No health insurance doesn’t mean no options

REGION — Debbie Decker of Beach Lake went to the Emergency Room following an irritated tick bite.  After an hour of waiting, a two-minute exam, a tetanus shot, an antibiotic, and a band-aid, Ms. Decker, who doesn’t have health insurance, received a hospital bill for $700, all to be paid out-of-pocket.

While this might be shocking, Ms. Decker is only one of some 760,000 adults in Pennsylvania who are without health insurance.  In managing this issue of astronomical proportions, Wayne County ranked 32nd out of the 67 counties in Pennsylvania in per capita uninsured, according to a 2004 survey.

Furthermore, while most people assume that the uninsured are of the working poor, 75% of the uninsured work, says Amy Kelchner, spokesperson for the governor’s Office of Healthcare Reform.   She also points out that the real uninsured are not those below the poverty line, because such people are eligible for Medical Assistance, but those who make too much money for M.A. and not enough to pay the skyrocketing premiums required by employer-provided health insurance.

Meanwhile, 6.5% of the premiums paid by those that are insured go to paying for the uninsured.

Juanita Sigarra of Audibel Hearing Care Center in Honesdale says that the outlook for the uninsured, at least on her end of things, is “pretty grim”.  “Even for those that have insurance, hearing check-ups and aides aren’t covered. There aren’t many options,” she says.

Elaine Rogai, Registration Technician in the Emergency Room at Wayne Memorial Hospital points out, however, that there is “plenty of assistance out there”.  The E.R. even has applications for Medical Assistance behind the counter in the registration area.  And while, yes, there is what may be termed an “insurance crisis”, patient education would go a long way, say both Rogai and Kelchner.  “If [Decker] had gone to a family doctor with no insurance instead of coming to the emergency room, it would have been costly, but she would have paid maybe $200 out-of-pocket instead of $700.  Most people just don’t realize it,” says Rogai. 

But what about if someone needs to go to the doctor not between the hours of 8 am and 5 pm, Monday through Friday?  Kelchner says that soon the state will start offering financial incentives to doctors who stay open later.  The incentives are part of a state-wide initiative to curb the rising healthcare costs, introduced by Governor Rendell in January of 2007. 

A revised form of the plan, called PA Access to Basic Care, or PA ABC, passed through the PA House of Representatives in March, is now awaiting Senate approval and being met with opposition in a republican-dominated house.  If passed, the initiative would offer affordable ($280 per month, per individual, maximum) health insurance to all adult Pennsylvanians.  It will also offer subsidized reductions for individuals choosing to keep their employer’s healthcare plan.  All children are already and will still be covered under PA’s CHIP program.

Until the initiative is passed or denied by a Senate vote, which could happen as late as January of next year, and then put into action, uninsured and minimally-insured Pennsylvanians are left with no other option than to make wise choices regarding the healthcare options they do have.  Among these, make sure your emergency is an emergency before going to the E.R.  If your children are uninsured, enroll them in the CHIP program, applications for which are available at the Wayne County Assistance Office on 8th Street in Honesdale—all children are eligible for it.  Write State Senator Lisa Baker, senator for our district, and tell her your thoughts on the PA ABC initiative.  Most importantly, educate yourself on your health and your options for it.

As for Ms. Decker, she agrees with Rogai, “I just wish there was some information available in the E.R. to let me know what’s an emergency and what can wait until I get to a clinic or my family doctor,” Decker said. 

More information on the PA ABC program and means to support the legislation are available on the state’s website for it at www.rxforpa.com.  Also visit the PA Department of Welfare website at www.dpw.state.pa.us to view your insurance options and download applications.  And don’t forget, as Kelchner told The Independent, “Everyone is just one illness away from being uninsured.  We can do something.”