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.
Specializes in Pediatric Intensive Care, Urgent 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.
One of the myths that allowed the powers in Washington cram Health Care Reform down our throats is that there are people dying from acute issues like cancer. I work with Medicaid patients. I have many patients who became enrolled in Medical Assistance because of issues like cancer. Those who truely cannot afford health insurance most likely qualify for Medicaid. Even those whose income is too high to qualify under normal circumstances would probably be eligible because of the high costs they are incurring. These folks are usually enrolled, receive treatment, then are disenrolled. Problem is that most people who have not been living in "the system" don't know how to navigate it, and aren't aware that they are entitled to assistance, and as a consequence suffer from poor health until someone comes along who can point them in the right direction. Most of the "pointing" is currently done by hospital social workers. Among my duties is to act as a liason between Medicaid and the medical community, and although I do receive an occasional referral from a doc asking for assistance in helping a patient enroll in Medicaid, most providers today simply do not understand how the system works.
Why do you keep re-gurgitating the same thing your politicians are telling you when there are people on here saying they don't have health insurance AND they dont QUALIFY for Medicaid...are you calling them liars??! Being unisured is real in this country...STOP downplaying it!
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.
One of the myths that allowed the powers in Washington cram Health Care Reform down our throats is that there are people dying from acute issues like cancer. I work with Medicaid patients. I have many patients who became enrolled in Medical Assistance because of issues like cancer. Those who truely cannot afford health insurance most likely qualify for Medicaid. Even those whose income is too high to qualify under normal circumstances would probably be eligible because of the high costs they are incurring. These folks are usually enrolled, receive treatment, then are disenrolled. Problem is that most people who have not been living in "the system" don't know how to navigate it, and aren't aware that they are entitled to assistance, and as a consequence suffer from poor health until someone comes along who can point them in the right direction. Most of the "pointing" is currently done by hospital social workers. Among my duties is to act as a liason between Medicaid and the medical community, and although I do receive an occasional referral from a doc asking for assistance in helping a patient enroll in Medicaid, most providers today simply do not understand how the system works.
Okay let me give you the real picture about this - from firsthand experience.
I'm a travel nurse. Earlier this year I had a contract fall through 5 days before my start date. I immediately was uninsured. My insurance ends last day of any contract unless I already have another signed contract in hand.
I could not afford COBRA as I was 3000 miles from home in CA and didn't know how long the money would have to last. I do not qualify for Medicaid because my recent previous income is too high. I could not buy affordable coverage individually since I am 56 years old with preexisting conditions - cost even with limitations was exorbitant.
So where do I fall in your picture? From my angle it was pretty scary to be "bare" of insurance for 7 weeks (not knowing how long it would be) hoping that I would have no urgent needs or exacerbations of existing health issues (and hoping my meds would last - remember the doctor I knew was 3000 miles away)
That's the reality of healthcare run by a for profit system.
If what you say 15isto2 is true, then what is the need for the multi-million dollar indigent care fund at a level 1 trauma center? The indigent care is for those who don't qualify for Medicaid, can't afford health insurance or are underinsured, but they need treatment.
There are people with cancer getting their chemo because of this indigent care fund.
Specializes in Clinical Research, Outpt Women's Health.
Here is what I think about:
My insurance is great (HMO and I happily follow all rules. However, if my husband is laid off again there is no way we could afford 1200 bucks a month for Cobra.
I would try to cover us through my for for 300 bucks a month for way less coverage and be grateful, but because we take BP meds to keep our BP at low normal and he takes allergy meds it will be a long (time) process and they may well deny us coverage. Even though we have o other health issues, eat healthily, and exercise every day. None of that will matter to them.
During this time if I suspected something was seriously wrong or growing I would not seek treatment except for office visits and meds because we would be required to bankrupt ourselves to pay for any surgery/hospital stays etc..... what good is survival if you lose everything?
My family and I were unfortunate enough to have our insurance threatened when my spouse was laid off early last year. He was out of work for six months, and his former employer-provided insurance lasted only two weeks after he was laid off. From that point on, it was COBRA or nothing. I was actually, honest to God, LAUGHED off the phone by not one but two different agents for private policies when I called to inquire about such things. Why? Because I have a significant pre-existing condition that has left me permanently disabled and retraining for a new job. It wasn't just that a private policy wasn't affordable for us - we simply didn't qualify because of me. (When the new health care reform goes into effect, insurance companies will have to offer us a policy, but of course the cost is uncontrolled, so no meaningful change there - the cost will simply be exorbitant.)
The only reason we managed to keep insurance was one of those government policies everyone keeps criticizing. The 65/35 COBRA plan Congress enacted (that has since expired) was our salvation; it cut our monthly COBRA cost from almost $1200 to roughly $380. That was still close to the cost of our monthly housing payment, but with a little help from family we managed to keep our coverage until my husband found a new job and his new employer-provided insurance began to cover us (an additional 90 days). But there are plenty of people like us out there now who don't have the benefit of the 65/35 plan, can't afford or don't qualify for private plans, and who don't have access to Medicaid (the rolls have been frozen in many places, and the ceilings for income have been tightened).
I am not an expert on the social net, but I am also not utterly ignorant of the system. I know enough to apply for hospital assistance beyond indigent care, and I know some of the government-supplied programs (like temporary assistance for needy families) that are available. But there are many ways people in this country can end up uninsured, without any significant options to alleviate the situation beyond begging for alms from the community and hospital. Terrible health situations can happen in the blink of an eye, plunging families from secure situations to severe debt, bankruptcy, and despair. That is why we need a more sweeping reform of the U.S. health care system. While every country's system has its problems, I have to admit I'm jealous of some of you in places like Australia and Canada!
I'm on COBRA now. My old job's health insurance is terrible (Cigna is evil), but it's cheap; COBRA for 2 is just under $700 a month. Thanks to Obama, we can keep COBRA for up to 18 months, though I hope to pick up some other coverage by then.
My husband has some medical issues. We just got a whopping bill from an ER visit last month, even with some insurance coverage. Between that and Hubby's recent surgery, we would be up a creek without COBRA. We had to fight like mad to get some issues fixed last year because he went 64 days without insurance, making his illness a pre-existing condition.
I live near the Canadian border. Quebecers like to shop in my town. Canadian national health care has its problems, but I've never met a Canadian who wanted Canada to adopt American health care.
Healthcare for those who are uninsured would be easy to provide if we could get rid of those who are abusing medicaid and sucking the healthcare funds dry, preventing those in need from receiving the basic care they deserve.
The fact that you haven't had a period in two months is not sufficient reason to take an ambulance at 0200 so you can pee in cup.
I really wish those who are making the healthcare policies would spend a few days riding along with EMS and in the ER. It might just open their eyes a bit.
Healthcare for those who are uninsured would be easy to provide if we could get rid of those who are abusing medicaid and sucking the healthcare funds dry, preventing those in need from receiving the basic care they deserve.
I 100% agree with this. I'm amazed at what people come into the ED for, during the day, when there are Urgent Care centers around.
Specializes in Clinical Research, Outpt Women's Health.
Healthcare for those who are uninsured would be easy to provide if we could get rid of those who are abusing medicaid and sucking the healthcare funds dry, preventing those in need from receiving the basic care they deserve.
The fact that you haven't had a period in two months is not sufficient reason to take an ambulance at 0200 so you can pee in cup.
I really wish those who are making the healthcare policies would spend a few days riding along with EMS and in the ER. It might just open their eyes a bit.
ok so i have done some reading up on america's healthcare system. it's a bit overwhelming trying to understand it all. thanks to dthfytr for explaining it very simplistically to me. 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?
the link below explains australia's health system so maybe if someone reads that they would understand where my confusion comes from.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Ok so I have done some reading up on America's healthcare system. It's a bit overwhelming trying to understand it all.]
Don't worry about that. Nobody understands it. Including the people who vote for or against solutions to "fix" it. I think "identify the problem" as the proper way to go about making the right decisions got lost around 1994 and it hasn't come home yet.
Anyone who is diagnosed with a chronic health condition is eligible to apply for Medicaid. Medicaid then should pick up the costs of treatment.
I wish it were true. . . they play hardball in my state if they discover anything that provides a source of income no matter how small. You need to have exhausted your assets before Medicaid will pick up the costs of treatment. If they are paying for your treatment and they find out you have a mutual fund you'll be hauled down for a hearing and then you will be mandated to pay back every cent you received. I guess we're left to wonder how a vent-dependent patient is going to come up with that at some point in the future when they are completely bedridden now with a progressive neuro-muscular disorder . . .True story.
In my (rural) area, I see lots of donation jars in local businesses and fund raising events being put on by interested groups, churches, etc., to raise $$$ for people who need expensive surgery or ongoing treatment for cancer, etc..
They are in my city, too. It disgusts me to know that parents who's children have an AT/RT brain cancer(for example), must divert their precious time with their child to attend a bake sale, a car wash, or make little jewelry trinkets to sell. And even more sad to me, they are profusely happy and grateful when these things are successful - netting maybe $5000. We all know how many miliseconds it takes for that $5000 to be wiped out after all the time and energy people pour into these events.
[One of the myths that allowed the powers in Washington cram Health Care Reform down our throats is that there are people dying from acute issues like cancer
That's not a myth. It's true.
I work with Medicaid patients. I have many patients who became enrolled in Medical Assistance because of issues like cancer. Those who truely cannot afford health insurance most likely qualify for Medicaid. Even those whose income is too high to qualify under normal circumstances would probably be eligible because of the high costs they are incurring.
In my state none of the above people would be enrolled unless they met the low-income requirement. Just talked to a man yesterday on Medicaid with dx of prostate cancer who got a bill for $7,500 from his radiologist as his part of the cost. If the treatment is long and expensive your part will rise to incurring high costs. They do provide some leeway if you get a job that doesn't pay much in the form of a deductible and co-pay, but if you don't pay those it's referred to a collection agency and eventually your paycheck will be attached.
If what you say 15isto2 is true, then what is the need for the multi-million dollar indigent care fund at a level 1 trauma center? The indigent care is for those who don't qualify for Medicaid, can't afford health insurance or are underinsured, but they need treatment.
There are people with cancer getting their chemo because of this indigent care fund.
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.
Mexarican
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