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I appreciate the fact a.com has made these political forums available for healthy debate. Some get a little combative with their responses/reactions, and that's because people are passionate about their POVs. But there also are some excellent points being made on all sides of many arguments.
In other threads, there have been references made to a lack of available health care for people in the United States. I would be interested in hearing specific anecdotal information about people in the U.S. not having health care availability. I know in my small city, we have policies that do not allow us to turn away anyone from an ER (I think that is state mandated, maybe federal), we also have Parish - that's County to the rest of America :) - Health Units that provide innoculations and other health care services to any citizen. We used the Health Units ferquently when I was a child - a bit accident prone to say the least. We also have a charity hospital that takes all patients on Medicaid or those without insurance. So, based on what is in my immediate world, I don't have the perspective that people in the U.S. are going without health care availablity. Also based on my experience, I would think there is a huge deficit for the uninsured in dental health services and prescription medications. Would anyone like to elaborate based on their observations?
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I believe they're referring to the fact that when you have no insurance, you're forced to use the county-run ERs for all medical care rather than using a family doctor for routine medical care. When those without insurance need routine medical care, they have few choices...pay outrageous cash-pay prices up front or wait until it's so bad that they must go to the ER. This causes several problems because it's much less expensive to treat a problem before it's emergent. Also, when we have people using the ER for their routine care, it clogs up the ER for those with true emergencies.Here's an example: Patient A has insurance. When she feels a lump in her breast, she goes to her doctor who orders a mammogram and she is diagnosed with breast cancer in it's earliest (and most treatable form). She undergoes treatment and recovers.Patient B has no insurance. She feels a lump in her breast, but because there's no pain, she doesn't go to the doctor. Fast forward 6 months to when there is pain. She goes to the ER and is diagnosed with breast cancer, but it's in an advanced stage. It's far more costly to treat, and substantially less likely to respond well to the treatment. She undergoes treatment but her prognosis is far less positive.
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It isn't so much about the truly poor, they can get medicaid. It's those who make too much for government help, but too little to affortd healthcare. When I met my husband, he had no insurance. It was a non-negotiable for me. We looked at his budget and cut out a couple of things and he got on BCBS. I think most could afford, at least catastrophic, if they really looked at their spending. Although I have insurance, it's crap. Last month I had kidney stones and had to have extensive treatment to get rid of them. My insurance paid $6,000, and I have bills in excess of $16,000. Now if they had admitted me rather than doing outpatient, it would have been covered. They would have paid up to $75,000 if I had been admitted, but only $6,000 for outpatient. I told them that next time I would asked to be admitted for ANYTHING. It needs overhauled, I'm not sure a national healthcare system is the way to go, but something does need to be done.
Another service that has cropped up in our area is clinics that charge a small flat fee for an office visit. I think it's $40. They don't take insurance because they don't want to mess with the paperwork and bureaucracy. If a patient has an emergent need - like the uninsured lady with a lump in her breast - she is referred immediately to the charity hospital (which also has many clinics available) - or if she had insurance - to her PCP. I am amazed at the number of insured patients using these clinics because they either do not want to mess with co-pays, wait for a visit with their PCP or use up a portion of their maximum allowable coverage that they might need at another time.
I don't use my insurance for my regular doctor. I get a bigger discount and she doesn't order anything that isn't needed. Mine is really catastrophic only. As far as the hospital, if I had hadn't used my insurance, I would have received a huge discount and actually paid less. Now that it was sent through my insurance, they refuse to give me a discount. Therefore, they shall get a small payment each month. They will get their money because we always pay our debts, but it shall be a slooooow payoff.
That is what is good about MA. Affordable health care is available to everyone and if you do not have healthcare you are fined on your taxes. So in essence you are penalized for not taking advantage of the system. We have MA Health which is like medicare if you are poor but if you are not poor enough for the medicaid, then there is MA Health where you pay a small premium for coverage.
EZ
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I go to a clinic that is funded by federal money and so has a sliding scale fee. I make too much to even qualify for that, but when I look at my expenses, it's tough to afford an expensive set of doctor visits. I was dx'd with a chronic condition this summer. It took 825 dollars to find out what that was. I had 600 in my flex account. The hospital told me I had more than enough to cover it, low and behold I didn't, now I'm stuck making payments.
It's ok, I'm not destitute, but I'd like to be able to not have to worry about getting sick as much as I do.