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Archive for Sunday, June 17, 2007

Uninsured workers face health care crisis

Lori Winfrey, nurse practitioner at Health Care Access, 1920 Moodie Road, checks the injured hand of patient Kerry Shaw, Lawrence, at the clinic. Shaw has a job but is not covered by health insurance yet. He visited the clinic Tuesday after looking online for free health care in Lawrence.

Lori Winfrey, nurse practitioner at Health Care Access, 1920 Moodie Road, checks the injured hand of patient Kerry Shaw, Lawrence, at the clinic. Shaw has a job but is not covered by health insurance yet. He visited the clinic Tuesday after looking online for free health care in Lawrence.

June 17, 2007

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The Uninsured in Douglas County

We see reports in the media all the time about the skyrocketing cost of health care and ever-growing number of those going without health insurance altogether. Tonight -- 6News Reporter Christine Metz brings the story of one of the thousands of people right here in Lawrence that struggle with the same problem. Enlarge video

Dr. David Goering talks about the increasing number of uninsured residents.

Listen to Dr. David Goering - a doctor who treats patients at LMH and a board member of Health Care Access - talk about the increasing number of uninsured residents. Enlarge video

Chat about the uninsured with Nikki King

  • More than 12,000 people living in Douglas County don't have health insurance. It's a number that has skyrocketed in the past decade regionally and nationally. Nikki King executive director of Health Care Access will chat Monday about who makes up the uninsured population in Douglas County.Submit a question

Funding for clinics

Health Care Access Clinic, 1920 Moodie Road, and Heartland Medical Clinic, 1 Riverfront Plaza, rely heavily on donations and outside support to keep the doors open. In both cases, what patients pay covers little of the operating costs.

For Health Care Access, a large part of its operations are doable because of in-kind donations: volunteer doctors, free medicine from pharmaceutical companies and services provided from the hospital. The clinic also receives money from the state, county and city, and local nonprofits. In 2005, the city chipped in about $17,000 and the county $13,000.

And, of course, the clinic does fundraising and accepts donations.

Heartland Medical Clinic is part of The Leo Center, a local Christian outreach and ministry nonprofit. The majority of its funding comes from church and individual donations.

For the first time, the clinic is asking for money from the city this year. It also is applying for other government grants.

Health Care Access serves only those who are from Douglas County, are without health coverage and meet the clinic's income guidelines. A family of four cannot make more than $3,083.33 a month. A $10 fee is requested, but no one is denied care if they can't pay.

Heartland Medical Clinic takes those who have insurance, are on Medicaid or don't have insurance. They too do not deny medical help for those who can't pay.

The cost of a doctor's visit at the clinic depends on the person's income, but the most patients will pay for a doctor's visit is $30.

Earlier this month, 53-year-old Desiree Stephenson biked over to the Health Care Access Clinic to take care of an itch.

She has an auto-immune disease that can flare up with stress and sun and needed some medication to stop the itching from a rash that had spread up her arms.

Stephenson doesn't have health insurance. Working as a customer service representative, she said it would cost $120 a month to be covered. And even then, she would have to pay the medical bills up front and be reimbursed by only 40 to 50 percent.

"I can't afford it," Stephenson said. "I live paycheck to paycheck."

For the past year and half, Stephenson has gone to one of two clinics in Lawrence that provide services for those without health insurance. Stephenson - who already has made five to six visits to the clinic - said she is also treated for high cholesterol, a thyroid problem and depression.

Without the clinic, she said she would either be "extremely sick or dead."

In almost every way, Stephenson represents the most common patient that walks through the clinic's door. She is a white woman between the ages of 22 and 59, and has multiple health issues and a job.

A gap

Stephenson is one of more than 12,000 people living in Douglas County who don't have health insurance.

It's a number that has skyrocketed in the past decade regionally and nationally, Dr. David Goering said.

Goering is a doctor at Lawrence Memorial Hospital and on the board of directors of Health Care Access, 1920 Moodie Road.

"The cost of insurance alone has gone up tremendously, a lot faster than the increase in inflation and the increase in the average worker's earnings," Goering said.

Janice Friedman works for the Kansas Department of Social and Rehabilitation Services helping clients in need connect to other social service agencies.

Part of the problem, she said, is a gap of people who aren't poor enough to qualify for government assistance but don't make enough money to pay for health insurance.

"The biggest thing is people fall through the cracks," she said.

The demographics

At 59, Rosemary Beers fits into Health Care Access' most common demographic. The bus driver was waiting for a prescription at Health Care Access on what was her first day of radiation treatment for breast cancer.

Beers said she could get insurance through her employer, but when her health history was factored in, the rate would be just too high or she might not even qualify. She has been diagnosed with cancer three times and has diabetes.

"I'll tell you, if this wasn't here, I'd probably be in a wheelchair now," she said.

Statistics kept at the Health Care Access Clinic show that last year more than 60 percent of the patients were women, 71 percent white, 81.6 percent between the ages of 22 and 59, and the majority had jobs.

However, a day spent in the waiting room of the clinic shows a demographic that goes far beyond those numbers.

The patients included mostly women but also some middle-aged men. Patients ranged in age from 8 years to almost 80. Some spoke Spanish, others French. Most had jobs, but some were recently out of work, and one woman had been homeless for years.

Among their ailments were breast cancer, back pain, muscle strain, high blood pressure, swollen hands, a fractured nose and a fluttering heart.

None of them had health insurance.

The cost

Across town, at the Heartland Medical Clinic in Riverfront Plaza, a similar demographic emerges. About three-fourths of the patients that come to the clinic do not have health insurance. The price of a doctor's visit at the clinic is based on a sliding scale and depends on the patient's income.

Nearly 90 percent of Heartland's patients are white, 55 percent are employed, 54 percent are female and the most common age bracket is between 45 and 64.

Less than a week after a hospital stay, 59-year-old Doris Goodlett was in for a visit to make sure her new medicine meshed with her old ones. She has diabetes, congestive heart failure and no insurance.

"I'm not working, and my husband is the only one working," Goodlett said. "He makes $8.50 an hour, and we can't afford the $300 to $400 a month on top of all of our bills."

Goodlett said she was reluctant to go to the emergency room because her last trip more than 10 years ago resulted in a $16,000 bill. At $100 a month, it took years to pay it off.

This time around, Goodlett said she applied for a grant that would cover her hospital stay.

"Hopefully, they will OK it, otherwise we will just have to do," she said.

Without Heartland Medical Clinic, Goodlett said she wouldn't go to the doctor. The clinic also helps Goodlett access cheaper medicine, cutting hundreds of dollars a month off the price.

Both the Heartland Medical and Health Care Access clinics use programs set up by prescription drug companies who supply free drugs. Each clinic received about $1 million worth of free medication last year from these programs.

Finding care

For the past six or seven years, Bonnie Davis has been coming to the Health Care Access Clinic. She's been unemployed for about three months. Paying the $300 a month needed for health insurance is out of the question.

But she can usually afford the $10 per visit donation request the clinic makes. And, if she needs drugs, she relies on the samples the clinic keeps on hand.

"It's either come here or go to the emergency room, and I can't afford no emergency room," Davis said. "When you get done there, it is $500 to $600."

Many of the uninsured, however, do end up in the emergency room for care, Goering said. Goering cares for the uninsured patients after they are treated at the emergency room and then admitted into the hospital.

"It is sort of a perennial problem in our society that people who don't have insurance end up getting the most expensive source of their care being from the emergency room," Goering said.

The Health Care Access Clinic has helped keep at bay the number of people coming into the ER, which lowers the amount of bills that go unpaid at the hospital, Goering said. And, in return, the hospital is a major partner with the clinic, donating close to $2 million in lab work and other services.

For both Health Care Access and the Heartland Medical clinics, diabetes and hypertension top the list each year of ailments their patients have. Another common problem is depression. Others have asthma or trouble with their eyes, nose and throat.

And most of the patients have more than one ailment.

"They hardly ever come in with one thing," said Renee Caldwell, grant writer for Heartland Medical Clinic.

Young adults

Barb Langner helped the Kansas Health Policy Authority compile data on the uninsured. She said the most likely uninsured person is between 19 and 28 years old. That demographic tends to be healthier, have jobs that don't come with insurance and a mentality that they are somewhat invincible, Langner said.

Langner also said studies show that those without health insurance divide pretty evenly between men and women. However, literature indicates that women are more likely to seek services than men, which could explain why a higher percentage of women are reported at the two local clinics.

While Langner said Douglas County is lucky to have two clinics that serve the uninsured, she noted they are a different kind of health care provider than the traditional doctor's office.

The patients tend to use the clinics for urgent care rather than managing chronic illnesses, screening or preventing health problems.

"People who don't have health insurance delay care, go for care when they are sicker, don't get preventive health," she said. "They don't have a medical home, and that obviously cuts into productivity, quality of life and has a lasting impact. Access to health insurance is important."

Comments

badger 7 years, 6 months ago

Remy said:

"How is $120 a month too much to pay for health care? Seriously? Your quality of life hangs in the balance and not eating out a few times or not having cable TV is too much of a sacrifice for your health!?!!! Hand me the budget anyone is living on and I'll fit in $120 for health insurance any day. I'm not unfeeling of anyone's financial situation, but to make health care a priority for this country, maybe we should make it a priority for ourselves."

All right, try this one:

Ten dollars an hour means about $1735 (forty hours a week, 4.333 weeks a month). Say you give up 20% in taxes, that's about $1390. You are divorced and your ex pays his court-ordered $300 a month about half the time, so it works out to about $1540 a month. You and your child have a two-bedroom apartment at $550 a month, leaving you with $990. Because you don't live anywhere near the bus line (or perhaps don't work near it), you need to have a reliable car to make it to work. You pay $190 a month in car payment ($800), about $60 in gas to drive to and from work ($740), and roughly $200 a year, on average, in routine maintenance (oil changes, new brakes, tuneups, 30k checkups, etc) at about $17 a month ($727). Insurance and tags, required by the loan company and the government respectively, run you $800 a year, which is $67 a month ($660). Your gas, electric, water, and phone total about $200 a month - 70 or so for gas, 60 or so for electric, 30 or so for water, and 40 or so for phone if you don't make a lot of long distance calls ($460). You're lucky enough that a neighbor will watch your child for a couple hours after school for fifty dollars a week, leaving you just under $260 for all the rest of your needs, including food, new clothes and shoes as they wear out, school supplies, field trips, laundry, and a savings account just in case of emergencies.

Sure, you could get rid of the car, or skimp on maintenance, or cancel all but the liability and hope the loan company doesn't find out, but if your attendance at work is dependent on reliable transportation and the bus is not an option, then you have to have a car that's not one of those thousand-dollar wrecks the transmission will just fall out of one day - and you have to take care o it and keep the required coverage on it. You could try to find a cheaper apartment, but much cheaper than $500 in any city puts you into some dangerous neighborhoods.

Now, in that case, your kid likely qualifies for Medicaid for Children, but you're going without.

sourpuss 7 years, 6 months ago

Until we as a country determine that access to basic health care is a human right, this problem will only get worse. For some reason we view radiation treatments, cholesterol medicine, and getting a broken bone properly set to be luxuries that only the well-to-do deserve. Health care is not an iPhone.

And for those among you shaking in your Bruno Maglis that somehow YOUR care will be at all lessened because a single mom working two jobs can go to the doctor, then you need a slap in the face. Innovation will not cease, private "top-up" insurance will not cease, and doctors will not flee the country looking for greener pastures (there aren't any - almost every major democracy, and many non-democracies, have universal health care). As for the problems in those other countries with doctor shortages, etc., well, the doctors come here, to America, and if we were all playing by the same rules, the doctors would be more properly dispursed. And besides, what sort of awful person are you to let people die just to make sure you own nest isn't disturbed?

Universal heath care now. Do you value life or not?

buffalo_star 7 years, 6 months ago

how does the greatest nation on earth NOT have health care for all its people? its a national disgrace and any national leader who will not work to solve this problem which is oppressing the working poor should be voted from office!!!! we can fly to mars and the moon but grandma can't get her meds!! we can throw billions down a rat hole in iraq but our fellow citizens go without there is no excuse anymore!

Doug Fisher 7 years, 6 months ago

Martin_D_15 (Anonymous) says:

<why don't all you libtards move to canuckland! what a bunch of whiney leftists.

Then America can be really GREAT!

I can't wait for you to leave, and be sure to take alec baldwin, babs, and bigmouth rosie with you!>

This has to be the most ignorant posting of Father's Day.. Keep up the good work Martin_ D_15. America would be better off if you left. Let the door hit ya on the way out.

Doug Fisher 7 years, 6 months ago

Martin_D_15 (Anonymous) says:

(why don't all you libtards move to canuckland! what a bunch of whiney leftists.

Then America can be really GREAT!

I can't wait for you to leave, and be sure to take alec baldwin, babs, and bigmouth rosie with you!)

This has to be the most ignorant posting of Father's Day.. Keep up the good work Martin_ D_15. America would be better off if you left. Let the door hit ya on the way out.

Kornphlake 7 years, 6 months ago

Being Native I get free health care, but it isn't the greatest in the world. I tried going the insurance route, untill they denied a simple claim at prompt care. To make a long story short, I got sued by prompt care for the visit, because they know that I'm a mutch easier target than the insurance company. Now I stick to the Native clinic. At least I don't have to deal with an insurance company.

christie 7 years, 6 months ago

Before I got on at another company, I was paying 25% of my take home pay for 'company' insurance. Even with that I was liable for the first $2000.00 in medical for EACH MEMBER, so I was liable potentially for the first $8000.00. Then they would deny claims left and right.

People go on and on about socialized medicine, how terrible it is, yet they are part of a socialized system. EVERY ONE of them has been vaccinated for FREE against items like smallpox. Remember when the entire country was vaccinated?

Yea. That's social medicine.

Griblit 7 years, 6 months ago

It's good to see that something is happening to help the uninsured and the medically underserved in our community- let's not lose focus on what really counts here- until an answer is produced, there are those friends and neighbors here who still need care each and every day, and if we dwindle into political bickering we lose sight of being a part of the local solution.

Kudos to Heartland Medical and HCA- you are both needed for your niche and we are glad for your work!!

erod0723 7 years, 6 months ago

""The cost of insurance alone has gone up tremendously, a lot faster than the increase in inflation and the increase in the average worker's earnings," Goering said." This is almost criminal in nature. My grandfather owns an insurance agency and has told me numerous times that the average costs per insuree has not increased substantial in the past ten years, but yet premiums skyrocket. He said a lot of the reason premiums have increased so much is in anticipation of the retirement of baby boomers. The boomers will place a burden on the insurance industry as never before, and the insurance people are scared that they will no longer make their 15% margins as in the past. The problem with healthcare in this country is not the doctors or hospitals, or even the government. It is the greedy insurance companies that milk every last dollar they can out of people, while at the same time decreasing benefits.

Allison_Wonderland 7 years, 6 months ago

Dialupdandy,

Your answer seems to suggest you'd be getting all of the liberals to move to Canada by all uninsured heading North. Is that what you believe? That everyone who isn't able to afford health care is liberal or wants to live in a liberal country? Are you sure that's a point you'd like to be making?

Remy 7 years, 6 months ago

How is $120 a month too much to pay for health care? Seriously? Your quality of life hangs in the balance and not eating out a few times or not having cable TV is too much of a sacrifice for your HEALTH!?!!! Hand me the budget anyone is living on and I'll fit in $120 for health insurance any day. I'm not unfeeling of anyone's financial situation, but to make health care a priority for this country, maybe we should make it a priority for ourselves.

sourpuss 7 years, 6 months ago

Okay, I LIVE in Canada for part of the year and have access to the health care up here and let me tell you, I do not have to wait a minute longer up here than I do for my doctor in Lawrence. If I have an appointment, usually about 15 minutes. I can get an appointment with about a weeks notice, and if there is an emergency, no problem, I can see someone within hours. Granted, I haven't had to have elective surgery, but my friend did (to repair a badly healed major injury) and she had to wait two months, which isn't unusual even in the states. So those of you who have never been on the Canadian system, keep your mouth shut about things you don't know about. And if you have and have experienced something else, well, remember, many people in America, especially in rural areas, also do not have immediate access to good health care either. As for being "overtaxed," yes, I pay a lot of taxes (14% sales tax on top of it) but hey, if I added it up, it is cheaper to pay taxes here than to buy health care in America. You pay either way, get it?

sourpuss 7 years, 6 months ago

I'm sorry to hear about your loss, dialupandy, but I have had exactly the opposite experience. In the states, I have had broken bones misdiagnosed as a "virus" and here in Canada, they do everything possible to find the real problem. I have had very personalized treatment, thorough testing, and careful follow-ups. I have had better medical care in Canada than I have anywhere in the states, especially LMH. I don't go to the doctor for sniffles, but I do believe in preventative medicine.

Well, I pay for everyone's streets even when I don't drive. I pay for everyone's kids to go to school even if I don't have kids... you are always paying for stuff you don't use. The thing is, with health care, you probably will use it at some point, and if you NEVER have to ever use the health care system, well, you are already extremely blessed, and consider the money paying for others to be good karma. However, that is unlikely... your turn will come.

Martin_D_15 7 years, 6 months ago

why don't all you libtards move to canuckland! what a bunch of whiney leftists.

Then America can be really GREAT!

I can't wait for you to leave, and be sure to take alec baldwin, babs, and BIGMOUTH rosie with you!

Bill Chapman 7 years, 6 months ago

The problems with the American health care system are numerous, but the main problems are fairly simple. The health insurance companies are in it for the money NOT your health. They don't give a rats' a$$ about anyone or thing besides their bottom line. I know this from experience - I had a lower back injury that required either the fusing of some of my vertebrae or a type of physical therapy that was in use in Europe (England & Canada too) for over 8 years. My insurance company allowed me to use the P.T. treatment, but they decided that I only need one third of the treatments that 2 years of testing and 6 years of practical data indicated I should have. I called the insurance company and it took me almost 2 weeks to get someone that MIGHT have the authority to change the decision. He referred me to one of their company doctors. Two days later I got ahold of the company doctor (he no longer has a practice - he is a paid employee of the insurance company) three days later (he was always in a meeting when I called, until I told the clerk I was going to get a lawyer specializing in insurance claims - then I was called back in 15 minutes). The doctor told me he had never heard of this treatment and couldn't recommend a change. I asked if he had even made the attempt to read up on the treatment and he said he didn't have time. I then asked what the average cost of back surgery involving fusing vertebrae was compared to the P.T. treatment and he said "That wasn't his area of authority" and hung up. I later found out from some websites concerning insurance malpractice that the P.T. treatment was allowed by the FDA (the FDA? Yes! The FDA has authority over medical treatments) only because it was in the final stages of approval. Insurance companies were denying treatment because if this - my company was only allowing me treatment so I would not have to go through surgery (and cost them roughly $20,000 - $30,000). One medical instructor I talked to at K.U. Med said they were doing the VERY minimum of the recommended treatment for the P.T. and that I would most likely need more than that given the severity of my injury.

The simple fact is : my insurance company was giving me the run around so they wouldn't have to spend any more money than they had to. Up to this injury I only used my insurance for dental appointments and health check-ups over 2 years (roughly $3,400 in paycheck deductions for insurance coverage).

Bubbles 7 years, 6 months ago

I take care of my own family puss. Don't make me take care of yours. Quit having kids. Eat healthy. If you get sick and die, oh well thats life. There are billions and billions of humans to replace you. So don't fret.

Health care is not a right.

M. Moore says Cuba's healthcare is the way to go. So why don't you.

May Soo 7 years, 6 months ago

Kornphlake (Anonymous) says:

Being Native I get free health care, but it isn't the greatest in the world. I tried going the insurance route, untill they denied a simple claim at prompt care. To make a long story short, I got sued by prompt care for the visit, because they know that I'm a mutch easier target than the insurance company. Now I stick to the Native clinic. At least I don't have to deal with an insurance company.

Just be happy you have a place to go for free even if it is not the greatest, lots of us don't have that option.

blackwalnut 7 years, 6 months ago

What a disgrace.

Republicans don't care about the people. After ending the horrible war, fixing health care is the most important job of the next, Democratic administration.

kchuskerfan 7 years, 6 months ago

Democrats care and Republicans don't. Funny. I will grant you that Democrats care about giving Illegals in this country healthcare over citizens of this country. Hilary was going to "nationalize" health care. (Ummm not a peep on it in her current campaign). Kerry was going to go to Canada for drugs and was going to go after those unfair HMO's that control the system. Again, not a peep since election ended. Yes, the drug companies are in it for profit. If they aren't making profit, they can't spend the resources to develop the new drugs. Our patent laws create an environment where they have to make quick profit, before a drug they spent all the money developing will go off patent protection and becomes generic. The insurance companies are in it for profit too. Oh, wait, we want to pay as little as possible, for our personal gain as well.
8 years of Bill Clinton didn't do diddly for health care. They all play the same games. I just hope we don't keep breaking the system in caring for non citizens. If you want to start somewhere in fixing the system, at least demand care of our own first.
My mom was diagnosed with cancer at age 55. She cared for her mother, who was 75 and thus did not have medicare, medicaid, or private insurance. She was literally told to go home and hope it doesn't spread too badly in the time it took to get through all the red tape to get her under medicaid as a special circumstance, and that was only after she was classified as permantly disabled with expectation to die within 12 mo's. I watched as numerous foreign, non english speaking people went into the ER and were given expensive tests, immediate treatment, etc. The only one that had to go through the system was us, as citizens, we had to play by rules. If they plucked her out of the ocean in a banana boat, defecting from Cuba, she'd of been in the hopital being cared for immediately.

pelliott 7 years, 6 months ago

it is a matter of life and death for not only the poor but the unlucky, the underinsured and even the insured. Proud to be called the loony left if it means i care what this country stands for and speak up for a decent life and healthier life. The medical rules are changing, while we sit and watch the news about celebrities, people with insurance and with out insurance are dieing for lack of minimum health access. Surely they have to help you if a simple procedure can save your life or mobility, not so. They cart people in wheel chairs to skid row and dump them. Los Angelos now, lawrence will catch up.

perkins 7 years, 6 months ago

Good article. Those with a decent paying job should be reminded to be thankful that horrible bad luck did not strike them They also should be thankful that they studied and worked hard, carefully chose a career, and made prudent life decisions so that they do have health insurance and an emergency fund. And if memory serves, there was momentum in the 90's for some socialized medicine in this country, but Mrs. Clinton nixed it by rejecting "incrementalism."

sourpuss 7 years, 6 months ago

Wow, I'm glad I don't view the world that way. I couldn't stand the smell from the pile of the b.s. I would have to stand in.

You could use spywell's argument for anything. National defense, roads, education. I mean, the goverment is protecting my assets with all those nukes they have. What if I can protect my own, personal assets more effectively and more cheaply? But I still have to pay for the nukes. Also, health isn't something you "attain." Seems spywell has never had a sick child, or had type 1 diabetes, or had lukemia, or wasn't born with a physical defect. Poor kid has nothing in the world and spina bifida to boot. Well, kid, no one's going to look after you, so you'd better get a job to pay for that operation. Oh, you mean the kid is the parents' responsibility? So it is okay to punish the child for being born with a bad heart because mom isn't working two jobs. I see. Okay. I get it.

Kat Christian 7 years, 6 months ago

We need to get rid of the insurance companies and go the route the Canadians have taken in medical care. I knew years ago when health insurance first began that it was too good to be true and darn if I wasn't right. I predicted that it was a matter of time before healthcare cost would catch up to these companies and they'd have to restrict what they covered. What I don't understand is: I'm not a genuis by far, I know there must have been thousands more in this country who saw this coming. Why didn't we stop this or put a hold on it somehow? Now we are in a bind and in the next couple of years more and more Americans - baby-boomers will be turning 65. Companies will beginning to lay off the old timers, opting for the young. How are these people going to support themselves, pay for medical care? How are these people going to prevent from becoming a burden on society? I'm beginning to think our government just doesn't care for the peasants anymore, except at election time. Then they want to be our friends and chum up to us until they get into office and its the same old rhectic all over again.

Bubbles 7 years, 6 months ago

Healthcare is expensive because productive people ARE already paying for others healthcare. Duh.

I am tired of paying for other peoples healthcare, shelter and food.

Why do we allow non-productive people breed? They can't take care of what they have now.

packrat 7 years, 6 months ago

badger, Using the scenario that you described I came up with an estimate of $1,630 for an Earned Income Tax Credit.( 2005 numbers) $120 x 12 = $1440. That more than covers the cost.

just_another_bozo_on_this_bus 7 years, 6 months ago

"Why do we allow non-productive people breed?"

Who are "we," and should they allow you to breed? Your posts don't indicate a proclivity towards productivity.

just_another_bozo_on_this_bus 7 years, 6 months ago

badger:

"leaving you just under $260 for all the rest of your needs, including food, new clothes and shoes as they wear out, school supplies, field trips, laundry, and a savings account just in case of emergencies."

packrat:

"Using the scenario that you described I came up with an estimate of $1,630 for an Earned Income Tax Credit.( 2005 numbers) $120 x 12 = $1440. That more than covers the cost."

Only if the $260 left over truly would cover all costs badger listed-- and clearly, it would not.

packrat 7 years, 6 months ago

The senario would also qualify for approximately $140 in Foodstamps a month. ( Old rules but probably even higher amounts now)

just_another_bozo_on_this_bus 7 years, 6 months ago

$140 a month won't cover food for a family of four for a month-- and even if it did, $260 won't cover the rest of their expenses. And even if they did manage to squeeze out the $120 a month for premiums, that would only cover the premiums, not the 40-50% co-pays.

The simple fact is a majority of Americans either have no health insurance at all, or what insurance they do have is extremely expensive, and if a major illness occurs, that can easily bankrupt most families.

Bubbles 7 years, 6 months ago

just_another_bozo_on_this_bus (Anonymous) says:

"Why do we allow non-productive people breed?"

Who are "we," and should they allow you to breed? Your posts don't indicate a proclivity towards productivity.?????????????????

Only had one kid and paid for all of the expenses.

Just like the puppies I own.

Maybe I should have had a dozen kids and then pissed and moaned that I don't have any money to take care of them. It's amazing how foolish people are and the people like yourself that defend them.. Maybe you are one of them?

Wilbur_Nether 7 years, 6 months ago

packrat wrote: "The senario would also qualify for approximately $140 in Foodstamps a month."

Which assumes the family would even apply. I have known a dozen or so qualifying families over the years that refuse to apply (out of pride). I am also aware of one scenario in which an individual's company began an internal investigation on her when she applied for and began receiving food stamps. The company didn't want the reputation that it kept its employees below the poverty level (wouldn't help in either recruitment or public image, you know) and used the "investigation" technique to bully her into withdrawing from the food stamp program. Only then did they close the investigation with no findings.

mom_of_three 7 years, 6 months ago

Yes, her health care was $120 a month, but do we know how much she makes? No. Also, we don't know how much the $120 a month actually covers. She says "And even then, she would have to pay the medical bills up front and be reimbursed by only 40 to 50 percent." So she would actually pay more than $120 a month for healthcare.
plus, if she is a customer service representative, she would probably be lucky to make $10 an hour.

This shouldn't happen in this country. I feel lucky that my husband has a good job, with decent benefits at a decent price.

Wilbur_Nether 7 years, 6 months ago

I agree wholeheartedly with offtotheright's position that people who do not need government benefits should not receive them. (I would even go so far as to suggest this include various benefits currently seen as entitlements, such as Social Security--if I am 83 and still pulling in a goodly income, I shouldn't be receiving Social Security no matter how much I paid in when I was a young whippersnapper of 58.) Where offtotheright and I differ, though, is I would require data--not a ventured guess of 75%--to demonstrate who needs and who does not need those benefits.

packrat 7 years, 6 months ago

Wilbur_Nether :

The bullying that you described was a federal crime in 1998, it probably still is. If the scenario is real, your friend could have sued for a considerable amount of money.

Food Stamps was (and probably still is) the most under-utilized assistance program. It was funded through the Department of Agriculture. I have absolutely no problems with the program now that the recipients receive Vision Cards which are harder to sell than the old paper coupons.

A family of 4 with the $10/hour X 40 hr would receive in excess of $250 in Food Stamps. ( Old rules, I don't know the current guidelines).

packrat 7 years, 6 months ago

Instead of talking about government programs to help this person, we really should be talking about the free market job market. In the US, workers who do not like the salary and benefits of their current position are free to pursue a position more to their liking.

If employers can't keep quality workers, they will be forced to raise salaries and benefits.

Bubbles 7 years, 6 months ago

offtotheright (Anonymous) says:

I would be happy to pay $120 a month for health care! That is a deal lady!

I have an idea. Why don't we cut off government benefits from people who don't need them. There is so much abuse. I would venture to guess 75% of people who receive assistance does not need it.


$120 a month is all we WOULD have to pay if the malcontents would pay their FAIR share.

Wilbur_Nether 7 years, 6 months ago

packrat wrote "In the US, workers who do not like the salary and benefits of their current position are free to pursue a position more to their liking."

Which is hypothetically true, but in reality doesn't quite work that way. At the salaries and benefits packages we're discussing (and with most of these jobs not offering paid vacation), many of these individuals cannot bear the cost of a job search. They typically work during the business day, when services such as the Workforce Centers are available to them. They cannot afford to take a morning or an afternoon off work to interview, or are often restricted geographically (in-town, close to a bus route, etc.) by whatever mode of transportation they have. Add to that the large number of employers at this level who will terminate a person for looking for another job, and it all adds up to having a right to look for another position which cannot be exercised because the cost is too high.

Regarding the bullying of the employee who applied for food stamps--packrat is right, the company was engaged in retaliatory behavior, which created tremendous liability. They also had the benefits of a very good (and highly compensated) in-house legal staff and of knowing that such a complaint by the employee would be too expensive and too risky for her.

Wilbur_Nether 7 years, 6 months ago

No, they aren't, offtotheright...they're economic limitations. And for those of us who have to balance our checkbook before we can buy a gallon of milk for the kids, they are very real. The rest of us who can take some of these things for granted don't have a good sense of the stresses and pressures it takes to live this life. Criticism is easy.

packrat 7 years, 6 months ago

When I'm looking for a new job, I either go on my day off or I take a vacation day. The trick is to make yourself valuable enough for people to want to employ you. I have no sympathy for people who are making excuses. I worked full-time, attended school, and raised a family. Upon graduation, my income doubled. I finally paid off my last student loan a few months ago.

Staci Dark Simpson 7 years, 6 months ago

How about docs not charging so much? If we could find $120 month insurance worth a hoot we might get it. $5000 deductible is not good coverage. We fall in the gap, we are not low enough income but barely scrape by. We don't have luxuries anymore. I think being charged $500 to walk thru the door of the ER when nothing is done is excessive. How bout you? When I was pregnant my OB would say "Lets order this test, you probably don't need it but you have insurance, right?" I would gladly pay for insurance if it was affordable but when it costs as much as another mortgage something is wrong.

Wilbur_Nether 7 years, 6 months ago

offtotheright read more into my post than is there. I am not personally in such dire straits that I cannot afford my family or my lifestyle. We have enough savings that if both my wife and I were out of work, we would make do for about 3 months (longer by belt-tightening). There are those among us, however, that are not so fortunate. And the reasons for that situation are pretty complex. More complex than reproductive rights or self-reliance rhetoric, such as patrack and offtotheright are writing here. And certainly more complex than our leftist friends would argue. And as long as both sides of the conversation engage in polarizing, sound-bite rhetoric, we'll never move forward. We need to address these issues as having the complexities they do.

preebo 7 years, 6 months ago

Look for Sicko hitting U.S. Theaters 6/29/2007.

From what I hear it is better then previous Michael Moore Propaganda films...

OfficeGirl 7 years, 6 months ago

It's unfortunate that doctors and hospitals won't accept from an individual the same prices they will accept that health insurance companies set.

nlf78 7 years, 6 months ago

Insurance companies should be regulated, so they are required to become not for profit businesses. I'm sure that would help lower the costs some. I'm very lucky, I can afford my portion of insurance through my employer. That covers myself and my child. But my boyfriend works for a small company that doesn't even offer health insurance. Whenever we get married, we will have to tighten our belts financially, to pay the premium for a family. All I can say is I'm thankful my employer offers it.

packrat 7 years, 6 months ago

OfficeGIrl, I don't know about the area around Lawrence, but my old doctor's office charged different rates to the insurance companies and direct private pay. Private pay were charged less if arrangements were made.

spacystaci8, you are charge $500 because a large number of people coming to the emergency room don't pay the bill. Hospitals and Doctors need to charge enough to coverage the people who don't pay and the cost of malpractice insurance.

kchuskerfan 7 years, 6 months ago

The issue is how to provide health insurance for uninsured people. You are talking of fixing private healthcare vs that of government provided care like Medicare/Medicaid. Private insurance has many issue's as well, but nothing to your personal situation is to the topic of where to get the money to provide for a 55 yr old divorced woman who stayed home with their kids, or a family where Sprint laid off the parents, some health care. The system is breaking from where we draw the lines and I find some things galling. What's described above can't get any coverage, Mexican migrant farm worker cuts his hand or hurts his back...Right to the ER, instant care.

Linda Endicott 7 years, 6 months ago

They go to the ER because the ER can't refuse to treat them. Doctors can and do.

Same with the uninsured, even those that are American citizens and those that are employed.

And I still say that paying for preventative health care SAVES more money in the long run. But even Medicaid and Medicare don't pay for that.

kchuskerfan 7 years, 6 months ago

There are changes that could be made to allow more money into the system. 1. Millionaires with earnings solely from their bond and stock interest/dividends receive their full Soc Sec when they don't need the money. It wouldn't be the first thing the wealthy had to forego as a penalty for wealth, but most would admit, if it fixed the system, or if they rec'd a tax break for donating it back, they'd do it... 2. Stop providing healthcare to illegal non-citizens until such time as we can provide for citizens first. 3. Simplify insurance application proceedures for Medicare/Medicaid and the new "schedule D" in addition to billing practices/requirements for Dr's offices. Most have real billing issues and difficult times being paid and it simply doesn't need to be so hard. Their expenses increase, as well as write-offs. 4. Charging the non insured so much more than the insured is ridiculous. 5. Car insurance doesn't cover oil changes. We have collision and comprehensive and normal maintenence is our responsibility. Medical insurance, especially taxpayer socialized insurance, should not cover check-ups and maintenence that breaks the system. Private insurance can cover that for those that can afford the luxury.. 6. Small business needs help or credits to be able to offer insurance. Most small business will create as a subchapter or LLC to protect personal assets from potential loss if the business isn't successful. They are also taxed at the highest as they have to pay corporate and personal income tax. The IRS has virtually killed the home office credits. A credit needs to come to business to offer insurance and a plan needs to be developed in the marketplace for small business. 7. Docs need to stop prescribing the hottest, most expensive drugs just because the drug reps brought over the free samples. There are many generics that will do the job, when appropriate, and will reduce expenses of medications. 8. Demand healthcare over pork programs. The ethanol subsidy, tobacco subsidies, studying the effect of cowfarts effects on the ozone, etc. We really need to look at priority. All of this BS over "roadmap for America" and supposed "New deal's" that the politicians bring up.. They aren't in the Social security system and they aren't with our health system. Everyone in Congress has little credibility on the health issue. In no particular order and to avoid offending most everyone... We are in various operations worldwide where we have troops on the ground, and provide aid to regime's in over 60 countries. Start some things a little more at home.

Linda Endicott 7 years, 6 months ago

Insurance won't always cover major illnesses or problems. I've known people who went in because something was wrong, something major WAS found, and then the insurance company wanted to claim that it was a pre-existing condition because the diagnoses said that the patient had had it for awhile.

They deny claims all the time, claiming they were pre-existing conditions.

If $80 is nothing to an insurance company, then why didn't they just pay the whole thing for my doctor visit, instead of just paying part of it?

Instead, they ended up paying only $25 of an original $80 charge. That amounts to a LOT of profit, considering the premiums that they get.

And speaking of cars...quite frankly, I've received better health coverage from my car insurance than I have from my health insurance. I had an accident once and had my leg broken in two places, and my ankle shattered. It eventually required surgery.

Yet my car insurance paid for ALL my medical bills, 100%, even physical therapy afterward. They didn't pay just a percentage of it, and I had NO co-pays...what's wrong with this picture?

Linda Endicott 7 years, 6 months ago

Well, I disagree with one of your points, Kchuskerfan...that medical insurance shouldn't cover checkups and maintenance.

In far too many cases, medical insurance doesn't cover that now...but it's idiotic not to. Paying for checkups and tests could find a health problem early, and thus cost the insurance company less in the long run.

If preventative medicine was covered, then little problems might never become big problems. A backache that is diagnosed and treated early may never result in surgery; one that is left for far too long and allowed to progressively get worse because the patient is afraid of the cost can very well require surgery by the time its cause is discovered.

Treatment that has to be given because people put off going to the doctor until their condition is worse is always going to cost more.

I recently had the flu, which resulted in both lung/sinus infections. The doctor's office charged me $80 for the office visit. I paid a $25 co-pay. The insurance company paid them an additional $25. This amounted to $50 altogether. The remaining $30 was written off by the doctor's office, and I'm considered paid in full.

Yet the charge for a regular office visit, lasting ten minutes or less (anything over 10 minutes is considered a "focused" visit, and costs even more), for those without insurance, costs $120. And they are expected to pay the full amount.

This brings up two questions: 1. Why do people who have health insurance only get charged $80 for an office visit, whereas those who are even less able to pay get charged $120?

  1. If they can afford to write off $30 of their fee for every person with insurance, then why can't they just lower their rates for office visits by $30? And for everyone?

I didn't mind too much about the $15 co-pay for my prescription, although if the doctor had prescribed more than one medicine, I would have had to pay $15 per prescription. But considering the overinflated cost of most medicines, this was much cheaper.

Nobody except the rich could afford to buy most of those drugs out of pocket.

kchuskerfan 7 years, 6 months ago

I agree that preventative check-ups can find serious problems early, just as oil changes prevent serious damage and large bills. However, most of these check-ups don't show serious problems. Unless you run into the types of practitioners that will order expensive tests to generate more office visits "just to be sure". I had mentioned reducing the costs for insured vs uninsured to be the same, as you had touched upon. My point is this office visit should be $80. All of these $80 check-ups break the system. The medicare/medicaid systems should be more for major medical and check ups are supplimental insurance or Feel free for employers and other private insurance to cover check-ups. I'd rather see major coverage for all than having entire groups that go without. I think what you are saying is that people won't pay $80 for what they feel is not serious and would not pay up for routine, preventative care. But if it's $15, they will. You can't expect the system to keep eating it on this nickel dime stuff. And in the healthcare world, $80 is NOTHING. If something major is found, the insurance would then cover it. Perhaps oil changes is a bad analogy. How bout Tires? Many will wait on spending the money there... Many wait til it's a flat to actually deal with it. They won't pay for rotation either. Cars with warranty won't cover the tires. But if they did, or only charged $15.... Then we'd all have great tires..... Til the warranty company went broke, or then they would only offer coverage on the more expensive cars.... At least, that's my theory. We can agree to disagree.

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