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.

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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.

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

Please cite the basis for this assertion.

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

Most states do but that's not the point. The testing is actually the cheapest part. Heck I can pay for most of the testing if payments can be made. What I cannot pay for is if something BAD is found. I don't have medical insurance. I cannot afford it due to pre-existing conditions that I didn't choose to be born with. So if I were to get cancer, have a bad accident, a stroke, a heart attack, or some other major medical problem, I'd just have to die as I certainly could not pay for any treatment. This is especially true if I get to the point where I cannot work. This is why I will not have any pap smear, mammogram, colonoscopy, or any of those other tests. I don't want to know. Everyone has to die sometime and of something.

The US healthcare system is broken it needs to be fixed. Some ways to fix it in my opinion.

1. get the lawyers out of healthcare

2. get the insurance companies out of healthcare

3. get the lobbyists out of healthcare

4. get the government out of healthcare

5. if the government has to be involved than remove the insurance companies, the lawyers, and the lobbyists. It's these non-medical people that make healthcare unaffordable and unavailable for the rest of us.

Yes my family also went through bankrupcy due to my uninsured mother getting cancer and dying. Tore my family apart.

Fuzzy :paw:

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.
Well, now I am confused, either I am wrong , you are wrong or we both are wrong. According to my state website dhfs.wisconsin.gov/MEDICAID/ it states that you may qualify for Medicaid if

1.You are a reletive caregiver of a deprived child.

2.Pregnant

3.Under age 19

4.Age 65 or older

5.Blind or Disabled

That excludes me, even though I have MANY health issues.Plus I have absolutely NO financial assets left.Have gone bankrupt.

Specializes in Pediatric Pulmonology and Allergy.

Depends on the state, I guess. In my state anyone with low income/assets qualifies regardless of age or health status.

Some appear confused by the definition of Medicaid and Medicare. Medicaid receives part of it's funding from the federal government. Eligibility is based on one's income and the state sets the income level limits and what services are covered. NYS has a higher income level than Florida, much higher. Medicare is entirely funded by the federal government. To be eligible for Medicare, when under the age of 65, you have to be unable to work and disabled for two years. I received Florida Medicaid for 18 months until my SSDI was approved. I was without any type of coverage for 6 months until I met Medicare's time eligibility. Right now I am in debt for more than $25,000 WORTH OF HOSPITAL BILLS. The bill collectors call all the time. I send to the hospitals, what I can afford. At this rate, I should be able to pay off this debt by the time I'm 100. I have no assets and more than likely leave behind a mountain of medical debts. My advice, don't get injured, don't become disabled and don't have more than a marginal income.

Grannynurseretired

Specializes in Oncology/Haemetology/HIV.
Please cite the basis for this assertion.

It is quite simple.

NOTHING in this life is free.

For someone to get lowcost healthcare:

- either the provider is providing for free, or low cost

- or it is subsidized.

This means the MD/facility/staff/equipment providers/drug suppliers are taking a loss. That includes us. Or we are paying in higher taxes, or higher health costs to subsidize the care of others.

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When was the last time that that the average nurse has worked two weeks and donated the check to the care of the indigent?

PS. Before you ask, I have done my time for charity and mission (outside of this country) . One cannot expect hospitals and MDs to pony up, if we are not willing to do so.

I can give you a solution in two words:

Universal Healthcare

Amen!

Specializes in Pediatric Pulmonology and Allergy.
It is quite simple.

NOTHING in this life is free.

For someone to get lowcost healthcare:

- either the provider is providing for free, or low cost

- or it is subsidized.

This means the MD/facility/staff/equipment providers/drug suppliers are taking a loss. That includes us. Or we are paying in higher taxes, or higher health costs to subsidize the care of others.

--------------------------------------------------------------------------

When was the last time that that the average nurse has worked two weeks and donated the check to the care of the indigent?

PS. Before you ask, I have done my time for charity and mission (outside of this country) . One cannot expect hospitals and MDs to pony up, if we are not willing to do so.

My question is how much of our healthcare dollars goes to basic care that actually preserves health, and how much goes to "frills" like fancier lobbies, perks for administrators, expensive diagnostic tests that don't have much of an advantage over basic tests, ditto for expensive new drugs.

I don't have a plan for how we would cut out the fat and leave the meat, but I'd like to see better pay for healthcare providers while cutting out a lot of the unecessary money being spent (like the inexhorable commercials for prescription drugs.)

The US healthcare system is broken it needs to be fixed. Some ways to fix it in my opinion.

1. get the lawyers out of healthcare

2. get the insurance companies out of healthcare

3. get the lobbyists out of healthcare

4. get the government out of healthcare

5. if the government has to be involved than remove the insurance companies, the lawyers, and the lobbyists. It's these non-medical people that make healthcare unaffordable and unavailable for the rest of us.

Yes my family also went through bankrupcy due to my uninsured mother getting cancer and dying. Tore my family apart.

Fuzzy :paw:

The non productive administrative costs are way too high. Insurance companies make a LOT of money and don't provide ANY care.

It is all waste!

They have a program called carelink where I live. My husband and I signed up for it when he became very ill and we ran out of money and credit.

We almost didn't qualify due to my low paying job since my low pay was on the high end of low. Luckily, my husband had been in terrible pain and fired from the few jobs he managed to get for calling in sick.

Carelink allows you to go to doctors and specialists with just your carelink card. You are also able to use it for hospitalization. They only require you make a monthly payment based on your income and I have heard of payments of as little as $19 a month. If you're on the higher end of the scale, they require that you authorize them to automatically deduct your monthly payment. They have express clinics to keep sore throats out of the emergency room and offer prescription medication at very reduced prices. It's not perfect, but it seems like a good program.

I wish we could have qualified for it before hitting rock bottom. I worked as many hours as I could, maxed out all my credit cards and sold anything I had of value to pay my own way as far as I could go. We are thousands of dollars in debt with ruined credit. It really didn't seem fair that people who didn't work and had 5 planed kids got everything free, but I guess everyone has a story. :o

OK, I have to weigh in on this. To paraphrase the manta of the conservatives during the Clinton administration, if universal health care is the answer, the question must have been exceedingly stupid, and for a number of reasons.

To begin with, let's examine the question of nursing salaries. One poster stated that if we are to enact universal healthcare, that we (nurses) must be prepared to accept serious cuts in salary. Others asked that poster to back up that statement. I'll do so, happily. To begin with, as pointed out by Caroladybell, it is unreasonable to expect that reductions in reimbursement will affect everyone except nurses. We will ALL take a salary hit. I look no further than Great Britain, where universal health care is the norm, to demonstrate. One nurse that I work with came to the US from England. According to this gentleman, the average nurse's salary there is only marginally greater than the average salary paid to McDonald's employees. How many of you are willing to continue at your present jobs for anywhere from 20 to 50% less than what you are currently making?

But it goes further. Since our federal government will be forced to pay for the health care of all citizens, it will have to raise our taxes. I believe that the average rate of taxation in countries that fulfill this mythical social contract is around 50%. So, not only will you see a reduction in salary, the government is going to take more of the smaller amount you make to pay for everyone else's health care. Think about that for a minute, and think about what you currently own. Will you be able, on that reduced salary, to make your current payments? Will you be able to continue to live the lifestyle to which you have become accustomed? Most nurses I know won't. They will have to sell homes, cars, furniture, whatever, in order to reduce their debt load. On top of that, they will have to accept living in smaller apartments, driving older cars, and bargain shopping for everything, which will probably be the best they can afford. And if you have student loans, well, you are just toast. Or are we as nurses being greedy in our expectations, and should we be willing to accept these cuts? Threads on salary seem to suggest this is not the case.

But there are other problems with the idea of universal health care. Think every dollar collected for such a program will go to the provision of health care? Think again. Consider the behemoth that is our welfare system. For every tax dollar that is collected for welfare, only something like 40 cents goes out in actual aid. The other 60 cents goes towards maintaining the bureaucracy that has been set up to administer the programs. Universal health care will be no different.

How many of you are concerned with the supposed loss of privacy you have endured under the present administration? That's going to get a lot worse. The federal government is not going to just pay for your health care without some knowledge of why the money is being spent. In other words, the federal government will maintain health care records on all of us. And those records will be available to any other federal agency, because we now have laws about records sharing between federal agencies. Just think. The FBI will be able to access your health record with nothing more than a memo, rather than the current warrant that is required.

And we still have not discussed things like rationing of health care, which will occur. Neither have we discussed the waiting periods that will occur. The arguments against such a program just go on and on.

No thank you, I'd just as soon the federal government stayed out of health care. Let me end by suggesting something really radical: Perhaps, just perhaps if uninsured=financial ruin, then maybe one should do what one must to maintain health insurance rather than expect the rest of us to carry the burden.

One other issue: If you think I painted a bleak picture for nursing, consider the situation for physicians and nurse practitioners. We too will see a reduction in salary. On top of that, folks like John Edwards, who have made their fortune through malpractice law, are not about to allow that system to change. Therefore, while salaries will go down, malpractice premiums will continue unchanged.

There are already places in this nation where the malpractice premiums for certain specialties are higher than what the provider can possibly earn in a year. That's only going to get worse.

Add it all up, and I can easily forsee an exodus of health care workers to other professions. That will make our current (mythical) healthcare crisis look like gentle summer breeze next to a Kansas tornado.

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