Those of us attempting to live on what was a shoestring budget even before the Great Unending Recession/Depression have probably been watching the large insanity of vacationing Congresscritters attempting to hold Town Hall meetings with their constituents back home with some bemusement. It’s no secret that the WingNut Network [a.k.a. Fox] and Hate Radio pundits have been inciting their faithful dummies to riot, since this has been ongoing ever since they lost the election last November in a big way. Between the clueless idiots who can’t believe a black man is a real American citizen (or that exotic Hawaii is actually a state) and the Bermuda shorts and gray hair crowd shouting “Keep the government OUT of my Medicare!” one really does have to wonder if maybe there’s something in the water making people lose what few IQ points they might have had back in kindergarten.

Some of us also know that going to a doctor regularly if you aren’t actually sick is not wise, thus are probably better off if we don’t suffer some chronic condition with our very limited access to the health care system than we might be if we had annual check-ups and the ability to demand whatever drug is advertised on television nightly. While it’s a sad truth that ~50 million Americans have no access to the health care system – and that’s an insurance issue – I haven’t seen anybody talking much lately about the health care system itself, which just happens to be the third leading cause of death in the United States.

Thus they’re fighting about “Health Insurance Reform” while the dismal failure of doctors and hospitals to confront the outrageous error rate, hospital-acquired infection rate, etc. that KILLS at least 195,000 Americans every year. Americans who DO have access to the system! The U.S. pays more per capita of our GDP on health care than any other industrialized nation – most of which have universal, single-payer health care systems – and are at the very bottom of the list on all measures of health care outcome. Life expectancy, infant and maternal mortality (tied to our ridiculous C-section rate and lack of prenatal care), general health, number of chronic diseases, etc., etc.

We’d all like to see universal access to health care. We’d like for insurance companies to be barred from canceling policies if the person gets sick, from refusing to cover those with pre-existing conditions, and from raising the rates at five times the rate of inflation every year just because they can. We’d like for the poor and working poor to be able to get health care even if they don’t work for a company that offers it, or don’t earn enough to participate. We’d really like to get our bones set and our cuts stitched when we need to without going bankrupt, and we’d like to get treatment for our cancers and our other serious ailments instead of simply dying of them because health care is beyond our reach.

But because something must be done about the current situation in this country no matter how loudly the idiots yell about not offering their government health care to others who need health care, we can expect that something minimal will indeed be done. Best advice to those who have managed to get this far in life without being regular users of the health care system or the drug companies’ medicine chest is to approach new access with caution. Nothing is being done to cure the rate of iatrogenic disease and death (iagrogenic means “doctor-caused”) in any of this political maneuvering, so increased access only means that the delivery system will be able to harm or kill even more Americans every year.

Make use of your intelligence and your access to the internet, go looking for reliable information if you or someone you love gets sick. Merck has their entire medical manual on-line, the Physician’s Desk Reference is available as well with good information about drugs and which ones may conflict with others – something too many doctors don’t keep track of, and a large contributor to deaths from prescription errors. There are lots of physician websites offering information about various conditions, as well as patient associations that often have collected information from people who have or have dealt with particular conditions with even better information. Always be careful of information, make sure it’s good and not just another quack selling the magical ‘cure’ for AIDS or cancer or whatever, because those are out there too.

And if you’ve got questions, write them down, collect the good information you’ve gathered, THEN take it to your primary care provider and ask. Don’t tolerate a physician or practitioner who gets his or her nose bent out of shape because you’ve done your homework, and never put up with a doctor who balks if you ask for a second opinion. If you’re in line for surgery or some other serious treatment, go to the website of your state government’s medical regulatory agency and search until you find a list of the physicians and other practitioners who have been disciplined by the agency for gross or repeated malpractice or errors. If your doctor’s on the list, get a new one.

And most of all, keep always in your mind the fact that your personal choices affect your health for the better more acutely than anything an insurance company or doctor or hospital can. No one else can “heal” you – people’s own bodies do the healing, health care providers can only help it along. Best not to get sick in the first place, and we’ve no excuse not to know that our diets greatly affect our health. Eating well, getting exercise, maintaining our environment, etc. will stave off many a nasty illness or condition – avoiding the plagues that come with obesity is much better than treating this plague or that plague after they’ve developed.

Now, sit back and enjoy the street theater spectacle of the ‘haves’ trying most desperately to prevent the ‘have-nots’ from getting anything! It’s black comedy at its most absurd, something we’ll probably never see again in our lifetimes. Laugh, because that’s the best medicine in the world!

More than 40 million Americans – including children – have no health insurance. As the economy continues to weaken and good jobs are outsourced to countries where universal care exempts businesses from having to carry the health care burden, millions more are being thrown into the ranks of the uninsured. Then there are those who have changed jobs, and encountered insurers who simply will not cover them due to pre-existing conditions. These days if you’ve ever had treatment for things like acne, high cholesterol or carpel tunnel you can find yourself on the growing list of the “Uninsurable.”

Now, if you don’t mind jumping serious hoops and get an early start in the fiscal year, states do have sliding scale plans and Medicaid allotments. If you are covered by one of these, you do NOT count among the officially uninsured. In my officially “economically depressed” region, approximately two thirds of the citizens qualify for food stamps and medical care, but there’s only enough money to cover less than half of them. The rest simply do without, at least until they simply can’t do without anymore. The cost of indigent care at our few public hospitals is yet another perpetually unpaid bill.

This blog offered many good tips and links to useful resources for the uninsured in a previous 3-part series Inexpensive Health Care Tips, Part 1, including in Part 2 some strategies for getting necessary prescription medicines, and in Part 3 how to negotiate access to primary and emergency care.

Now that approximately half of the citizens of the US are either uninsured or underinsured (have high deductible “junk insurance” or coverage that is routinely denied), we cannot expect that things will get any better any time soon, at least not so long as the inside-the-beltway crowd has unlimited free health care. The progressive political website Daily Kos is hosting a Thursday series by diarist ‘nightowl724′, part 1 of which is 10 Survival Topics for the Uninsured.

There are some good resources, advice and strategies presented (topics 1 – 6 of the promised 10). The project arose from the Daily Kos Health Care Google Group. The posting schedule for this month is worth noting:

August 14: Survival Tips for the Uninsured, Part 1
August 15: Uninsured and Lucky to be Alive Part 1
August 21: Survival Tips for the Uninsured, Part 2
August 22: Uninsured and Lucky to be Alive Part 2
August 28: Living with a Chronic Illness

Interested readers can subscribe to the series here.

Links:

Inexpensive Health Care Tips, Part 1
nightowl724’s page
Inexpensive Health Care Tips: Intro
Inexpensive Health Care Tips – 2: Necessary Medicines
Inexpensive Health Care Tips – 3: Primary and Emergency Care
Basic Health Maintenance: Part 1
Basic Health Care Maintenance: Part II
Medical Rationing and Medical Tourism

In response to increasing unaffordability of health insurance in America and justifying his repeated vetos of State Children’s Health Insurance Program [SCHIP] expansions, President George W. Bush declared during an appearance in Cleveland last July that:

“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room.”

As if that weren’t clueless enough, the New York Times reports today (April 23) that one of the nation’s largest health insurers, UnitedHealth, announced disappointing first-quarter earnings (profits), saying the weakening Economy Has Dented Its Prospects. In short, as premiums rise, employers are dropping insurance plans for their employees, more employees are opting out, and rising unemployment is reflected in increasing numbers of uninsured.

The for-profit industry has also shot itself in the foot by increasing premiums to protect its profits over the quickly rising cost of care, not covering people who may have health problems, and simply refusing to pay for health care for the insured. Medical bills now account for a full half of all bankruptcies in the US, and ER treatment is NOT “free.”

So in this installment in the series of inexpensive health care tips, let’s look at some resources out there for people who don’t have insurance, or have “junk insurance” that doesn’t actually cover anything, and those who simply cannot pay cash for doctor’s visits, eye care, dental care, hospitalization or any other aspect of health care in this country.

The readers of this blog have access to a computer (or they wouldn’t be reading). There are some searches you can do through Google or some other search engine to access information on free or sliding scale health care in your area. I did this for my state and locality, western North Carolina. Here are some of the results…

On a search for “free eye care NC” I found Unite for Sight’s Free Health Coverage Program Portal, with hot links to every state. It also links to many sites out there for free basic health care resources, SCHIP coverage programs for children, free eye care, veteran’s insurance by the states, Medicaid and Medicare, free prescription medications, and the states’ free health coverage programs generally. This is a valuable resource page which is featured weekly on CNN International.

In North Carolina, I was also returned a Blue Cross Blue Shield Association page listing a total of 69 free clinics across the state supported by the foundation. North Carolina has the nation’s largest association of free clinics, but it also has a high number (~1.3 million) of uninsured and working poor who don’t have access to insurance. The state Medicaid and Children’s Insurance programs are capped due to funding shortfalls, leaving thousands who qualify for the coverage out in the cold.

The clinics are often traveling, available only on certain days or months. But if you plan ahead and do your homework, this can be a good way to get basic primary care. The NC Department of Health and Human Services, Division of Medical Assistance administers our SCHIP program. The waiting list is long, usually ‘forever’ long in that emergency situations take precedence (as they should), but you never know. Keep applying, someday you might get your children in. The coverage is for all regular and emergency medical needs, and is supposed to be available on a sliding scale to 200% of poverty level income. At that level, it’ll only cost your family $567 per month per child! At poverty level, it’s just $50 a month for one child, $100 for two or more. Plus there are deductibles you must pay out of pocket. I know… not much of a deal, is it? I mean, if you had an extra $100 a month, you could probably just go to the doctor and pay cash.

A better bet when you need help and there are no free clinics available is your local Health Department. Most cities (or counties) offer immunizations and flu shots, cancer screening, child and adult primary care, dental care, and physical examinations for work and school requirements. This is government medicine at its bureaucratic worst, but it is honest-to-goodness medical care. It’s worth bookmarking your area’s health department site for when you may need it. If your family has some income, expect to pay on a sliding scale. So have your income and expenses list ready, along with pay stubs, utility bills, etc. Keep them in a folder or envelope to take with you whenever you access a free or sliding-scale provider.

All I can say is that until and unless America offers single-payer coverage to all citizens, there will be tens of millions of American citizens who have no health care. Estimates of up to 80,000 people die every year due to lack of medical care – don’t let that figure include you or your family. Be prepared to get what you need when you need it, and do NOT take ‘no’ for an answer.

In the most extreme – if you or someone in your family is in serious need and access is being denied, go ahead and bookmark your area’s free legal services association. When in real need, there’s no sense in standing on pride if that means you lose your life or your child’s life. Every other civilized country on the planet offers universal care to their citizens (and most also offer it to visitors). The only reason the US doesn’t have universal care is corporate greed.

I do not believe that some corporate greed-head’s golden parachute or multi-million dollar salary is worth even one person’s untimely death. More people in this country are victims of the “Death by Spreadsheet” industry than fall to terrorists or either of our current wars. This is simply unacceptable. Be a Boy Scout – Be Prepared.

Links:

Economy Has Dented UHC’s Prospects
Free Health Coverage Program Portal
Department of Health and Human Services
Discount Drug Company Assistance Programs

Previous Posts About Health and Health Care:

Inexpensive Health Care Tips – Intro
Inexpensive Health Care Tips – 2
Inexpensive Health Care Tips – 3
Medical Rationing and Medical Tourism
Basic Health Maintenance: Part I
Basic Health Care Maintenance: Part II

The New York Times reported on Monday, April 14 that Co-Payments Soar for Drugs With High Prices as the nation’s largest health insurers struggle to keep their profits high and their payments for health care low. The new pricing system forces patients taking name-brand medications to pay a percentage of the cost rather than a fixed co-payment of $10 to $30 a month for each medication they take.

The situation, and plans for a public demonstration in San Francisco during the AHIP annual meeting on June 19th are outlined in Insurers target the sickest: Say bye bye to $20 prescription co-pays.

This means that the burden of increasingly expensive health care now affects the insured, who may now have to pay thousands of dollars a month for medications in addition to their high monthly premiums and treatment co-pays and deductibles. America’s sickest citizens are once again being abandoned by a system that was originally designed to spread the costs of their care across a large pool that includes healthier people. Insurers say the new system will keep everyone’s premiums down, just at the time of year that Americans are discovering that they must pay double or more for the same health insurance they had last year. That’s not a very impressive system, considering that all other developed nations on the planet have universal health care.

Thus this installment of the series of inexpensive health care tips will offer some alternatives for obtaining drugs that may be beyond your ability to afford.

Because large public hospitals and smaller hospitals serving the public in smaller towns make up the backbone of the American health care delivery system are also being driven to bankruptcy by greedy insurers who increasingly refuse to pay for covered services [see Health Insurance Racket as Organized Crime and People of New York vs. Vampires], the gaps in our system are quickly widening and threatening to sink doctors, nurses, hospitals and clinics in the process.

The first place a strapped citizen should try to contact, even if s/he does not qualify for Medicaid or other subsidized health care plans is the Department of Health and Human Services in their area – the good ol’ Health Department (search for “health department” and your state or city). Most health departments offer both sick and well child services, just call ahead to find out what days they are available – you don’t want to be taking a well child in for immunizations or flu shots on sick child day, where they’ll be exposed to God knows what. Immunizations and flu shots are one of their specialties. The same services are available on certain days for adults, just make your inquiries ahead of time. If medications are prescribed, the patient is usually informed of generic alternatives, referred to pharmacies that partner with HHS for low cost, and some will give brochures for pharmaceutical company free drug programs if the medication is expensive or long-term.

Some localities also offer free or low cost clinics staffed by volunteer doctors and nurses a few days a week. Again, these physicians will usually know if there are generic drugs that can substitute for higher cost name brand drugs, and prescribe accordingly. Walmart offers $4 prescriptions on a general basis, and some states also have drug assistance programs. Often, just getting prescriptions filled at Walmart or another participating chain pharmacy is cheaper than using the deductible schedule, even for the insured or Medicare/Medicaid patients.

If you or someone in your family suffers from a condition for which the best drug treatments are solely brand name and very expensive (or you take a sufficient number of prescriptions to put a serious dent in your income), the big pharmaceutical companies offer free and low cost prescriptions directly via funded programs. If your doctor or health department doesn’t give you the information you need, you can search on the manufacturer’s name and go to their website. They usually have readily accessible links to their programs, or you can do an internal search. SelectCare Benefits Network has some programs and offers useful links for health care professionals as well as patients to get them started on finding free medicines and prescription assistance programs.

In the next installment in this series, we’ll take a look at ways to gain access to doctors, tests and (not prescription) treatments for conditions without going broke. Good luck to all out there as we weather the necessary growing pains that accompany our shift from private, for-profit health care to a modern system that offers health care to all citizens without fomenting class warfare. Keep your chin up, there ARE alternatives!

Links:

Discount Drug Company Assistance Programs
Department of Health and Human Services
Walmart $4 prescriptions
SelectCare Benefits Network

Previous Posts About Health and Health Care:

Inexpensive Health Care Tips – Intro
Inexpensive Health Care Tips – 2
Inexpensive Health Care Tips – 3
Medical Rationing and Medical Tourism
Basic Health Maintenance: Part I
Basic Health Care Maintenance: Part II
Shoestring Budget: Nutrition Posts