re: #200 Naso Tang

Yes, I take your point. However it is more complex than that. People without health insurance can get medical help, but the reasons they don’t as much is not simply because they can’t afford it (they can in an ER), but because of social attitudes.

A minor example, a year ago I saw a rental tenant with a grandson visiting, about 10, who showed me a tooth about to come out. He and grandmother thought it was a baby tooth with another coming; at 10!!

It was severe cavities at that age, and these were not people I would call bottom of the social scale. They were nice people.

I work at a FQHC and most of our patients are uninsured or on Medicaid. We offer a variety of primary care services and please believe me when I tell you that when offer these services or a referral to see a specialist, they ask one question first: how much will it cost? And sometimes it’s not the direct cost of the service, it’s the cost of the gas or the cost of the medicine or the cost of taking off time from work. Yes, it’s complicated and ignorance can play a role, but mostly it’s cost. Most of our patients have low paying jobs with no benefits and can’t get time off or don’t want to take time off because they need every penny. Most don’t have their own transportation and many drive in from small towns that don’t have any health care facilities for low income people. Our city’s county hospital, where many have to go to see a specialist has waiting lists that are months long. We are making appointments for people in December. And the ER is packed because of high numbers of uninsured people and the fact that some people are coming in from as far away as 30 miles. ERs are also the least economically efficient way to deliver health care. The USA should be ashamed to not have a universal health care system. The more I work within the system the more it doesn’t make since. It’s stupid economically and morally.