Uninsured=financial ruin

Nurses Activism

Published

admittedly this is anecdotal but the story still speaks to a larger issue. having affordable access to health care is an essential part of the social contract. being uninsured and lacking access to health care puts patients at risk for early death and is one of the single greatest causes of personal bankruptcy in the us. both of these eventualities are quite likely to play out in this woman's life.

from daily kos: http://www.dailykos.com/storyonly/2007/1/14/1438/61856

(emphasis added)

a woman came to the emergency room with advanced cancer. against the advice of several doctors, she decided to delay treatment until she was sure she had been accepted by medicaid.

...

i must tell you from my vantage point, we have evolved into a society where there are tiers of citizenship.

one tier for those who are barely hanging on.

another tier for those who have slipped through the thoroughly destroyed safety net.

and a tier, for very fortunate people like me. people who can afford to patch together a life and pay for healthcare when the insurance company refuses to honor the social contract.

what you're going to read is about honoring the social contract.

a woman, let's call her inez, came to the emergency room last week. she was complaining of various symptoms (which i'll spare you) but they weren't good.

turned out she had advanced cervical cancer. naturally, it was recommended that she begin treatment immediately. chemo, radiation, surgery. she was an uninsured amercan. perhaps had she been insured, she would not have waited until her symptoms became acute to seek treatment. but she did wait, fearing financial ruin--not for herself, but for her family.

she was frightened, proud and tentative. finally, as she spoke, all the pieces of the puzzle began to fall into place. she was uninsured. she had applied or was in the process of applying for medicaid but was still not approved.

her doctor told me she said over and over, "i can't leave my family with a mountain of bills."

i am worried about inez because he said she was resolute. she absolutely would not think of beginning treatment until her medicaid application was approved. that begs the question, will it be approved? and what will happen to her if it isn't approved. i. don't. know.

most tragic, she was certain that her country would come through for her. again, her doctor related to me what she said. "how can they not accept me?" "i am sick, but i am an american citizen."

i'll tell you why they may not accept you, inez. because in the united states of america, health care is only a right if you are rich, powerful or an elected official.

Specializes in Case Management, Home Health, UM.

My sister has been without health insurance since 2002. First, she lost her job followed by her COBRA, when it ran out. She tried to buy a policy afterwards, but was turned down because of her medical history. She also was turned down for Medicaid, because my BIL's income from his Social Security and VA benefits disqualified her for eligibility. In 2005, she was diagnosed with bladder cancer. The specialist who diagnosed her refused to do her surgery until he was paid up front. She and my BIL had to resort to borrowing money off the equity in their home at a very high interest rate (which they are still paying). Her hospital bill alone for the outpatient procedure was over $11,000.00. To date her medical bills have amounted to over $20,000, and not a day goes by that she doesn't receive harassing phone calls from bill collectors demanding money....that neither she or my BIL have. To stay afloat, my sister began working part-time as a bookeeper. Well, when the VA found out that she was working, they cut my BIL's benefits, adding insult to injury. If she doesn't work, the bills don't get paid. If she does, the VA takes away their money.

On the other hand, my son's sorry and irresponsible 19-year-old SIL, who is pregnant for the second time in less than a year (and a convicted felon, to boot), has just qualified for Medicaid. What does she do? She quits her job at Wal-Mart, just as the baby's father gets fired from his job.

What is wrong with this picture??? :angryfire

Specializes in Psych, Assertive Community Resource Team.

I can give you a solution in two words:

Universal Healthcare

How do you explain Medicaid then?

Don't confuse the issue. The problem is not that only rich people can afford health care. The problem is that we punish the hardworking low-wage earner while rewarding those who contribute the least. So if you are unemployed, you are eligible for Medicaid (which provides reasonably decent coverage if you can get it) but if you have a job, working hard and barely scraping by, you are eligible for nothing. That's the injustice.

Ok, here is my story, I am still(1 1/2 years) waiting for approval to get Social Security Disability.I have gone through my savings and now am being supported 100% by my grown children, thank God for them or I would be out on the street.I go to a free clinic, which I am greatful for but, the care ,because of cost issues is sometimes marginal. I have tenatively been diagnosed to have inflammatory arthritis( possible RA) by a volunteer orthopedic surgeon .They wont refer me to a Rheumatologist or order the nessessary lab work to make a definative diagnosis, so I am in the position of having to wait for my hearing to have a ALJ either aprove or deny me SSDI benefits, which in my case because I have depleted my funds, WOULD allow me to get Medicaid. In the mean time my hands a getting more crippled by the week it seems. I also have DDD, DJD spine/DJD bilateral knees/starting cataracts both eyes.I think it is a national disgrace that after working so damn hard in LTC for 27 years that I and others in my position have to be practically begging for healthcare.:(
Specializes in Hospital Education Coordinator.

HM2Viking did not state whether or not a social worker had been consulted. I know that one of the ways to get Medicaid is to have a lot of medical bills. By getting the help she needs this patient might be able to qualify sooner. If not, go bankrupt or agree to a long term payment plan. Sounds like there was some denial in this patient's decision. The accounting dept at the hospital is skilled in finding money when no one else can and the SW can be of real help. Hope this lady's story has a happy ending.

Many couples I know have gotten divorced after years of marriage so a spouse can qualify for benefits. They live together and lie to the agencies for assistance. It is an accepted things in this area.

Specializes in Pediatric Pulmonology and Allergy.

There is a general disdain for people who do underhanded things like that, or work off the books and hide income to qualify for government help. But sometimes it comes down to doing what you gotta do to survive.

Specializes in LTC, Psych, M/S.
Many couples I know have gotten divorced after years of marriage so a spouse can qualify for benefits. They live together and lie to the agencies for assistance. It is an accepted things in this area.

I have a coworker who did this recently. His wife has MS. The outrageous part of this is, she was covered by insurance - good old Blue Cross Blue Shield from the employment she had when she could work. He got so sick of dealing with them - they were outright nasty. They would 'drop' his calls, and would just string him along every time a claim was made. Sickening.

Specializes in Infection Preventionist/ Occ Health.

My state has a program that pays for well woman exams, contraception, pap smears, mamograms, etc. for low-income, uninsured women.

We'll never have a feasible universal healthcare plan until we as nurses are willing to take a huge paycut.

Many couples I know have gotten divorced after years of marriage so a spouse can qualify for benefits. They live together and lie to the agencies for assistance. It is an accepted things in this area.

My first husband got very ill and had to go on disablility about 6 months after we got married. I was 23 years old.

While waiting for his social security disability to be approved we applied for assistance.

The caseworker at the state SSI office (whoever that was I dont remember) actually told us to get a divorce so he would qualify.

My government told me to get a divorce so they could help me.

That is so wrong.

How do you explain Medicaid then?

Don't confuse the issue. The problem is not that only rich people can afford health care. The problem is that we punish the hardworking low-wage earner while rewarding those who contribute the least. So if you are unemployed, you are eligible for Medicaid (which provides reasonably decent coverage if you can get it) but if you have a job, working hard and barely scraping by, you are eligible for nothing. That's the injustice.

WRONG, you are not automatically approved for Medicaid because of unemployment, you must prove you are DISABLED. It is a LONG arduous process to warrent Medicaid, it takes up at least a year and in most cases 2 or more years to be approved.I know this first hand , it has been way over year for me, am waiting for my hearing in front of a SS ALJ. This is NOT a given benefit to we Americans, just because of unemployment.Many people go broke or even die before they are approved, read accounts of people and what we go through to try to get Medicaid on the Social Security Disability Forum.
Specializes in Pediatric Pulmonology and Allergy.
WRONG, you are not automatically approved for Medicaid because of unemployment, you must prove you are DISABLED. It is a LONG arduous process to warrent Medicaid, it takes up at least a year and in most cases 2 or more years to be approved.I know this first hand , it has been way over year for me, am waiting for my hearing in front of a SS ALJ. This is NOT a given benefit to we Americans, just because of unemployment.Many people go broke or even die before they are approved, read accounts of people and what we go through to try to get Medicaid on the Social Security Disability Forum.

If you have no or very low income or assets, you qualify for Medicaid. You don't have to prove you're disabled. Maybe the unemployed have resources (house, car) that count against them when they apply for medicaid, but if you're broke, you qualify, even if you're able-bodied.

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