Have you ever noticed how the Health Care Safety Nets such as "Free" Clinics, Medicaid, Medicare, and other such programs are touted as a "Safety Net" to "Prevent people from going without health care" and to "assist citizens in local communities"? I have seen these programs touted by government officials and some government employees as a safety catch-all that will supposedly help everyone. They receive commendations for their innovation and serving the citizens that can't afford to pay for health care. They are great things, really, they provide a service to SOME of the citizenry and they fulfill a need for a portion of the population. So I am not really speaking ill of them because they are a good thing. My beef is with those who tout them as a complete "safety net" without understanding that they only serve a small portion of a population. I have heard too many people say that "everyone qualifies for something" and that "there are public health programs that will serve those who don't want to pay for insurance"; all such statements really get to me because they are so untrue.
I have researched every "free clinic" in North Carolina. Every single one that I have found has the same criteria for eligibility. In order to obtain services, you have to have income at or below 200% FPR and you must be a resident of the county in which the clinic is located. So let's say you're sick, you need to access health care but you can't afford it, you make an appointment at a clinic and spend the required time filling out paperwork to see if you qualify. If you are poor enough and your condition is not critical or doesn't require anything more than basic care then you can receive health care services at a free or reduced rate. However, if you are middle class or earn more than 200% FPR or you need more than basic care or if you don't live in the right area then you can't receive care from a "free clinic".
Medicaid is critically important for adults that are very poor and earn less than $9004.00 per year and for children, especially children with special health care needs. Many children would not be alive today if the parents didn't make the significant sacrifices to ensure that the children qualified for Medicaid. Medicaid is a well managed program that provides excellent health insurance coverage, especially for children with special health care needs such as Cystic Fibrosis. I don't have anything negative to say about the program, I do wish that it would expand some things that it covers, but it certainly is better than private insurance.
My point is that we are completely lacking any "safety net" for the people who earn more than 200% FPR. Our current Health Care system encourages the poor to remain poor in order to maintain access to services and it encourages those who are not poor enough to qualify to limit their assets and incomes in order to obtain qualification for services. The middle class, or those that earn between 200% and 400% FPR, have limited to no access to health care.
Hospital Charity Care Programs operate a little bit more fairly, that is if the adult that applies for the program doesn't have a child/children with severe special health care needs on disability. They count disability payments as income even though disability law says that the family has to use the disability payments exclusively for the care of the child with the disability and the use is limited to certain criteria. Hospital Charity Care Programs are great for the average middle class adult with a healthy child if that adult meets the other misc. criteria.
So what is available for the middle class self employed adult with a child/children with special health care needs that seriously needs access to health care? Nothing free or at a reduced cost. Adults in that situation are told to give up their careers and try to be smart, talented, and lucky enough to find and hold a job that offers health care even though they may be currently very sick and needing medical care, or get a divorce and either that adult or their spouse disappear, or give up all assets and income and go on welfare, or give up their child/children with special health care needs. Great options there, lets divide families, increase divorce rates, traumatize children, increase unemployment rates, and shatter dreams all to try to gain access to health care.
The current "Safety Net" programs require extensive paperwork and an entire qualification process to be completed to see if a person deserves to obtain services. I find that entire process so morally wrong, requiring a person to jump through paperwork hoops to see if they qualify or deserve health care and opening their entire lives where they have to share everything and explain everything is such an invasion of privacy and it demeans and demoralizes that person. We all deserve access to health care at an affordable price and we shouldn't have to fight and jump through paperwork hoops.
We need truly comprehensive Health Care Reform with a National Public Health Plan that will cover everyone, regardless of income or situation. As a society, we should be more concerned with saving lives and promoting the health and well being of our society than corporate profits and keeping the status quo. I'm just one more voice for the 50 million uninsured, and I fear that without access to affordable health care then I will soon be 1 more silent voice for the 18 thousand people per year that die due to an illness that goes untreated.