her the number of a nationwide mail-order supplier, and after several days of frustrating unreturned calls, Garcia finally managed to place an order. She also has another option, as New Times subsequently discovered. She can also return to the Navarro drugstore with her Medicare account information, receive the test strips, and let the federal government pay the bill. Then maybe she’ll be able to afford an occasional evening at the theater.
