'No Insurance' Should Not Mean 'No Care'

It is still somewhat baffling to me that 44,000,000 Americans have no health insurance. This figure has been around for so long that it has lost the shock value that it once had. It is only immediately meaningful if you are one of those without healthcare coverage and need it, or if as a physician, you donate your services to those who are in need.

Many of the uninsured are not who you might think they are. Most of them are employed and work for small businesses unable to participate in some of the programs available to larger employers. Many are unemployed and might not meet the criteria for government-sponsored programs. What many people do not know is that there are options for those needing non-emergency health care. These services are often available at low cost and occasionally at no cost.

Working with the System
If you have children who are not covered by insurance, Badger Care is available for them and it should be your first contact. No child in the state of Wisconsin should be without some form of government-sponsored care.

Do not assume that you do not qualify for any insurance programs at all. For people living in the Milwaukee area, the Medical Society of Milwaukee County's web page has links to the following programs:

1. Badger Care
2. Milwaukee General Assistance Medical Program
3. Medicaid
4. A list of 18 area free clinics

You will have to expend some time and energy to navigate the system. My experience as a physician is that most if not all of the people that work at these agencies try to be as helpful as they can. You will likely be asked to have handy information such as your social security number, recent W-2 forms and other information to determine whether you qualify.

If the problems for which you need help are the result of substance abuse, or involve the need for shelter, food, or financial assistance, contact IMPACT or simply dial 211 on the telephone if in Milwaukee County or 1-866-211-3380 if outside Milwaukee County.

The free clinics usually have limited hours and may have some kind of screening to see if there are other options for your care in order to make their services available to the most medically needy.

Working around the System
Your best first stop is still your family doctor. Before you make your appointment, call the office that you want to go to and ask to speak to the business manager. Explain that you do not have health insurance at this time and would like to know the options available for those who want to pay out-of-pocket - specifically ask if there is a "sliding fee scale".

When seen, tell the doctor that you are paying out-of-pocket and would prefer that no testing is done until the need and costs can be determined. If medications are needed, ask that they be generic only. Some offices may provide samples, but these are only useful for short-term use.

For other more costly prescription medications that are needed longer term, check the website of the Partnership for Prescription Assistance. There are clear directions as to how to proceed.

Try not to get too discouraged. In special situations, I have found that physicians, hospitals, and some insurance programs are far more understanding and willing to negotiate than many people would imagine when they have some sense of the need that they are responding to.

For those who think that help in a comprehensive form is just around the corner, your optimism, though laudable, is unjustified. There are no solutions to this problem of the uninsured that are anywhere near implementation. In that light I would suggest that waiting too long for health care is a bit like delaying needed attention for your car. The longer you wait, the greater the cost.

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