uninsured

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Free Health Clinics Fill The Gap For Uninsured

Massachusetts tops the nation when it comes to residents with health insurance. Still about 277,000 men women and children in the state remain uninsured. How do they get medical care?

WBUR’s Martha Bebinger reports that “a loose-knit network of free clinics in churches, synagogues and vacant offices around the state — often run by retired doctors and nurses — is quietly caring for many of these patients.”

Here’s a bit of her story this morning:

“The flu season this year is really bad, and there are flu shots available. Who’s interested?” asks Julia Koehler, in Portuguese and English, as she glances from one weary or pale face to another. Twenty-one men, women and children sink into folding chairs in a hallway at Congregation Beth El in Sudbury. On this night, the hallway lined with folding chairs has become a makeshift waiting room.

Free flu shots are a bonus on this night for patients who’ve come in with a sprained back, dizziness or a feeling that their diabetes is getting worse.

“Now, have you lost any weight?” Dr. Dick Wolk asks as he waits for an interpreter to translate his question into Portuguese.

“No,” his patient says sheepishly.

Wolk wags a long finger at the admittedly overweight woman he’s brought to his “office” — a card table behind a striped cloth folding screen. Wolk’s patient wants to know if she’s taking the right pills to control her diabetes.

“We can give you all the pills in the world, but only you can lose weight. It’s up to you,” he says. “There is only so much medicine can do.” The patient promises Wolk she’ll pay more attention to calories and get more exercise.

Wolk is one of seven to nine physicians (most are retired) who spend their Tuesday evenings treating patients at what’s become known as the MetroWest Free Medical Program, in the temple sanctuary. Continue reading

After Shooting, Conversation Turns To Health Insurance

(Sysmatic/flickr)

The heated debate over gun control following the July 20 movie-theatre massacre in Aurora, Colo. has quickly evolved into a discussion about health insurance. Kaiser Health News reports that some of the victims most seriously injured in the shooting rampage have no insurance coverage, so in addition to struggling for their physical lives, they are also fighting to pay their medical bills. Carol Eisenberg reports:

The most seriously wounded continue to fight for their lives and may face medical bills in the hundreds of thousands and even millions of dollars. Among them is 23-year-old Caleb Medley, who is in an induced coma after being shot in the head, and whose wife, Katie, gave birth to their first child last week. The couple has no health insurance, and their friends and family are raising money online to pay their medical bills.

Like Medley, many of the victims are between the ages of 19 and 34 – a group with a 28 percent uninsurance rate in Colorado, the highest among any age group, according to a 2011 survey by Calonge’s group.

Calonge notes that many young people are employed and have the opportunity to buy insurance through their jobs but decline coverage because they are making comparatively low salaries and see themselves as young and healthy.

“One of the things the tragedy points out is that assessment of risk isn’t always right,” he said.

…Some believe the discussion about the victims’ medical bills may change attitudes about the 2010 health care law. “It will make the issue of people without insurance suddenly needing care more vivid,” said Norman Ornstein, resident fellow at the conservative American Enterprise Institute.

Last week, in a column in The Boston Globe, John McDonough offered his own health insurance perspective to the Aurora story:

Here’s another thing you can do: remember, next time Mitt Romney talks about how he will “repeal and replace” the Affordable Care Act/ObamaCare (with no replacement in sight), that if fully implemented in 2014, the ACA guarantees that no American citizen will have to go through the second assault Caleb is now facing because of our nation’s despicable health insurance system. Continue reading

Why Are So Many Low-Income People In Massachusetts Still Uninsured?

By Nancy Turnbull
Harvard School of Public Health

A new report by the state’s Health Connector and the Department of Revenue has rekindled my curiosity and concern about two questions regarding Massachusetts health reform: Why does Massachusetts still have so many low-income people who are uninsured? And what can we do about it?

The Connector/DOR report presents an analysis of the health insurance status of adults in the state, based on 2009 state tax filings. The analysis uses the HC forms that most of us are required to fill out as part of our annual state tax return.

The major findings for the 2009 tax year are very similar to the analyses of the 2007 and 2008 tax filings; widespread compliance with the filing requirements (99% of the 4.7 million tax filers complied); a relatively small proportion of the 4.1 million tax filers who completed an HC form reported being uninsured for the entire year (4% or 170,000 people); and another small proportion of people (4%, or 150,000 people) had a time spell during the year in which they lacked coverage. The uninsured are disproportionately younger, and appear to be disproportionately male (although the gender of one-third of tax filers cannot be determined based on the information on the tax return). Rates of coverage were very similar in different geographical areas of the state

This is the chart that keeps me awake at night:
Continue reading

Study: Who Remains Uninsured In MA? Mostly Working Poor. Why? Money.

You figure that when a press release comes in from Physicians for a National Health Program, it has an agenda. But that doesn’t negate the value of the research it highlights — which, in this case, was a paper from Harvard Medical School researchers just out in the Journal of General Internal Medicine.

It’s titled “Reasons why patients remain uninsured after Massachusetts’ health care reform: A survey of patients at a safety-net hospital.” And here’s its summary:

After full implementation of the Massachusetts health reform, those remaining without insurance are largely the working poor who do not have access to, or cannot afford, either employer sponsored insurance or state subsidized insurance.

The reasons why people lacked insurance varied, from having recently lost coverage through a job to fear of giving their personal data. From the Physicians For a National Health Program press release:

To understand why people remained uninsured after the reform, the study authors surveyed 431 patients, ages 18-64, who were visiting the emergency room of Massachusetts’ second largest safety-net hospital.

The researchers found that of the 189 patients without health insurance, two-thirds (65.9 percent) were employed, but only a quarter had access to employer-sponsored insurance. In addition, about one-third (35.2 percent) of uninsured patients reported having lost previous insurance coverage, with the majority of these (51.9 percent) having lost their coverage due to loss of a job or transition from one job to another. Continue reading