It's all OK

Nathan was in last night. We haven’t seen him for several months. He has been receiving his care from a referral source.

I have a soft spot for Nathan, as he suffers from the same chronic health condition my husband has. I know what a tough journey it has been for us, and we have so many resources – insurance, a primary care provider, family and friends – so much support.

Nathan told me last night that he is no longer receiving treatment for his condition – the side effects of the medication had taken a toll. So, he’s off treatment until next spring.

He also told me that he lost his job; the company he was working for has closed. He was without work for a few weeks; fortunately he was able to borrow money from his dad and his sisters in order to make it. When he can’t pay his rent, he works for his landlord – painting, yard work, whatever needs to be done. He just started a new job making $7.40 an hour. His paycheck covered his car payment, with $1 left. He is thankful he was able to make the car payment after not having any work. But he is having a hard time making ends meet. He finally broke down and applied for food stamps – “just to get through” he told me. He doesn’t want a handout.

He told me several times “It’s all OK” as he told me his story.

He proudly showed me his 10 year sobriety token. He told me as long as he stays sober, it is all OK. That is his primary focus; he needs this new job to provide for himself, and to stay sober.

It’s all OK.

Maybe I need to remember that sometimes.

It’s all OK.

The Beginning, Not the End

I was so excited about October 1, 2013 arriving, with the promise of healthcare reform, or more accurately, access to healthcare insurance.

But, it has been messy.

The website is overwhelmed, and not functioning as we had hoped. But, that doesn’t mean that healthcare reform has failed, or that it will fail. It just means that many of us who hoped to help people find access to healthcare insurance will have to wait.

We will wait, patiently, until the bugs are worked out. We will still be able to help people with finding access to real healthcare.

Here at the clinic, many of our patients will qualify for the newly expanded Medicaid that Michigan passed. It was a battle, but next spring we will see the benefits of having healthcare coverage for our most vulnerable.

October 1, 2013 was the beginning – not the end. The opportunities are still there. Open enrollment will last until March 31, 2014. In the meantime, we continue to provide healthcare to those in our community who have no other resource.

OCTOBER 1, 2013

Today is a historic day. The major provision of the Affordable Care Act begins to take place today. Millions of uninsured, working Americans can begin to apply for healthcare coverage using the newly developed Marketplace.

So, what is this Marketplace? It is a one-stop shopping arena for purchasing health insurance. You can look at all the options and have all the information you will need to make a decision. The Marketplace will be available online, by phone, or in designated locations. If you don’t get your insurance from your employer, then you can shop the Marketplace. The information from all the insurance companies will be available in one place and you can compare coverage options – side-by-side, with the same information for each company explaining the coverage and the cost.

The Marketplace offers insurance in what they call “Four Metal Levels”: Bronze, Silver, Gold and Platinum. The factors affecting your cost are the premium, or monthly cost for health insurance, the out-of-pocket expenses that you will pay at the time of service, the benefits you will receive and the amount the insurer will pay.

In order to make the health insurance more affordable for working families, there will be tax credits that will go towards your monthly health insurance premiums. These tax credits will vary depending on the size of your family and your income. There is also some money available for cost sharing, which means you could get lower deductibles and co-payments if you meet the income guidelines.

There are penalties for not purchasing health insurance. If you have insurance through your employer, you are all set. If you are uninsured and do not purchase health insurance, the penalty is 1% of your income or $95 – whichever is greater. But, by the year 2017 that amount will increase to 2.5% of your income or $695 – again, whichever is greater. There are some exceptions to the mandate.

For those in our state with the lowest incomes – those living at or below 138% of the Federal Poverty Level, you will qualify for Medicaid when expansion takes affect sometime next year (hopefully, by April). If you have a family of 4 and make $31,322 or less, you may qualify for Medicaid next year.

If you have questions, call 1-800-318-2596 or go online to healthcare.gov. They are available 24/7 and can answer your questions about healthcare reform.

 

What does healthcare reform mean for Michigan?

From FamiliesUSA

Robert Update

Following his hospitalization for atrial fibrillation, Robert came into the clinic every single Tuesday night. Sometimes he needed medications, sometimes he needed to see the doctor, but what he ALWAYS needed was the reassurance that he was doing okay. He was so scared, and this was the place that he felt safe. Safe – here at the free clinic, he felt safe. How did he feel the other six nights a week? Frightened, alone, scared – I can only imagine.

We noticed that he had not been here for a couple of weeks. One of the volunteers expressed concern; I had noticed too that he wasn’t here.

Last night he came in – almost dancing. He feels good. His health is so much better and he feels alive again. He needed his medications, so he came in to pick those up and was on his way saying: “Thank you. I feel GREAT!”

Rose Update

Rose has not had an easy path post-amputation. She was re-hospitalized with an infection; she was wearing a pump on her leg to assist with circulation the last time I saw her.

She seems to be doing okay emotionally, but her daughter who is her caregiver is really struggling. It is so hard as a child to have to become the parent to your parent – to be the caregiver.

Yesterday I received a call from one of the larger regional hospitals – not the one where she had her surgery – and they were discharging her. I asked why she was there, since her surgery had been done somewhere else. She wasn’t there because of her leg – she had been admitted there with Congestive Heart Failure. Another example of how fragmented our healthcare system has become.

Veterans

Last night, I talked with one of our veterans for quite a while. He had come to the clinic for healthcare. He’s a veteran – served in both Gulf Wars. And he is getting his healthcare in the basement of a church. We really can’t do any better than that? He is entitled to VA benefits – we have tried to help him access them. But, there has been a change in personnel in the local office; he has been lost in the chaos. He’s a veteran, for crying out loud. Can’t we do better?