Healthcare - Uninsured At Any Price

In a sense, I belong to four separate elite health clubs, all of which, I wish I could quit. There are a lot of similar health clubs, that I don't belong to -- but basically, they all have the same issues.

They are all linked under an "umbrella" of a much larger health care entity. This parent organization has a name, "Uninsured Americans." This "club" has at least 45 million members in America. Like all statistics, the figures don't really add up (more about that later).

I didn't join these health clubs on purpose. My annual dues are certainly more than I can afford. Because of their "lifetime membership" rules, I feel sort of like I'm living inside the Eagles song, "Hotel California" with these organizations. You see, they'll let you in, but you can never check out. I'd resign my memberships in a heartbeat, but no one will let me.

The purpose of my writing this hub, is to share a little knowledge about what to do, if you are in the same or a similar situation. First, let's talk about the current membership club membership cards I carry and how I got them:

I joined this organization at birth. It's sort of like being inducted into the DAR. You get in because of your parents, grandparents, great-grandparents, etc. Maybe they didn't sign you up on purpose, none-the-less, you are a member of these clubs, like it or not.

Sometimes, you and your family, don't always know at birth, that you are a club inductee. Some of our memberships aren't revealed until much later in life. Sometimes, this can be a secret society, where no one knows anything, even the doctors treating you. Even if you were inducted into this society at birth, it's not a whole lot of fun being one of this group.

In my case, I should have been suspicious early on, when certain family members all died of the same heart disease, all at young ages. I should have checked out why I had some of the club membership qualifications, and hadn't yet hadn't been asked to join. It took me over fifty years to find out, I was already a member of this club. It took the insurance industry about a week, to make me a member of this elite health club. The end result is:

I can't get health insurance at any price, because I have a life-threatening, pre-existing heart condition.

In the beginning, I had health insurance for a majority of my adult life. Actually, I belonged to many "I've Got It" health clubs. They were like belonging to a union -- members pay large monthly dues for protection. I can't say I was grateful for the amount that was coming out of my meager paychecks for them to protect me. Unfortunately, I let my memberships lapse time and time again, and was eventually transferred over to the "Can't Get It At Any Price" health club.

You see, prior to being outed about the undiagnosed heart condition, and forced to join that other health club - The Pre-exisitng Condition Club" -- I belonged to several "I've Got It" health clubs. Additionally, if I had all the money I laid out in membership dues to these entities, I'd be a whole lot richer. However,being young, I never needed to use their facilities and experts, so back then, I viewed that money as wasted. It was money I needed to take care of my young family.

Naturally, I was young, naive, invincible, and I had a bad case of "I know it all." My membership dues sometimes became too high, so I would opt out because I had other priorities. Later, as with many women, my spouse's club membership was better, so I didn't worry about it and would drop my coverage and switch to his. That worked fine, as long as he didn't change jobs.

Then, as with many on a fast track career path -- with each career move, I'd join the one club and quit the old club, and then do it all over again. So, there were gaps in my memberships. Call it young, naive, or stupid -- I didn't let this worry me.

Frankly, at some other times, the membership dues were overshadowed by my own early career low wages, the need to feed my children, and the belief that "tomorrow is another day, another opportunity." I would get around to joining again, when times got better.

I wasn't mature enough to realise that someday, I would want to be a member of the most elite health club -- The Insured Health Club. However, by then, they would not allow me to be accepted as a member. As we all know, that club is quite picky about who they let join and the older we get, the more the membership dues become outrageous in cost.

I've kept a nice short letter from one of the "Insured Health" club's membership officers, the one who rather rudely stated, "Coverage denied." It's my souvenir, a painful reminder of why I should have re-thought quitting the previous dead-end job that paid well and had great benefits.

I'm a relatively new member of the Pink Ribbon Club, because I have breast cancer. My membership came as a late in life surprise. You can read a little more about how I feel about it, in another hub, that I recently wrote http://hubpages.com/hub/The-Gift-That-Cannot-Be-Returned.

Now, here is a club that grows with 260,229 new members, each year. 40,800 sustaining members get to leave, but leaving is highly not recommended. It isn't all bad, but not one of us would be crazy enough to sponsor another woman to join. All of the members of this club, are like me, captive members. If, in addition, they are members of any of the following, they had an added burden:

• Denied Coverage Club
• Can't Get It At Any Price Club
• Never Had It Club
• Pre-Exisitng Club

Not everyone knows this, that if you do not have health insurance, and you are a member of this club -- you are twice as likely to die, than a women who does have health insurance.

One member of this club that every American should hear speak, is Cathy Baskins. I've provided a You Tube video below, of her telling her story. Listen and say a prayer for Cathy and her family. Then, say a second prayer for all of the Cathy's in this country and their families.

Don't get me wrong, I'm not ashamed of my club membership. I'm one of the lucky ones, who was diagnosed early and has a good long term prognosis. I'm glad to be alive, even if I am a member of the club.

The fourth membership I am a card carrying member of is, the "Don't Have Prescription Coverage" club. It goes hand-in-hand with not having being able to get health insurance at any price. It's the most expensive club I ever joined.

Supposedly, there are over 45 million uninsured Americans, that's the equivalent of the total populations of twenty-three states. The trouble with statistics is the numbers come from the government. If you do the math, the number of uninsured Americans, is well over 70 million and/or probably uncountable since they come from census records.

For the sake of not arguing though, let's assume, the given number of 45 million uninsured Americans is correct. That's the total population of these twenty-three states combined:

Alaska; Arkansas; Connecticut; Delaware; Hawaii; Iowa; Kansas; Maine; Massachusetts; Mississippi; Montana; Nebraska; New Hampshire; New Mexico; Nevada; North Dakota; Oklahoma; Rhode Island; South Dakota; Utah; Vermont, West Virginia; and Wyoming.

In my opinion, these are very unacceptable numbers. Taking a closer look, my fellow members of the "Uninsured Health" club are also:

• 17 million households who earn over $50,000 a year (Some presume that these families are making a choice to not have insurance, but let's get real -- living on less than $50,000 before taxes, means going without basics, if you throw in high medical insurance premiums). Yes, there are some members of this group, who made a lifestyle choice, but the vast majority would still prefer to have health insurance -- they just can't afford it);
• 9 million households who earn over $75,000 a year (Like their counterparts above, insurance coverage affordability, again may or may not be a choice. Affordability, depends on a lot of variables, such as: size of household, location, etc.);
• 18 million young adults between the ages of 18-34 (This is a divided group of members. Some make an active choice to not carry insurance, preferring to have more money in their pockets. Somewhat understandable, because often they are earning less. Still, others make a different active choice to not carry insurance because they are young, naive, and feel invincible. Getting sick or injured, happens to "others."
• 14 million households who are eligible, but don't enroll in health insurance plans -- (This group boils down to -- one's ability to know where to go to for help, and knowing that help is out there);
• 12 million households who are illegals, undocumented workers, or compassionate entry health care recipients --(These are the most controversial groups. (1) The undocumented members, also include foreign visitors to our country. I live in a tourist destination. It's a fact of life -- vacationing tourists from around the world, clog our hospital emergency rooms. Yet, they still get care and most don't pay; (2) Undocumented workers and illegals aren't going to, choose to, or be able to pay for something they can get free; (3) Compassionate entry health care recipients from Mexico -- If you've never heard of this -- you don't live in a U.S. border town;

To recap -- In the Eyes of the U.S. Government -- Who Are the Uninsured in America?

• Uninsured Eligible for Government Programs
• Uninsured Not Needing Financial Assistance
• Uninsured Needing Some Financial Assistance
• The Uninsurable

Supposedly, that leaves another estimated 8 million uninsured in America who do not have health insurance through no fault of their own, of which I have to assume, I'm one of at this point in my life.

I'd be the first to admit that I found myself in this predicament in part, through not making wise decisions earlier in life, when I had health insurance. Although, I would have to question, if I had stayed in certain dead end jobs -- would my coverage been dropped, once the insurance companies and my doctors discovered I had a pre-existing condition?

As I stated earlier, the purpose of my writing this hub, is to share a little knowledge about what to do, if you are in the same or a similar situation. Before I do that, I need give you a little background, you need to know, that in my former career paths:

• A life-time ago, I was a lobbyist for the group that passed the legislation for HMOs to exist. (If you are not a fan of HMOs, don't hate us. We were all young, idealistic, and thought we were giving America a great thing. We had no idea of what it would morph into);
• I worked in hospital administration, at one of the nation's most prestigious teaching hospitals. Part of my job was fielding malpractice suits;
• I worked for a Fortune 500 company as a market research analyst. One of that company's primary revenues was and still is -- to sell your health insurance and medical record information.
• I am a Vietnam era veteran.

This professional background, combined with my experiences as a patient and uninsured American, gives me a unique perspective. I know first hand, for instance:

• How powerful the lobbyists in the insurance and pharmaceutical industries are on Capitol Hill;
• What really goes on with some government officials;
• What problems "uncompensated care" means to hospitals -- who are, first and foremost -- big businesses;
• Why other business entities depend on keeping health care working the way it is and always has been;
• What the level of health care is really to be found in a government run facility (this one may surprise you). 

Hospitals are both friend and foe -- for without them, we could lose our lives. No doubt about it, we need them. With few exceptions, they are all fine entities. For the most part, there are no better people than those who work in them. Doctors, nurses, and hospital staff -- they all should be our heroes and heroines. They have tough jobs and are a caring lot. That said, here are a few important facts about being uninsured and going to the hospital:

Hospital Uninsured and Underinsured Facts:

• Not all hospitals are alike, in that some are privately owned, some are public; some are corporations; some are university owned.
• Some hospitals charge uninsured more than four times more than they charge insured patients.
• Many hospitals are big businesses and these businesses understand that uninsured patients are not aware that they are being overcharged. Nor, do the uninsured know how to fight overcharges or negotiate lower bills, a fact that hospitals understand.
• Medicare and Medicaid help hospitals cover the costs of caring for the poor and uninsured. Therefore, sometimes the level of care that you receive is limited (just like with some health insurance companies) to what Medicare and Medicaid will pay for);
• The hospital bills that result from going to the hospital without insurance, immediately end up at third party collection agencies. They have the ability to bankrupt your family, make your life miserable, and permanently ruin your credit.
• There are many financial options and programs that will often pay for hospitalization of the uninsured. However, usually no one is going to volunteer that information. You, "the patient" will need to actively seek out financial help. There are exceptions to this, some hospital are very good at helping patients find outside funding for their impending bills;
• If you are uninsured, fearful of what the bill's going to be, and put off seeking health care, because the emergency room is your only choice of physician or medical care -- you risk your life.
• By federal law and many state laws, hospitals cannot refuse to treat you, once you enter their emergency room or come within so many feet of it's front door. However, what can happen, is that you can be later sent to an inferior community hospital, if you are not clearly in immediate danger of dying. Patient dumping still happens, especially in large cities. 

There are many federal, state and county programs available for the uninsured. There are also private programs to help the uninsured. However, it often takes a little determination to find help. Finding help can be particularly frustrating if you don't know where to look or what a program is called in your state or community.

Likewise, online searches are cluttered with slick insurance company sites that are not as much about helping the uninsured as casting a wide net for new insurance clients. Online searches are also hampered by organizations that have other agendas.

In some states it's highly unlikely anyone is going to help you, unless you demand help or ask for it. Some states don't obviously advertise what programs are available, because they are underfunded and overburdened with the uninsured. Other states are very cooperative and open about services that are provided.

There are both national and state uninsured plans set up for those who can't get insurance, those who are self-employed, unemployed, denied because of a pre-existing condition, or have low income. There are many private organizations with free or sliding scale programs.

The starting point for any uninsured health services search should begin at your local city and county level. Additionally, the following suggestions should be a starting point at the state level (NOTE: This preliminary list is not by any means the entire uninsured health programs of any state):

• Arizona- AHCCS Care; AHCCCS for Families (AFC); Arizona Long Term Care System (ALTCS); Baby Arizona (SOBRA); Breast and Cervical Cancer Treatment; Family Planning Services (FPS); Federal Emergency Services (FES); Freedom To Work; KidsCare (KC); Medicare Cost Sharing (MCS); Medical Expense Deduction (MED); Pharmacy Discount Program; Sixth Omnibus Budget Reconciliation Act (SOBRA); SSI CASH/SSI Medical Assistance Only (SSI/MAO); Social Security Disability Income - Temporary Medical Coverage (SSDI/TMC); and Young Adult Transitional Insurance (YATI).
• Arkansas- ARKids; SSI; TEA/AFDC; AABD; SOBRA; UA-18; MN; FOSTER; REFUGEE; QMB; FAM PLAN; and TEFRA.
• Alabama - Alabama Breast and Cervical Cancer Treatment Program; Alabama Child Caring Foundation; Alabama Farmer's Federation/AFLA; All Kids Program; Medicaid; Public Education Employees' Health Insurance Plan (PEEHIP); State Employee's Children's Health Insurance Health Insurance Plant (SECHIP); and SOBRA Medicaid.
• California- MRMIP (Major Risk Medical Insurance Program); Healthy Families Program; AIM (Access for Infants and Mothers Program);PacAdvantage (Pacific Health Advantage); and Supplemental Health Insurance Policies.
• Colorado - Colorado Indigent Care Program (CICP); Medicare; Medicaid
• Delaware- Community Healthcare Access Program (CHAP); Delaware Health Children Program (S-Chip);
• District of Columbia - District of Columbia Primary Care Association (DCPCA); S-chip; DC Healthy Families; Medicaid; Medicare;
• Florida - Florida Kids Care; Partnership for Prescription Assistance; Access; Florida Community Health Centers; Healthy Access; Uninsured Health Helpline (800) 234.1317;
• Georgia- Amerigroup; Georgia Health Policy Center; Peachcare;
• Hawaii-- Hawaii Immigrant Health Initiative; Community Health Centers; Native Hawaiian Health Systems; Hawaii Covering Kids; Kekumuloa Fund;
• Idaho - Idaho Community Health Centers; Terry Reilly Health Services;
• Illinois- Uninsured Discount Program; Christian Care Program; All Kids Program; Wisewoman Program;
• Indiana -Healthier Indiana Plan; Hoosier Healthwise; Indiana Check-Up Plan; Indiana Family and Social Services Program;
• Iowa - Healthy and Well Kids (Hawk-I); SChip;
• Kansas- HealthWave21; Wy/Jo Care; SChip;
• Kentucky- Surgery on Sunday; Kentucky's Physician Care; National Breast Cancer and Early Protection Program; Kentucky Women's Cancer Screening Program;
• Louisiana- LaChip;
• Maine- CarePartners;
• Maryland - Kids First Act; MCHP;
• Massachusetts - Merck Prescription Discount Program; Mass Health; Commonwealth Care; Commonwealth Choice; Health Safety Net Fund; Children's Medical Security Plan (CMSP); Prescription Advantage; Breast and Cervical Cancer Treatment Program; Center Care; Elder Service Plans; Group Adult Foster Care; Healthy Start; Insurance Partnership; Kaileigh Mulligan Home Care Program; Mass Med Line; Medical Security Plan; Qualifying Student Health Insurance Program; Senior Care Options; HIV Drug Assistance Program; Acupuncture Treatment for HIV/Aids; HIV Mental Health Services; Enhanced Medical Management Services; Comprehensive Home Based Medical Care; Dental Ombudsperson Program;
• Michigan- Michild Program; Free Clinics; Kids Connection; Healthy Kids;
• Minnesota - Sage Screening Program;
• Mississippi - Mississippi Breast & Cervical Cancer Program; Adolescent Health Services Program; WIC; First Steps; Children's Medical Program; Children's Health Insurance Program (CHIP); Dental Corrections Program; EPSDT; Early Hearing Detection & Hearing Program; PHRM;
• Missouri - Missouri's Show Me Women's Health Program; St. Jospeh's Hospital Uninsured Discount Program; MC+; Missouri HealthNet for Kids; Missouri HealthNet for Pregnant Women;
• Montanta- Montana Healthy Kids; The Caring Program for Children; Montana Cervical and Breast Health Program; Montana Comprehensive Health Insurance Program;
• Nebraska - Every Woman Matters; Hope Medical Outreach Program; Nebraska Kids Connection; Nebraska Colon Cancer Screening Program; Nebraska Comprehensive Health Insurance Pool;
• Nevada- Child Health Insurance Program; Nevada Check Up; World Doc Foundation; Access to Healthcare Network; Nevada Covering Kids and Family;
• New Hampshire - New Hampshire Covering Kids Programs; Breast Cancer Coalition;
• New Jersey- NJ HealthLink; New Jersey Family Care; KidCare and Family Care; IHC; SEH; Charity Care; Pharmaceutical Assistance to the Aged & Disabled (PADD); Catastrophic Illness in Children Relief Fund; FQHCs; CHC's;
• New Mexico- First Choice Community Healthcare; First Nations Community Health Source; Albuquerque Indian Health Service; Albuquerque Healthcare for the Homeless; New Mexico Department of Health; University of New Mexico Health Sciences Center;
• New York - Child Health Plus; Family Health Plus; Atlantis Health Plan; Healthy NY; United Hospital Fund;
• North Carolina- Communicare; North Carolina Association for Healthcare Access; North Carolina Breast and Cervical Cancer Control Program; North Carolina Community Health Centers;
• North Dakota - Child's Special Health Services; Health Tracks; Healthy Steps Children's Health Insurance Program;
• Ohio - Summit Program; Breast Cancer Fund of Ohio; Well Child; Well Families;
• Oklahoma -
• Oregon- Oregon Prescription Program; Oregon Health Plan; Family Health Insurance Assistance Program; Healthy Beginnings; Ochoco Health Systems; Volunteers in Medicine-Clinics of the Cascues; Kemples Childrens Clinic;
• Pennsylvania- Pennsylvania Breast Cancer Coalition; Urban Solutions HIV Programs; adultBasic Health Insurance; Healthy Women; Vaccines for Children Program; Breast Cancer and Cervical Cancer Treatment Program; Philadelphia Corporation for Aging; Special Pharmecutical Benefits Program;
• Rhode Island- HealthAccessRI; Women's Cancer Screening Program;
• South Carolina- Communicare; FQHC's;
• South Dakota - Covering Kids;
• Tennessee- Tenncare; Project Access Community Health Partnership;
• Texas - Catholic Health Association of Texas;
• Utah -
• Vermont-Vermont Health Access Program; Catamount Health; Dr. Dynasaur; VPharm; V-HAP; V-Script; Healthy Vermonters;
• Washington -
• West Virginia- West VirginiaRX; West Virginia Breast Cancer and Cervical Cancer Program; West Virginia Community Access Program;
• Wisconsin- Wisconsin Badgercare; Bureau of Primary Health Care;
• Wyoming - Cancer Prevention Partnership Breast; Good Neighbors Health Care; Health Care for Homeless Veterans; Maternity and Women's Health Service; Northwest Buffalo Community Health Care Center;

(Note: This list will be updated and I welcome any suggestions for additions).

If you are uninsured or uninsurable but you served in the military before September 8, 1980 you probably have VA health benefits, depending on your discharge circumstances. After that date, you may also have benefits but the rules change. With the VA there is an income threshold, however, just because you make more money doesn't mean you'll be turned down. It just means you'll have a co-pay. This is a God send, if you have a pre-existing condition and can't get insurance.

In the recent past, we've all heard about all that is wrong with our VA Medical Centers and clinics. Indeed, some of the older facilities have issues. It's easy to complain and "how terrible it is" makes a better news story and article than news with a positive slant.

However, as a Vietnam era veteran, I know this system, albeit not perfect -- it is a well run, highly efficient testimony to good health care. It's a very overburdened system, largely due to the ages and sheer numbers of the veterans who need to use it from WWII, Korea, and Vietnam.

Yet, many veterans from those time periods, absolutely do not know that they are entitled to VA health benefits (and other benefits). It wasn't always something at the time of separation, that was wholly explained.

Unfortunately, many of the young people who are currently serving our country and those who served in the Gulf War, etc. do not have the life time benefits that those of us from earlier service have. There is an enrollment period and a cap on the number of years that they have VA benefits available to them. To me, this is wrong because many of the health problems they may encounter later in life, that may be a direct result of having served in the military. We owe then a lot more. If we can give health care to the illegal and undocumented -- we can afford to give care to ALL veterans regardless of what war time they served in.

Considering I have breast cancer, I am personally tremendously grateful that I have this option. The care I get is not only equal, but has greatly surpassed what I've had in civilian health care. Yes, we have to wait in lines. Yes, the facilities are sometimes outdated, the staff overworked, and the parking lots full. However, the team approach and preventive care can't be beat, when you weigh the value against what it costs out of pocket.

This well run system tells me that our government is capable of running a health care program that leaves no one without health insurance.