Friday, September 9, 2011

Why I won't be seeing a doctor this year

Most of my blog posts in the past have focused on individual choices you can make to live a healthy life: eat more vegetables, exercise more, learn to cook from scratch. While these are important steps to take, they don't constitute the whole picture of healthy living. There's a whole host of forces in society that make it more difficult to be healthy. And one of the biggest problems, one that I often overlook until it slaps me in the face, is lack of access to quality health care.

Disclaimer: This post is long. If you don't have time to read it all, the general message is this: Not having health care is a major problem for many people of different income levels. Please consider donating to clinics that serve uninsured individuals, and support policies that will improve access to affordable health care.

As you may have guessed, I support universal health care for multiple reasons. I think it's a fundamental right that Americans deserve. I think it's the job of our government to care for those most in need. But the biggest reason I support universal health care? Because without it, I can't even get a basic doctor's appointment.

Now theoretically, getting a doctor's appointment should be easy for me. I come from a middle-class family and have a college degree. I speak English as a first language, and I'm not afraid to speak assertively to persons of authority. All these things are to my advantage, and yet scheduling a doctor's appointment has always been my idea of a living hell.

Know why? Because I don't have health insurance.

I have held wonderful teaching jobs for the past three years, but only one was full-time, and I haven't had health benefits for a year or more. Unfortunately, health insurance is not offered by all employers. People who work part-time or for a non-profit or are self-employed are usually uninsured, unless they want to pay through the teeth for private individual insurance. States offer insurance for low-income individuals, but these are not often affordable. In New York, I would have paid $350/month for basic health insurance, while working two part-time jobs.

Therefore, I am stuck with no health insurance. And that means I will probably never see a doctor unless I absolutely have to. Unfortunately, at this point in my life, preventative care is just not worth it to me, considering the hassle, humiliation, and financial challenges I have to face to see a doctor.

Here's a recent example. My newest employer, a nature center run by the city, asked me to get a health physical before beginning the job. A simple request, for most people who are insured. But for those who aren't, it's much more complicated...
Step #1: Find a health clinic who will take me. 
While the wonders of the internet should make this simple, I have a few limitations. I can't go to a regular private clinic, because the costs for uninsured patients are outrageous. Even if I did want to shell out the money, I don't have an assigned doctor there, so I would have to wait a month to have a "New Patient Appointment," then wait another few weeks to see a doctor. This would mean I couldn't start my new job for at least two months. 
I also can't go to some of the free clinics, because they don't offer routine preventative care like health physicals. They're also only open limited hours, mostly during the weekday, leaving me no options if I am already working full-time. (I'm not, but others often face this problem.) 
Step #2: Make the appointment. 
This involves waiting on hold for at least twenty minutes, if not longer, since low-income health care clinics are often understaffed. I finally got through to the county health clinic, and they told me the earliest I could see a doctor was in November, and that was for a New Patient Appointment. (See Step #1.) Wonderful. 
Crossing that clinic off the list, I moved on to the Cristo Rey clinic, whose website said they serve uninsured community members at the low cost of $20 per visit. Perfect. Keep in mind that this nature center job that requires the physical, while a wonderful opportunity, is only paying me $9/hr, so I can't afford an expensive doctor visit. 
I decided to call this place. After my second attempt at connecting with someone, the receptionist was very confused and rude when learning that I needed a physical for employment. "Don't you have a family doctor?" she snapped. No, I replied patiently, as I already told you, I don't have health insurance, and haven't had a "family doctor" since I was 17. After we got through these introductions, the clinic then informed me that they don't do physicals for new patients, and if they did, it would cost $80. I would have to work more than a full day to pay that off. 
So far I have spent at least 45 minutes on the phone in this process, and still no successful appointment. I also tried Planned Parenthood, whose website said they do employment physicals, but apparently this was erroneous. The receptionist there was shocked when I asked to schedule a physical, and derisively told me "we don't do that here."
Now, this particular story actually has a happy ending. Someone suggested that I look for an urgent care facility, and I was lucky enough to find one which actually took walk-ins and only charged me $39. Awesome for me, but not typical. In my experience in both Chicago and New York, the costs were much higher. I have paid $350 out of pocket for a gynecological appointment, and have heard stories that are much worse. But at least I found a place, so that meant I could move on to the next step.
Step #3: Get to the clinic. 
For most people this requires taking time off work, which often equates with a smaller paycheck. I also needed to consider what neighborhood the clinic was in. When I lived in Chicago, there were several neighborhoods where I didn't feel comfortable walking alone. And taking a buddy along was not really an option. Who's going to come to a doctor's appointment with me in the middle of the workday? 
I'm also lucky enough to have a car, but many people need to navigate bus routes, resulting in even more time off work. 
Step #4: Actually get seen by a doctor. 
Now, this is my least favorite step. I have gone to my share of county clinics, and some are better than others. But most are loud, busy, smelly, and stressful. The receptionists are shouting, babies are crying, moms are yelling. The wait is usually at least an hour, if not more (which is annoying at best and takes away from precious work time at worst). The medical staff are trying their hardest, but they're underpaid and understaffed, and stressed. As a result, "welcoming" is not a word I would often use to describe these clinics.
The rest of the appointment is probably pretty typical whether you have insurance or not: the nurse gets me and takes my vitals, then I wait another twenty minutes to see the doctor, then the doctor breezes in and out since I'm her nineteenth patient that day. 
 But finally, after giving up time, money, patience, and dignity, I have seen a doctor.
Now, this small experience, which I have repeated every time I need to see a doctor, is the reason why I support universal health care. It's the reason why the employer-based health care system is not working. The system is not providing people with health care that will prevent them from getting sick.

But until this system gets fixed, please consider donating to a low-income health care clinic in your area. There are people who are facing much larger health issues than I am, and they have a right to see a doctor.

Image source: Carolina Living Health Care

1 comment:

  1. Wow! I guess I'm lucky that I've always had insurance when I've needed it. I also believe that universal healthcare is the way to go...and have thought that since I first learned about it way back in my intro to nursing class. I am glad that you were able to get your physical at an urgent care clinic...I've had good luck at those too! Stay healthy!!

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