How To Access Medical Care In The USA If You're Poor

Americans like to think they have the best medical care in the world, and in some respects, for some people, they actually do. People who are diagnosed with cancer live longer in the United States than they do in other countries. People who need reconstructive surgery have better options in the United States than they do in most of the rest of the world. In the United States, your doctor may not be able to help you prevent a heart attack, but if you survive it, you are likely to get percutaneous cardiovascular surgery that opens arteries (at least temporarily) in minutes and you may even go home the same day.

The US still leads the way in developing new pharmaceuticals and new surgical techniques. Diseases that were a death sentence even in 2000 are being cured today. However, the unique downside to American healthcare among all the nations of the industrialized world is that it isn't available to everyone.

What's Wrong With Relying On The ER?

Detractors of the Affordable Care Act often claim that every American is actually covered for every condition, because federal law requires all emergency rooms to offer life-saving treatment. The law does not, however, require any emergency room to give patients the treatments they need to overcome their conditions, and it allows hospitals sometimes to "dump" patients on other facilities, and to take their time in making the transfer.

If you go into the emergency room with chest pain, the hospital or clinic must diagnose your condition and treat the pain. However, it can conveniently give you, say, an EKG and a blood workup and send you on your way when, as the writer of this article had, you have six blockages in your coronary arteries and almost any stress will trigger a heart attack. If you tell your doctor you can't afford medicine, you may get samples of whatever the latest pharmaceutical rep has left behind, and the doctor may not have to screen to see if you are in the 1 to 2 percent of patients for whom, for example, an anticoagulant can cause sudden death. This has also happened in this writer's experience. Many doctors care. Some will just get rid of you even if they are knowingly sending you to your death.

READ Why American Doctors Feel They Are Poor

Didn't Obamacare Take Care Of Coverage?

The widespread availability of health insurance with subsidized premiums has resulted in coverage for over eight million Americans who were not insured before. However, over 25 million Americans still do not have health insurance. That's because people who make lower wages were supposed to get free coverage in the form of expanded Medicaid, and the governors or legislatures of 22 states refused to accept federal funds to cover more people who need healthcare. The State of Texas, for example, turned down over $100 billion in federal assistance for healthcare for the poor, because, officials claimed, it could have to spend $1 to $10 billion more in future years. As a result, only people poor enough to live on the streets get Medicaid in many states.

Five Things You Can Do If You Need Medical Treatment And Don't Have Money

If you don't have health insurance but you have at least a little money, you can always go to walk in clinics. Even your regular doctor may be glad to accept cash rather than go through the hassle of filing with an insurance plan. It can be very hard to get medical care in the USA if you don't have money.

1. During the next open enrollment season, take an optimistic look at your next year's earnings.

Never lie on a federal form. However, the next time you can enroll in Obamacare, see if you can't possibility earn enough to meet the minimum income to qualify for insurance subsidies (a little over $12,000 a year for individuals). If you can, claim that amount, and get your subsidy so you can afford insurance. If you don't earn the requisite income the next year, you will owe either nothing or a small penalty for not qualifying for the insurance you have received. Congress could change this law, but you will at least have had coverage, which can get you the medical attention and drugs you need to stay healthy, or just to stay alive.

2. Enroll in your city or county's healthcare system.

Many cities and counties have medical schools attached to teaching hospitals that offer care to the working poor. The application process may not be dignified, but the care may be superb. Typically, city or county healthcare systems charge only token fees for doctor visits or medications, and offer hospitalizations or even surgery for free. However, you may be used as a teaching case for medical students and residents, seeing as many as a dozen doctors instead of one.

3. If (or when) you do get bills you can't pay, don't ignore them.

It's never a good idea to ignore a huge bill from an emergency room or a hospital, even if you can't possibly pay it. Often hospitals and clinics have access to charitable foundation funds, or they get reimbursed by the federal government for charity cases. You usually won't get help from those funds if someone in the hospital administration isn't helping you with your case. Stay in touch with the clinic or hospital's financial office until your bill is resolved.

4. When you have to get treatment in the ER, ask the doctor to make sure any prescriptions are for generics.

Many pharmacies sell medications on a list of about 500 products for as little as $4 a month. When you doctor gives you a prescription, ask for a generic. Sometimes you have to have a more expensive product, but many chronic conditions are managed with inexpensive medications. Even if you have insurance, you are likely to get these inexpensive medications whenever applicable.

READ Why Silver May Be Better Than Gold (Or Platinum) For Obamacare

5. Don't delay healthcare just because you don't have money.

Chronic problems can get worse if you don't get help for them. It's better to go the ER when you are just a "little sick" than it is to wait until you need a full-blown hospitalization. It can be scary, or a major hassle, to deal with the billing office, but it is better to deal with a financial hassle while you are relatively healthy than to wait until you are seriously sick.