It frustrates me when I hear people talking on TV and in print about so many not having “access to health care.” Maybe I’m living in a different world, or just haven’t seen it with my own eyes, but I don’t understand this statement. I’ve been a practicing RN for over 30 years. Right at the bedside, not in an office, in a busy metropolitan teaching hospital. I haven’t ever seen anyone denied health care based on inability to pay, or for any other reason, for that matter.
I will admit that I don’t know what goes on in the business and bill-collecting offices of the hospital where I work. I don’t know what transpires with the patient and family on the money end of things. I only know that, as far as health care goes, any and all who need it, get it.
I know a pediatrician in private practice who gives out her beeper number to all her patients. She feels a deep committment to taking her fair share of Medicaid and non-insured patients. She believes that this is her duty, her responsibility, and her privilege. She could not stay in practice if all her patients were non-insured or covered by the government; the reimbursements from the government do not cover the cost she herself pays to provide care. The cost of immunizations alone, which she buys–they are not provided by someone–are never paid for in full by Medicaid.
She gives her beeper number out to all her patients’ families, as I said. She does this out of conscientiousness, but also out of a belief that if they have access to her by phone, she can perhaps keep them out of the emergency room in the middle of the night. And we all know that ER visits are by far the most costly form of health care, costs which are often passed on to all of us.
This pediatrician is a rare find. The other 3 physicians in her group do not take any Medicaid patients, although they do trot off to some other country once a year for a two week “mission” trip. I find that ironic somehow. The pediatrician I know doesn’t have time to take off to South America for a mission, but, IMO, she works a mission all year round.
I think many are confusing “access” to health care with the “expense” of health care. It isn’t that health care isn’t accessible, it’s just that it’s “expensive” to go to the doctor. A catastrophic accident or illness can severely damage or even destroy a family’s finances. Which is why I go without some things in order to pay the premium each month for the old-fashioned catastrophic health insurance I carry. No, it doesn’t pay for each visit I make to the doctor’s office. It doesn’t pay for any prescription drugs I might need. I have to pay for those just as I have to pay for my car’s tuneups and oil changes, since my auto insurance doesn’t cover those. I carry a high deductible, and if something major happened, I would need to make payment arrangements in order to pay that deductible. But, I have the peace of mind that comes with knowing that no matter what health crisis might befall me, the cost to my family, (financial anyway) is limited.
Health care is costly, and I will be the first to say that I haven’t figured out quite how to rectify that. It costs a lot to provide health care. But we mustn’t confuse access with high cost.
I’d love to hear any thoughts any of you have on this.
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I appreciated reading your opinion about this. I am a physician. I have never denied anyone healthcare. Don’t know of anyone in my practice who has. I agree that some are confusing access to healthcare with the cost of healthcare. I would like to take that one step further, though. There are people out there seeking care that they don’t need. Many believe they are ill and want treatment. They are upset that they aren’t getting treated and then blame it on the doctor not wanting to care for those without insurance. Many of these people do hurt. Many people are lonely and miserable. These feelings translate into physical symptoms for which the treatment is psychologic. Many present with complications of obesity, for which, the best solution is to diet. They want people to fix them when the power lies within themselves. We can’t “fix” many of these problems, but I’m told that I won’t. And yet, every day I get up and treat them the best that I can anyway. Too often, people want to blame others for their problems or feel that the solution is someone else’s responsibility. I can’t change how they feel just as I can’t cure their emotional hurts. But I do the best that I can. Access is there. Many are looking in the wrong place though to cure what ails them.
Pup, this is an excellent and well written post. I too have been wondering about what the term “broken” means that is used to describe the health care system. And Julia made some great points about what people are expecting. I saw a physician on a program today who charges people $79 per month for healthcare, like an insurance program. It’s for those who don’t have any insurance. The government came in and said there were some laws that he was violating and that when people were sick, he needed to charge them $33 for the office visit. Kinda strange…I didn’t know there were laws about how much a doctor has to charge. But I wouldn’t be surprised, what with the govt. wanting to tell us how to live so much these days. If Government-run health care is what we have to look forward to, I guess all the doctors will quit making any money and will have to look for another line of work. I too worked for a company with Medicare accounts, which were 6 months behind on payment, what little was paid. Radiologists get quite testy when they haven’t been paid for awhile.
Julia,
Sorry for the delay in thanking you for your excellent comment. I thank you for completing my post with great points, and agree totally with you. As a nurse at the bedside, I fully understand and see all the time how unrealistic many people’s expectations and understanding of their illnesses are, and how the complete lack of responsibility for their own bodies’ well-being doesn’t seem to occur to them.
You sound like a very good doctor, who works hard to provide good care. I wish you luck with the coming government-run health care.
Keep in touch!
Pup
Kathy,
Thanks! I saw that story too, and didn’t understand the problem. I’m sure it’s just the beginning of the rules that are to come. And yes, I think that many doctors will decide to retire early, and then pursue something else. I learned a lot from having a physician friend with a private practice. Doctors may “make” a lot of money compared to many of the rest of us, but the expenses of being a doctor in practice are quite high too. I compared my hours worked/pay received to her schedule and income once, and she wasn’t actually making that much more “per hour” than I was, after taking out expenses.
I get so tired of people being so resentful of someone else making more money than they do. Even though they weren’t willing to do the 12 years of education/training to become a doctor.
You got that SO right. I believe our new administration, having come from the “community organizing” background is still doing just that…stirring up the people’s discontent and making the “will nots” quite conscious and envious of the “haves”. I mean, why would he quit now?
…and do we know yet who paid for the President’s expensive education at Columbia and Harvard?
Well, I do know that the system is somewhat broken, since I was married to one also in the health care field. Insurance is regularly denied to those with chronic conditions. I’m 55 and an asthmatic, and so the costs of the policy and riders I would be charged preclude me from carrying any insurance for the very disease that I need it for. My daughter also. And then you can’t change it if you use those benefits, and are at the insurance companies mercy and stuck with the carrier no matter how high those premiums then go.
Wait until you do have to eventually use those benefits. And then see what happens. My sister’s husband has COPD and now cannot get coverage as a small business owner.
So, access is not there for all. Since there are many doctors that, if you are not insured, want their money up front in full. Many.
You should have stopped writing after the statement, “I will admit that I don’t know what goes on in the business and bill-collecting offices of the hospital where I work. I don’t know what transpires with the patient and family on the money end of things.”
You’re right about one thing, anyone can go to the ER to get help. However, who ends up paying for it? That is the big question. And I don’t call waiting in the ER for hours to get looked at by whatever physician is available “equal access” to care. As an RN with health insurance, did you get to select your PCP or (if you have children) your OB or your pediatirician? I’ll bet you did. That kind of individual choice should be accessible to everyone.
Carla,
Gosh, commenting on a post almost a year after I wrote it. I’m amazed you found it.
You’re welcome to express your opinion here anytime, within the guidelines. I have just a couple of remarks to add.
I didn’t use the phrase “equal access” to care anywhere in my post. You say you would not call “waiting in the ER for hours…’ “equal access” in quotes, and I said that all HAVE access. Oh, and as a per diem employee I did not receive health insurance from my employer; I searched for, applied for, and got my own policy with Golden Rule, and paid for it myself. Yes, I could and did pick my own physician. I paid more for that option.