The Surprising Role of Free Clinics and County Hospitals in Providing Affordable Health Care
During March of 2010, President Obama made history when he signed the Affordable Care Act into law. What has become commonly known as “Obamacare” was intended to provide people with low incomes with the same healthcare insurance options that everyone else had available. Those people who relied on free clinics and county-run hospitals for their basic care would finally have choices in the healthcare providers and the types of medical treatment they received. No one expected the need for free health clinics to become even greater once Obamacare was the law of the land.
The Failure of Medicaid Expansion – The Biggest Reason Free Medical Clinics are Still a Necessity
The one area where The Affordable Care Act falls short of its goals is with Medicaid. This government program provides assistance to low income families who have no other resource for affordable health care. Originally, The Affordable Care Act was meant to expand the number of people covered by Medicaid in each state, resulting in thousands more people having health insurance. However, when the Supreme Court ruled that the states would have the right to decide to implement the Medicaid expansion, many declined.
As of January of 2016, 32 states have expanded Medicaid while 19 have not. This “Medicaid Gap” has resulted in millions of people still not having coverage. Preventive care, short-term treatment for illnesses and injuries, and ongoing care for chronic conditions are expenses they can’t afford from a private healthcare provider. Their only choices are to ignore their healthcare needs or to take advantage of the services offered in local free health clinics.
Why Affordable Health Care Isn’t Affordable to Everyone – Another Reason Many People Still Seek Alternatives for Affordable Health Care
For the many people who have gotten health insurance coverage for the first time, getting the medical treatment that is right for their needs may still be out of reach. The growing costs of healthcare and the limits placed by insurance companies can still result in a big financial burden that the patient can’t afford. Although they may have help paying their insurance premiums, the actual costs of going to the doctor may remain out of reach. Below are some of the reasons that health care isn’t affordable for everyone; even if they have health insurance.
Lack of Coverage for Some Services
One of the benefits of Obamacare is the availability of free screenings that allow for early detection and treatment of common and serious health conditions. Mammograms to screen for breast cancer, colonoscopies to detect early signs of colon cancer, and simple tests like screening for high blood pressure are some examples of life-saving free screenings. On the flip side, some of the most basic types of healthcare that can impact general health and quality of life are not included. Two of the most significant are vision and dental care.
Many of the insurance plans offered on the marketplace do not include dental or vision care for adults. The new healthcare law provides these types of care for children. While it is important to start early and maintain vision and dental care in children, adults who are at the greatest risk for a number of conditions that cause loss of vision and deteriorating dental health do not have access to the treatments they need.
Vision care has become increasingly expensive, resulting in a large number of insured and uninsured adults who simply let their eyes go unchecked. A routine eye exam and eyeglasses can easily cost hundreds of dollars that the individual must pay out-of-pocket; an expense that is nearly impossible for anyone living on a low income to meet.
In addition to loss of vision, there are signs of other health conditions that can be detected during an eye examination including diabetes and neurological disorders. Many people are turning to programs and clinics that offer free or low cost vision care to get these much-needed services. There are also those people who are not aware of these services and don’t know where to look for help in their area. If more people were aware of the free health care offered at free dental clinics and medical clinics, this number would probably grow by much greater increments.
Like vision care, dental care has become increasingly expensive. Technology has led to new techniques and products that allow oral care professionals to provide patients with more options to keep their mouth healthy and help them retain their teeth longer. Good oral health has an impact on overall health. Without proper dental care, bacteria can grow out of control, lead to infection that may travel throughout the body. Straight teeth are also important for chewing food and preventing conditions from developing that can cause gum disease and pain from misalignment.
Many people feel that dental insurance is not a real benefit as the coverage often falls well short of the actual expense for many services. Policies often cover preventive services such as annual or biannual x-rays and cleanings but only pay a percentage of the fees for any procedures needed to correct problems. Many do not cover services provided by an orthodontist and only consider straightening teeth a cosmetic procedure.
Free dental clinics often provide essential oral care that will prevent more severe problems from developing in the future. Performing examinations as in the image below will allow dental professionals to find hidden problems. Cleanings, fillings and extractions are common services offered that many people simply can’t afford from regular dental clinics. In many cases, the people providing the services at the free dental clinic are the same ones who provide services at a significant fee in their private practice.
Although dental insurance is offered as an option on the marketplace, the actual benefits may not be worth the additional cost. The benefit of screening for dental problems is lost when you are unable to follow-up with the necessary treatment. Many people feel that finding a free dental clinic is a better option than paying for something they can’t afford and which will not help them keep their mouths healthy. If you will only be using dental insurance to pay for checkups and cleanings, you may be paying more for your premiums than you would for these services from a dentist. At a clinic that offers free or affordable dental care based on your income, you get the same services by a trained professional without the high cost.
Regardless of your situation, visual and oral health should not be neglected. One thing that vision and dental care have in common is that with some conditions, once damage is done, there is no replacing the quality of health that has been lost.
High Co-Pays and Deductibles
Regardless of how well an insurance policy pays, high copays and deductibles can still prevent the insured from being able to afford healthcare. Although “junk” insurance that was expected to be eliminated once The Affordable Care Act went into effect, the ruling by the Supreme Court has resulted in many policies offered on the marketplace having copays and deductibles that are out of reach. In addition, a lot of the insurance being provided by employers only prevents them from getting a better insurance policy and costs so much that they can’t afford to get health treatment.
Many people are confused about copays and deductibles, especially when some of their services are paid entirely while others are not covered at all. Determining the benefits from insurance can be very complex, making it difficult to know if you can safely schedule a needed procedure without worry that it will bankrupt you.
A copay is the amount of money that you have to pay when you see a doctor or have a prescription filled. Most insurance cards have these amounts printed on the insurance cards for easy reference and they only change when you go to a different type of doctor or have a different type of service performed.
The deductible is the amount you must pay before your insurance coverage kicks in. Junk insurance policies, as mentioned earlier, may have as much as a $5,000 deductible. That means that if you go to the hospital for an illness or inpatient treatment, you must pay the first $5,000 of the bill before you can have the treatment.
There are some other factors that may impact the amount you have to pay such as discounts for using in-network providers that may reduce the total amount of your bill. If you are not required to get pre-approval, you may not realize what your actual cost may be until your bill arrives. Medical treatment in a hospital is priced for those who have top tier insurance or an unlimited amount of money to cover any medical costs.
Free clinics and county run hospitals treat people who do not have the money to pay for insurance or for these high-priced medical treatments out of pocket. Today, there is a broader range of free health services being offered such as mental health care and pediatric services as well as specialty treatments for specific conditions such as cancer.
Treatment for Chronic Conditions
Low income people with chronic conditions may encounter a number of obstacles to getting the supplies they need to manage their conditions. Many do not have the money they need to pay for regular medical care, leading to more people foregoing their healthcare and putting their health at risk.
Another problem managing chronic health conditions is that insurance companies often dictate how often you can receive care and supplies, making it necessary to spend more money on transportation and copays. Putting restrictions on refills helps them limit costs to only essential items. At the same time, it may prevent those who need them the most from having access to them.
One example is that of the rising cost of diabetic care. Prescription medications such as Metformin and insulin, along with supplies such as syringes, glucose meters and strips are just some of the basic expenses a person with diabetes will incur. There are also complications that require additional medications and office visits. For low income patients, copays and transportation costs may result in their not having the needed supplies to monitor their blood glucose levels, to take their insulin regularly, or to have secondary conditions diagnosed that result from the diabetes. On average, a person who has been diagnosed with diabetes will spend more than $10,000 more on health care than those without the condition.
Free health clinics understand the obstacles that low income patients face and many will allow them to take the supplies they need to ensure they can accurately manage their diabetes. Paying nothing, or only a nominal fee, allows those with diabetes and other chronic conditions to see a physician as often as needed.
How Free Medical Clinics Work
There are some differences as to how free clinics get their funding and in the diversity of the services they offer. Some are mostly voluntary, with qualified physicians, nurses, and other staff members from around the area volunteering their time. Others may have a regular full-time staff to serve as the core operation in addition to a number of volunteers to supplement their offerings.
Some clinics rely on government and/or state funding while others are funded by private donations. They may also use a combination of these sources. Some provide only free services while others may charge affordable fees based on income.
There are advantages to many people, including the insured and uninsured alike, of getting free medical care. For those who are uninsured, free healthcare clinics and county hospitals may be their only resource for life-enhancing and life-saving medical treatment. For those who are insured, free or affordable health care is a part of a comprehensive plan to get the treatments they need at the lowest possible cost.
If you are unable to pay for insurance or the healthcare you need to stay healthy, learn what types of free medical clinics are available in your area. You may have more options for getting health care than you think.