I was pleased to participate in Friday’s noon march and rally for health care changes in Racine. (See picture at top originally published in the Racine Post with accompanying story.) There are many reasons why people are not able to receive quality health care. As a practicing health care professional, I have observed and discussed all of these reasons:
They have lost their jobs, due to plant closings, business layoffs, downsizing and other factors relating to our current economy.
They have depended on receiving benefits from a spouse’s health care plan and the spouse has lost his or her job due to plant closings, business layoffs, downsizing and other factors relating to our current economy.
They have a job, but it does not provide health care benefits. They must pay for all health benefits out of pocket.
They are in transition – just graduated from high school or college, for instance, and are hunting for a job. Or they may have moved with a spouse to a new area and are still job hunting. Or they may have moved home to care for the needs of an elderly relative which they consider their unpaid “job.”
They have depended on receiving benefits from a spouse’s health care plan, and the spouse is abusive (physically, emotionally, sexually) to themselves, their children or both. They must leave the relationship to maintain their safety, sanity or their lives. Once they are divorced, benefits are no longer available.
They have health care benefits but the insurance policy has a very high deductible ($4,000 or more) and they cannot use any benefits until that annual deductible is met.
They have health care benefits but cannot afford the fees that are out-of-pocket expenses, including co-pay charges, medication charges and the like.
They have health care benefits but the benefits are very limited and do not cover certain procedures or kinds of care. Strangely enough, one benefit that is not covered by some insurance policies is treatment for nicotine addiction, which as we know, brings or exacerbates multiple serious physical health problems – high blood pressure, heart attacks, respiratory difficulties and the like.
Their health care plan does not provide for pre-existing conditions. This means that if you have a medical problem which exists at the time you enroll in or purchase your health insurance, the insurance company will deny all claims pertaining to this medical problem for a certain period of time. In other words, a person facing an emergency situaton may have to wait 12 to 18 months to receive treatment -- at which time the siutuation could deteriorate.
Certain parts of their health care plan are limited to a specific number of sessions, perhaps just six or 10 sessions a year. This is common with certain policies relating to mental health treatment. While some issues are able to be addressed in that amount of time, other serious conditions may need much more time to treat and resolve.
Their health care plan does not provide for treatment from certain hospitals, clinics, physicians, dentists or practitioners. They are extremely limited in the care they can receive and from whom – even if they would be better served by the practitioner or clinic of their own choice.
Their health care needs can be resolved – often easily and more affordably – from a practitioner who uses complementary or alternative medicine, such as an acupuncturist, massage therapist, naturopathic physician or another professional in a similar field. Their insurance policy does not recognize the value of these fields, nor does it reimburse for such treatments.
Education to prevent disease, reduce stress (which is often the precursor for physical and mental health problems), high levels of training for practitioners and changes in certain lifestyle habits that contribute to illness are also important, of course, but not a substitute for good health care.
