When I was little, the Sears Wish Book would arrive weeks before Christmas. These books had things I had never seen before and things my friends never owned. Ever the dreamer, I would dog ear the pages of things I really wanted and make notes on how much they cost. The sale price was a very important factor in whether my wish remained one or became a reality that year.
What about the people on the waiting list? People on the waiting list don’t have an equivalent to the Sears Wish Book; they don’t have a lot of amazing choices. Also, if there were all of the choices, there would be no money for the purchase. We have created a system where there is no assured transition from school to adult life for people with disabilities. Existing options are mediocre at best and poorly funded. After you graduate in June, you face the waiting list. It is frustrating to parents, scary to these young adults, and challenging to elected officials who advocate for help but do not see a viable path forward.
The existing system has evolved from layers of procedures that include medical care models, paperwork, and billing codes created for short term services, with only one payer. A one payer reality constrains innovation and interferes with the quick delivery of new, innovative efficient methods to those we support. We need more than an evolution of small gains and great losses – we need a revolution.
More next week.