Uninsured patients

Nurses General Nursing

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There has been a rather heated discussion on health inusurance and drug coverage on a disney forum I subscribe to and it got me thinking (I am from the UK so not really familiar with US health care), what happens if a patient is unisured but requires care, not thinking on "emergency" care such as major trauma but more arround cancer or long term health needs.

I am not trying to start a discussion on the NHS VS US health care but am genuinely interested in the situation in the US for uninsured patient.

Thanks

Colin

Is that funded by donations? Trauma is an area that I'm always curious to know - how do they survive in an area where the costs are highest and payment is lowest.

It's funded by the taxpayers of the city. The taxpayers passed a levy 50 years ago and continue to pass it when it comes up for renewal. There are donations as well that fund a portion, but the majority of it comes from the levy.

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Specializes in Plastics. General Surgery. ITU. Oncology.

Well thank God I'm from the UK where healthcare bankrupts no one individual but costs us all a small tax levy.

It is worth every penny and I will defend it to the death. A CIVILISED society has this centrally-funded system. All of Europe has more or less an NHS.

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Specializes in Geriatrics, Home Health.
I am still curious though as to how prescriptions and doctors visits work? Is it basically that you can't visit a GP without insurance, or they are just that expensive that if you don't have insurance most people can't afford to visit them?

From my experience, as someone who has been both insured, uninsured, and "medically homeless" (insurance, but no PCP), uninsured patients can still see a GP. However, the few GPs that see uninsured patients usually want to be paid up-front. People without insurance generally don't have hundreds of dollars lying around for an office visit.

Urgent Care centers are another option. Some are run by hospitals, some are run by private companies, but they're supposed to provide non-emergency walk-in care. Availability can be a problem. I used to live in Boston, which has a huge shortage of doctors (you generally have to wait 3 weeks to be seen, unless you're actively coding). Until 2 years ago, when two pharmacy chains opened walk-in clinics, the area had no Urgent Care centers. People with good insurance ended up going to the ER for minor issues because they had no other options. One hospital in my area (NE Vermont) charges the same for ER visits and Urgent care visits, which seems like a bad idea to me. If you want people to use Urgent care, why not charge less than an ER visit?

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From my experience, as someone who has been both insured, uninsured, and "medically homeless" (insurance, but no PCP), uninsured patients can still see a GP. However, the few GPs that see uninsured patients usually want to be paid up-front. People without insurance generally don't have hundreds of dollars lying around for an office visit.

Urgent Care centers are another option. Some are run by hospitals, some are run by private companies, but they're supposed to provide non-emergency walk-in care. Availability can be a problem. I used to live in Boston, which has a huge shortage of doctors (you generally have to wait 3 weeks to be seen, unless you're actively coding). Until 2 years ago, when two pharmacy chains opened walk-in clinics, the area had no Urgent Care centers. People with good insurance ended up going to the ER for minor issues because they had no other options. One hospital in my area (NE Vermont) charges the same for ER visits and Urgent care visits, which seems like a bad idea to me. If you want people to use Urgent care, why not charge less than an ER visit?

Yes. I use the clinics at Kroger or Walgreens. They are cheaper than Urgent Care, but the hours aren't as long, and they can't do as much. It's mainly for basic routine care. And for my yearly Paps I go to Planned Parenthood.

We have Urgent Care as well around here, quite a few of them. The fee is $75, but of course you have to pay for of all tests as well, up front.

Some lady came into the ED the other day because she thought she had the flu. I've never gone to the doctor over the flu. I bet she racked up a $500 bill because of the flu, but you know it won't be paid, ever.

My hubby and I have lived without insurance for 2 years now. Very scary. But he just got a raise, so we'll be able to afford health insurance, just hopefully nothing large happens because we won't be able to afford that.

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I'm not a fan of nationalized HC (lived in the UK and it sucked compared to the US system - although folks in the UK may say it's OK since they've never experienced anything better). It's never as advertised. Rationing still happens so that CA pt may still be still denied. Also, HC isn't a "right." It's a service like any other. For everyone who gets free HC, some other schmuck is getting heavily taxed to pay for it (that's tantamount to stealing from strangers). BTW, with nationalized HC, unless one is poor, one usually pays for it. For example, in Germany, people pay about 15.5% of their yearly incomes for national HC. They aren't given a choice as to whether or not to carry insurance, either. Anyway, it ends up being just about as expensive for the avg person as it is now...the big diff is the waiting lines (up to 2 yrs in some cases) for non-emergent procedures & heavier rationing. Also, our poor already receive free HC, so no need there. (As you can see, I think Obamacare is a joke...the "almost" poor are basically just getting stuck on Medicaid and everyone else is getting screwed and being forced to pay for it.) Quite frankly, I don't think hospitals should be required to treat emergency cases when it involves illegal immigrants. Upshot: if I get sick and can't pay, it shouldn't be your duty to pay for me. My tough luck. Hopsitals are businesses like any other. Overall, the only people who may benefit from Obamacare are PA's & NP's whose scopes of practices may be expanded even more as MDs/DOs leave the profession due to anticipated poor pay under Obamacare. Even the PA's/NP's will end up suffering lower salaries though. (Also, in the UK, you're often stuck with a foreign physician...they import a lot due to their willingness to work cheaply...sounds some like nursing...ah, but I digress...)

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

overall the only ones who benefit from a single payer, not for profit health care system are those who will not be bankrupted by forays into the system....could be you, or you, or even you

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

civilengineer2rn - I think you're right that people tend to mentally put an "all things being equal" into system vs system comparisons when all things are not equal in terms of wait times, distances travelled, available treatment options, DNR status, clinical trials, and how much you can be expected to be done on your behalf before the system says they are done treating you.

But "stuck with foreign doctors" is an unfair and untrue remark. I think we should judge every person by their talent and character.

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Specializes in LTC Family Practice.

Urgent care centers are just like doctors offices, if you have NO insurance you must pay all fees up front. If you are poor and uninsured your only recourse is the emergency room.

I'm unemployed and uninsured because I'm single with no children I am not elegible for Medicaid, even though I no longer have any unemployment benefits left. I've called our social services and they have nothing to offer me other than to go to the local churches for help so I tried that and they have nothing either.

So at 60 year old, I'm facing homelessness like millions of Americans right now, I'm out of safety nets. I'm ready willing and able to work, last spring I took a phlebotomy course and passed a national certification test...still no job, I'm lucky if I get interviews. In order for me to get my nursing license re-instated here in GA I would have to attend a cost prohibitive refresher course. I can't move without money or the sale of my home. Yes I made a big boo boo letting my license lapse and never in my wildest dreams did I think it would be such a problem in this state, but I maintain an active one in OH by online CE's.

My point being, that I have joined the poor uninsured and my only option for care is the emergency room because I have no money and I HATE it. I'm very aware of the abuses the ER's deal with, but I'll bet there will be more and more people like myself who are left with no other options.

Going to the ER for non-emergent issues is not a good solution but for myself and many others it the ONLY option.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

You're not alone by any means, DogWmn. It's quite a shock to realize that you've (meaning "we've") found ourselves one paycheck away from catastrophe and taking care of patients who do qualify for Medicaid when we're unable to afford the premiums for ourselves or not yet eligible for public assistance.

I have found there are kindhearted and reasonable doctors and urgent care centers who, if you explain your situation, will knock the billing code down a notch, or let you pay a deposit and the rest on installments. I found one doctor-owned Urgent Care where the man wouldn't charge for an ear lavage or a blow into the peak-flow meter that they nearly always charge for these days. He uses PAs a lot but if it helps him keep costs down I don't really care about that. I hope things get better for you.

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