Powerball is No Kind of Health Insurance

lotteryLast week I met up with my friend Ben, a 26-year-old construction worker. His hand was wrapped in bandages. When I asked about his injury, he laughed and said it was the result of a stupid mistake.

A week earlier, while doing demolition, Ben reached over to pull out a piece of ceramic, still attached to the wall. Had it been wood, or any other type of material, Ben would have been fine. But ceramic, when broken, is razor sharp and the tile cut through his hand. Within seconds his hand was covered in blood and it was obvious it was cut almost to the bone.

Despite the blood pouring from his hand, Ben debated with his coworkers about whether he really needed medical attention. Like all the other guys there, he didn’t have insurance. When his hand was still bleeding a half-hour later it became obvious that he needed stitches. That afternoon, he walked out of the emergency room with a bill for over $9,000.

When Ben told me that story, I was mad. No—I was outraged. A $9,000 bill? He should have had insurance, I thought. Then I realized: He can’t afford it. His employer should provide insurance then, I thought. But as a small business, with rates for insuring construction workers at a premium, they couldn’t afford it either.

“It’s so unfair!” I vented. “For a simple accident? One bad move and you now owe almost half of your yearly income for a hospital bill?!”

Good-natured and optimistic Ben shrugged off my indignation and joked about having bought a ticket for Powerball.

As I stammered through a condolence and incoherent condemnation of insurance companies, I realized that Ben didn’t need simple answers about what he should have done. Moreover, he is not alone. Millions of young people face the same decision as Ben. They get injured, or get sick, suffer from chronic pain or just face a nagging voice in the back of their heads reminding them they haven’t seen a doctor or dentist in years. They are early in their careers, but too old to qualify for their parents’ insurance. (26 is the cut-off age for that now, under the Affordable Care Act; it used to be younger.) Despite working long hours and hard days, they can’t afford insurance.

After my initial outrage I realized what Ben and folks like him do need is some information about what they can do now. They also need to know that an answer to the broken system is on the way.

So here you go, guys:

An option now:

Community Health Clinics. These clinics are funded by a combination of federal grants and state money, private donations and the fees that they collect from seeing patients. They take people with and without insurance and charge on a sliding scale, according to your income. It isn’t free and the hours are limited, but the cost is far below the cost of emergency rooms, private doctors, and privately run urgent care facilities. Moreover, you can establish a relationship with your doctor and be seen for routine care and preventive care. They can treat for chronic things like diabetes and high blood pressure. And you can be seen for more minor things before they become big bad things. You don’t have to sit at home and hope that nothing comes of that nagging cough or the soreness in your back.

The Texas Association of Community Clinics has set up a great website that allows you to locate a community care clinic close by, see their hours, and see what kind of services they provide.

Your options in the future:

2014 is going to open up a few great new options for you.

The Insurance Exchange – Through the health insurance exchange, you will be able to purchase low-cost health insurance on a website that will allow you to compare plans just like you compare flights on travel sites. It’s going to make the process of buying individual or family health insurance a whole lot easier. Subsidies and discounts will also make it a whole lot cheaper, and the Medicaid program will be open to more people who don’t earn very much.

There will be a 50% tax credit for small employers who purchase insurance for their employees. Perhaps, more importantly for anyone working in construction or other hazardous professions, health insurance companies will no longer be able to charge your employers more to insure you.

In advocating for the Affordable Care Act, there is a lot of emphasis on the way that it will help children, the elderly and families get access to affordable health care. And, it will.

But its also going to help out a lot of young people, with and without families, who are fully employed, working hard every day to make ends meet, but cannot currently afford insurance. They too are going to end up healthier, safer, and happier Texans. Supporting the Affordable Care Act is going to make sure that hardworking, good-natured guys like Ben won’t need a Powerball ticket to compensate for a mistake!

Written By: Juandrea Bates, guest blogger

Posted in The Texas Treatment|

8 responses to “Powerball is No Kind of Health Insurance”

  1. Renata Keller says:

    Thanks for the great information about the Community Health Clinics–I had no idea they even existed!

  2. Tara says:

    I really enjoyed reading this, as someone who is lucky enough to be employed somewhere that provides me with decent if not good insurance coverage, and seeing how lucky I am just to have insurance. It’s easy to say, as you initially did, ‘Well they should have insurance’ in response to such stories. But really it’s not that simple at all.

    Are the programs you mentioned state programs, or federal? Just curious if they will be available here in New York State as well.

    Thank you! Tara

  3. Sara Lytton says:

    I’m angry about what happened to Ben too! I also don’t understand how stitches could possibly cost that much.
    Overall great post! The options coming in 2014 sound good, and I also didn’t know about those Community Health clinics.

  4. Rusty says:

    I drove ben to brackenridge, considering triage it is 6+ hours at the least, on a good day.

  5. Juandrea says:

    Hi Tara,
    That’s a great question! Community Health Centers are funded by a combination of federal and state grants and they do exist in all 50 states.

    The ones in New York are mostly concentrated in New York City, but there are some in Upstate NY as well. The Community Health Center Association of New York has a website that allows you to locate Community Health Centers throughout NY State.

    (http://www.chcanys.org/index.php?submenu=Find_A_Clinic&src=directory&view=Membership_Directory&category=Health%20Centers)

    Most states have a Community Health Center Associations with websites that provide information on community health centers in their state. And, the U.S. Department of Health and Human Services has a website that allows you to search all 50 states.

    (http://findahealthcenter.hrsa.gov/Search_HCC.aspx)

  6. Juandrea says:

    Also a great point, Rusty!
    We all know what its like wait for what seems like forever in emergency rooms. With so many people uninsured small ailments go unattended until they escalate into large problems that require immediate care and emergency rooms get overwhelmed. Community Health Centers provide a better option because they allow you to see a doctor before things escalate.

    It’s not a perfect system though. Community Health Centers aren’t ideal for life threatening situations and appointments for non-emergency care can take longer to schedule than an appointment with a regular doctor.
    That’s another reason why it’s so important that Texans support the Affordable Care Act. With the insurance exchange providing more affordable, easier to purchase insurance, more people will be able to see doctors regularly and alleviate some of the strain on emergency rooms.

  7. Felipe says:

    I did not know where to find community clinics, even though I had heard of them before… I just thought they were like the dodo… thanks!

  8. Tara says:

    Thank you so much for researching that for me and answering my question so thoroughly! I am bookmarking this for the next time I hear of a friend or family member who may be in this situation.
    Thanks again! Great post!!
    Tara

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