Several years ago a former babysitter for my children called to inform me that her teen daughter was complaining about abdominal pain. Mrs. Walker, for anonymity purposes, was concerned and wanted my opinion on what to do next. She and her family did not have health insurance and received most of their care from a local Federally Qualified Health Center. The husband had an engineering background but his employment included only contract work where insurance was not an option or was too expensive for a family of five. Prior to this situation, this family had no major medical expenses and was able to reasonably afford acute care and pediatric well care.
I explained to the mother that I really needed to examine her daughter and invited them to my home to do so. Once they arrived, I noticed immediately that their daughter did not look well. She was pale, moved slowly and deliberately across the room, and she felt warm. My examination revealed that she had right lower quadrant pain and to all medical providers this was indicative of acute appendicitis until proven otherwise.
I now had the unpleasant task of explaining to this hard working American family that their daughter needed an emergency room visit, a CT scan of her abdomen, blood work, possible surgery and hospitalization. If this were indeed an inflamed appendix and it ruptured, this could potentially kill her. I recall feeling nauseated as I explained what was happening that day. As a parent, I could not imagine being placed in such a predicament, wondering in my mind how I was going to afford such care. The concern in the parent’s eyes brought tears to mine.
Of course the parents asked me approximately how much I thought this would cost and I replied thousands of dollars. Hospital stays are astronomical! Everything is overpriced. For this particular case, you also have to factor in the imaging costs, the fee for the doctor who read the x-ray, the surgeon, the anesthesiologist, the cost of the operating room, medicines given including Tylenol and a host of other costs.
After the parents recovered from their sticker shock, they simply said they would cross that bridge once at the hospital. A visit to one of the local children’s hospital confirmed that Mrs. Walker’s daughter had acute appendicitis and needed emergency surgery. The teen’s hospital course was unremarkable and she recovered without complications. In addition, the family was able to work out a payment plan and survived this near bankruptcy catastrophe.
In 2013 an estimated nearly 2 million people filed bankruptcy due to medical debt. Approximately 25 million people refuse to fill medications, forego doctor’s visits, or miss doses of medications because of financial hardship. Families have to juggle food, meds, needed preventative tests, and living expenses every month.
After experiencing stories like this on a regular basis, I find it hard to understand some of our society members who continue to believe that basic access to health insurance is not our collective responsibility. Believe it or not, everyone pays for the uninsured, including you. Hospitals have to recoup their losses somehow and insured patrons constitute the shortfall.
The aforementioned example was an emergency and could not be avoided. But what about the thousands of patients that utilize the emergency rooms for non-urgent matters like upper respiratory infections or ear infections simply because they lack a primary care provider? Having an emergency room physician treat a minor illness is analogous to using an AK-47 to kill a gnat! It is beyond impractical and a waste of needed resources.
We now have the opportunity to provide our citizens with affordable health care but the process has been laden with attempts to repeal the law, computer inefficiencies, states who refused to expand Medicaid and tremendous amounts of false information being fed to the public to dissuade sign up.
The technical issues have improved and there are countless forums around the country explaining the process and its benefits. Many health facilities also have workers who will assist patients in signing up and using the website. Please do not allow a lack of understanding to prevent you or your loved ones from getting health insurance.
Open enrollment for the health insurance marketplace ends March 31st. Visit www.healthcare.gov to get started or if you lack access to a computer call 1-800-318-2596 for personal assistance. Remember, if you do not have health insurance in 2014, you may be penalized.
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
