Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More
It is that time of year when we make wishes and resolutions for the New Year. My hope is not a resolution so much as it is a very fervent wish. What I wish for in the New Year of 2008 and all the years after is for everyone in the United States to have some type of health insurance coverage that allows them to receive basic health care services for themselves and their family members.
The American Medical Association has published a number of disquieting articles about research findings from such places as Harvard Medical School and elsewhere. What is being reported falls into two categories: 1) Medicare and, 2) Health of the uninsured.
In the area of 1) Medicare it seems that the health of many people who were previously uninsured greatly improves once they turn 65 years of age and can receive medical treatment that they could not afford before that age because they had no health insurance. It seems that many people delay getting medical help if they are uninsured because medical costs, including laboratory procedures, MRI’s and other types of tests are prohibitively expensive. Even those with symptoms of heart disease will delay seeking treatment if there is they have no insurance.
The Uninsured: It may defy all logic that in these United States there are millions without health insurance. How is this possible?
Waiters and waitresses from small diners to prestigious restaurants work without health insurance coverage. In fact, they work for salaries below the minimum wage on the premise that tips are the free enterprise way for them to greatly increase their salaries. Unfortunately, as reported to me by many waiters and waitresses, not all patrons are generous with tips and some chronically do not give tips regardless of quality of service.
Many small businesses and even some of the large corporations reduce costs by hiring people on a part time basis so as to not have to provide worker benefits such as health insurance. Starbucks is one of the few companies that provide health insurance for everyone working 20 hours per week or more. Colleges and Universities across the nation have attempted to reduce costs by hiring what are called Adjunct Faculty to teach classes on the undergraduate level. Adjunct faculties are part time teachers who cannot ever receive tenure and are not entitled to health benefits. To make ends meet many instructors who cannot get full time faculty jobs teach classes in several colleges and universities, all of them on an adjunct basis. In other words, it may appear as though Americans are fully employed but, in point of fact, many people are working part time at several different places of employment all of which do not provide health insurance.
2) As the AMA reports, the health of the uninsured are not as good as other people because they delay going to the doctor. In the cases where there are chronic illnesses, many of these are neglected because of the lack of insurance. What is being referred to here is not the use of the healthcare system for frivolous reasons but for serious, acute and chronic illnesses. In some of the most serious cases the delay in seeking medical attention is dangerous and can and does result in death. What is sad is that the U.S. has one of the best healthcare systems in the world but too many people cannot afford to make use of it. When they are forced, by circumstances, to use the medical system they are left with bills that they cannot afford to pay. This leads to the next point: Co pays and Deductibles for those who have health insurance.
3) Co pays and Deductibles: What I have become increasingly aware of are patients who have health insurance coverage with copes and deductibles that are so very high that, even after their medical bills are paid they are left with burdensome bills. Deductibles refer to the amount of bills that a patient must accumulate and pay by themselves before their insurance will take over. For instance, some people I know have anywhere from $2000 to $400 dollar deductibles that they must pay before their health insurance begins to pay. The way it works is that the doctor or hospital sends the bill to the insurance company who then denies payment until the deductible amount is paid off. If it a two thousand dollar deductible, the patient is responsible for that amount and only then will the insurance pay. The trouble with this is that doctors and hospitals want and expect payment regardless of the deductible. Too many hard working people cannot even afford the two or four thousand dollar deductible.
Co pays refer to the amount the customer must pay for medications in addition to what the health insurance company pays. Co pays vary in amount from $5 to $30 dollars a drug depending on the expense of the drug and the type of health insurance the customer has. Since most patients require more than one medication, particularly as they get older, the cost of the copes can become prohibitively difficult to meet. For that reason, many doctors try to prescribe generic medications. Generic medications are made more cheaply by smaller drug companies. The reason they can sell the drug so much more cheaply is that it is less expensive than the original medication under a famous name.
Know your medical insurance and know your rights. Know what you are and are not entitled to. Go to doctors and hospitals that accept your insurance coverage.
If you do not have health insurance, you and your family may be entitled to either Medicare or Medicaid.
Your comments are welcome and encouraged.