Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, May 9, 1993 TAG: 9305090266
SECTION: HORIZON PAGE: F1 EDITION: METRO
SOURCE: Caroline Click
DATELINE: LENGTH: Medium
Then she thought it was a joke. But when the hospital didn't laugh, she got angry.
She tried to give the blue-and-white sling back, but hospital personnel said that was against its policy. Ditto for donating it so that some poor soul with no health insurance could rest a little easier.
"They said they would just throw it away," said Mays, 30.
Mays got a rude introduction to American Health Care 101, where guessing everything from the price of an aspirin to the cost of a life-saving surgical procedure has become a kind of society mind game.
Mays, a Bedford County resident, was taken to a hospital emergency room after suffering a bruised shoulder and dislocated jaw Feb. 20 in a four-car pile-up.
An employee of the National Park Service, her Blue Cross-Blue Shield insurance paid the entire $475 emergency room bill, including the cost of the visit, two sets of X-rays and the infamous sling.
Her insurance also covered treatment for her 13-year-old son, and the cost of seeing a specialist to have her jaw put back in place.
But Mays wonders what happens to those who don't have insurance.
"If people can charge $164 for a sling, how can people without insurance even begin to pay on their medical bills?" she said.
The catch is, they can't.
The so-called working poor, who earn just enough to disqualify themselves from government aid but are not working in jobs that provide health insurance, are forced to postpone care or take on huge debts that realistically never can be paid.
Those who do qualify for Medicaid, the government program to pay for indigent care, theoretically have access to free medical care through public health clinics and physicians willing to take on poor patients.
But the Medicaid system serves only about 40 percent to 50 percent of the nation's poor. The rest fall through the cracks, appearing periodically at emergency room doors for some of the most expensive treatment in America.
No one knows exactly how the system will be reconfigured.
But people like Mays and others believe the uninsured must be a top priority.
For Dr. Don Stern, director of the Roanoke Public Health Department, health-care reforms necessarily must involve access and cost.
"Her [Mays'] observation begs another question: Why is is that some supplies and materials are so expensive?" Stern said. "The variables are so complex that changes in one area may impact significantly on other areas of the system.
"As far as the working poor, there is a major gap. They are not eligible for Medicaid. It's darn scary," he said.
Stern also echoes Americans who suggest it is time the country invested in health, rather than illness insurance.
"We are focusing on illness care, and what I've tried to do is bring attention to health policy reform that will help people maintain their health or prevent disease," he said.
He believes that citizens must be held accountable for lifestyle choices. "We can't blame the government if they are suffering from alcohol abuse, or tobacco abuse or promiscuity," he said.
"We're still willing to pay the tremendous cost of care and lost productivity of smokers," he said. "You add up all those costs, the disability deaths and lost productivity and compare that to the revenue from the tobacco."
-CAROLYN CLICK
by CNB