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

Specializes in ER, Trauma.

I can answer your question from current personal experience! Been out of work since January due to a perfect storm of back problems. My sick time ran out in late March. To see a Dr it's $30 up front, and if I don't have it they offer to reschedule my appointment. Prescriptions also required from 20 to 45 dollars copay if the insurance company agreed with the doctor that I needed that medication. All I wanted was someone to fix me so I could get back to the ER nursing.

15 (fifteen)! doctors later, most with multiple appointments at $30/per, I'm near bankruptcy. I've been paying for all these Dr's visits, meds, and my health insurance via COBRA ($$$) with credit cards. Borrowed money from my daughter to pay rent, eat PBJ sandwich's, no income since 1st week of April, I owe over $30,000, and Social Security has just begun giving me disability payments, 1 so far.

I used up all my retirement savings, my wonderful coworkers have helped out, I'm now living with my daughter for free. I still hope to find a way to earn a living, but cannot do a job requiring standing, walking or lifting. The rehab doc says get a phone from home job.

The net result is that after selling all my personal belongings, maxing out my credit cards, and the wonderful generosity of coworkers and my daughter I survived to get income from SS disability. Without all this help my life expectancy would have been only months.

My answer to your question is that without money the healthcare system will shun you. Sorry for the verbose answer but it's been a long difficult year, and all I want is someone to fix my back so I can work. Numerous medical encounters have made it quite clear that without money, it's not their problem if I die.

Sounds like some awful experiences... dthfytr you are a very strong person to go through all of that...

This might be an ignorant question from a Canadian, but if the system is so awful with helping people in need, then why is everyone against Obama and his health care reform policies??? Is it just that the economy is so bad that people want him to focus on the making the economy better before addressing the health care system or are there just so many people out there that refuse to pay any more $$ for taxes so that everyone can have health care when needed? Our system is far from the best in Canada, especially when you look at cancer care and the expense of cancer drugs and different drugs being approved in different provinces for coverage but at least you can go to the dr and get diagnosed without paying = earlier diagnoses and better prognosis...

Specializes in Psych, EMS.

The taxpayers pay the bill, and/or the hospital "eats" the cost.

I'm a social worker in Michigan. Medicaid has nothing to do with illnesses people may (or may not) have. Medicaid is for people with very low income and assets.

That's nice that that's how things work in Michigan, but there is big variation in Medicaid eligibility and benefits among states. I am a psychiatric nurse who has done case management in my state, plus I have tried to help poor acquaintances find resources to pay for healthcare. In my state, Medicaid eligibility depends v. heavily on specific illnesses. If you are not under 18 years old, pregnant, or have one of a few specific chronic illnesses, it's basically impossible to qualify for Medicaid in my state, no matter how low your income and how limited your assets. And, AFAIK, my state is not the only state that has cut back significantly on Medicaid.

Specializes in PICU, NICU, L&D, Public Health, Hospice.
Sounds like some awful experiences... dthfytr you are a very strong person to go through all of that...

This might be an ignorant question from a Canadian, but if the system is so awful with helping people in need, then why is everyone against Obama and his health care reform policies??? Is it just that the economy is so bad that people want him to focus on the making the economy better before addressing the health care system or are there just so many people out there that refuse to pay any more $$ for taxes so that everyone can have health care when needed? Our system is far from the best in Canada, especially when you look at cancer care and the expense of cancer drugs and different drugs being approved in different provinces for coverage but at least you can go to the dr and get diagnosed without paying = earlier diagnoses and better prognosis...

A big part of the reason that the US could not accomplish a single payer system with the recent reform is because of FEAR...and huge doses of that were served up by some Americans, many of them who identify with the most "conservative" politics of the country. Certain segments of the general public quickly became fearful of death panels, and rationing, and never ending waiting lists, etc. Again, and in my opinion, most of that fear rested within the "conservative" members of our citizenry.

To my thinking, that makes sense...like minded people tend to acquire information in like minded ways from similar if not the same sources. For instance, consider how motorcycle enthusiasts inform themselves...or scuba divers...just like with that, people seeking information which reflects their very conservative social and political interests read, watch, and listen to very similar, if not the same, sources. Those sources chose topics of fear and chose "personal responsibility/acountability" over "compassion".

Honestly, I agree with Florence Nightingale - "How very little can be done under the spirit of fear". I do think we will accomplish further change, I am not sure that we have a choice...

In essence, a portion of our society were horrified by the thought of allowing a Medicare type option to all Americans, for a fee. Visions of death panels forcing "granny" into assisted suicide or mandatory euthanasia had lots of people very nervous.

Specializes in ER, Trauma.
Sounds like some awful experiences... dthfytr you are a very strong person to go through all of that...

This might be an ignorant question from a Canadian, but if the system is so awful with helping people in need, then why is everyone against Obama and his health care reform policies??? Is it just that the economy is so bad that people want him to focus on the making the economy better before addressing the health care system or are there just so many people out there that refuse to pay any more $$ for taxes so that everyone can have health care when needed? Our system is far from the best in Canada, especially when you look at cancer care and the expense of cancer drugs and different drugs being approved in different provinces for coverage but at least you can go to the dr and get diagnosed without paying = earlier diagnoses and better prognosis...

From where I look at it, it just comes down to money, and confidence in the government. Insurance and drug companies make obscene profits continuously finding ways to avoid paying for members healthcare, and raise rates for those who need insurance the most so that they end up on government assistance. In essence. Health insurance is reserved for the healthy, and the medically needy (like me suddenly after working hard all my life) are priced out of the market, and the govenment has to pay to care for those sickest. Dialysis is an automatic move to government coverage, for example.

Looking at this, our bankrupt postal service and the national debt, people conclude that government healthcare would be too expensive. In reality a single payor system covering all Americans would be cheaper because it wouldn't need to make a profit, and changing our system to this would mean only taking responsibility for the healthiest citizens. The sickest are already covered by the government. No system is perfect, but it's obscene that in the richest country in the world people die because they can't afford even basic healthcare. Our constitution guarentees the right to life and I beleive eventually somebody will tie that to the right to healthcare. Currently all men are NOT created equal, the wealthy are treated better. The classic struggle between the haves and have nots. Thanks for listening and asking. I'm surprised I made it this far because I've always been independent, and losing that has hurt very dangerously.

wow. good question 15isto2. i don't really understand america's health system either, but this has definitely given me a great insight into it. honestly i'm quite amazed at it all. no offence to any one here but i have to say i'm pretty glad i live in australia.

Specializes in ER, Trauma.
wow. good question 15isto2. i don't really understand america's health system either, but this has definitely given me a great insight into it. honestly i'm quite amazed at it all. no offence to any one here but i have to say i'm pretty glad i live in australia.

see if this helps you to understand.

competition is supposed to drive prices down and quality up through supply and demand. the insurance companies are loosely regulated by the states, and so competition doesn't really exist. there are only a few health insurance providers in each state, and consumers are not allowed to buy health insurance across state lines.

the insurance companies exist to make a profit, like any other business, but without the pressure of competition. this leaves the insurance companies free to "cherry pick" their customers. they insure healthy people and dump sick people, who must then get government assistance (which isn't easy or luxurious), or they just go without health care altogether.

american health insurance companies are hugely profitable, since they avoid insuring sick people. government health care is a huge drain on taxes since it must care for all the people who are chronically ill and rejected by health insurance companies.

so, in america, money talks and is now more important than life, an equation i find vulgar. but since insurance companies have millions of dollars to influence government policy, the wealthy are protected, and poor are shafted

See if this helps you to understand.

Competition is supposed to drive prices down and quality up through supply and demand. The insurance companies are loosely regulated by the states, and so competition doesn't really exist. There are only a few health insurance providers in each state, and consumers are not allowed to buy health insurance across state lines.

The insurance companies exist to make a profit, like any other business, but without the pressure of competition. This leaves the insurance companies free to "cherry pick" their customers. They insure healthy people and dump sick people, who must then get government assistance (which isn't easy or luxurious), or they just go without health care altogether.

American health insurance companies are hugely profitable, since they avoid insuring sick people. Government health care is a huge drain on taxes since it must care for all the people who are chronically ill and rejected by health insurance companies.

So, in America, money talks and is now more important than life, an equation I find vulgar. But since insurance companies have millions of dollars to influence government policy, the wealthy are protected, and poor are shafted

Wow. It's really your own choice whether you want Private Health Insurance in Australia. Many people do because it helps keep your Medicare Levy down in your tax refund or they want the additional benefits of private rooms, shorter waiting lists, getting to choose your own doctor at the hospital or the extras benefits (ie cheaper/free chiro, optometry, physio etc) but it has nothing to do with your job besides whether you can afford to pay the Private Health Insurance fees. You choose your own Insurer and your own benefits.

Also our Private Health doesn't do medicals or anything like that. You just sign up and start paying - you might have waiting periods before you can claim certain extras.

But then you don't apply for Medicare here either. Every Australian citizen has a Medicare card and can go to bulk billing doctors. If you go to a different doctor you'll still get a Medicare refund...From what I can tell it's kinda like your co-pay. Except you pay the doctor and then go to Medicare to get your refund. I guess our health system is still hard to explain too.

"So, in America, money talks and is now more important than life, an equation I find vulgar. But since insurance companies have millions of dollars to influence government policy, the wealthy are protected, and poor are shafted"

EXACTLY! This is shameful!

Specializes in ER, Trauma.
Wow. It's really your own choice whether you want Private Health Insurance in Australia. Many people do because it helps keep your Medicare Levy down in your tax refund or they want the additional benefits of private rooms, shorter waiting lists, getting to choose your own doctor at the hospital or the extras benefits (ie cheaper/free chiro, optometry, physio etc) but it has nothing to do with your job besides whether you can afford to pay the Private Health Insurance fees. You choose your own Insurer and your own benefits.

Also our Private Health doesn't do medicals or anything like that. You just sign up and start paying - you might have waiting periods before you can claim certain extras.

But then you don't apply for Medicare here either. Every Australian citizen has a Medicare card and can go to bulk billing doctors. If you go to a different doctor you'll still get a Medicare refund...From what I can tell it's kinda like your co-pay. Except you pay the doctor and then go to Medicare to get your refund. I guess our health system is still hard to explain too.

I like yours better. You'd think such an essential human need as healthcare would be easier to manage. Enjoyed the chat. Stay well my friend, it's bedtime here. Paul

I like yours better. You'd think such an essential human need as healthcare would be easier to manage. Enjoyed the chat. Stay well my friend, it's bedtime here. Paul

Yes I agree. Basic needs such as healthcare should be the most important thing politicians think about. Our healthcare system isn't perfect either and in certain areas it's worse but I admit that I do feel better having our system. Very enlightening chat. Thank you.

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