Disparity found in insurance

For those who are uninsured, or under-insured my prayers are with you. for I am one of them and understand the disparity this causes. First I will tell my story, then explain why this situation is present and my hope for the future.

At one time in my life I had the best of the best Blue Cross and Blue Shield have to offer. It was in this time I had found out that I was a diabetic, I had access to any specialist in any field in the medical community. I was an executive and my premium was paid for by the company, any co-pays I en cured was submitted to my company and I was reimburse. So essentially my health care was free. Through the possibility of losing my family I resigned my position with the company not knowing what would befall me concerning my access to health care. Cobra was the first to contact me to breach my coverage but the premium for the same benefits were nearly $900.00 per month, hardly affordable being recently unemployed. With luck my wife went back to her old job and they bridged the gap from when she left and she received full benefits and I was added to her policy. The insurance was comparable to Blue Cross, and Blue Shield so I felt no disparity in this transition. However a year later we divorced and my coverage was lost permanently. It has been four years now that I have been without any insurance and my disparity abounds. Currently I have a chronic sinus infection that requires a specialist and possibly an operation to correct. Way beyond my ability to pay for so my condition remains and has been almost a year now that I continue to dispare over this. I have found in this time because of the pre-existing condition I am unable to get coverage for a year even if I elect to get insurance through my workplace which at the moment does not even offer health care insurance. So I am left without choice, access, and help.

The system we have in place now is problematic in two areas and leaves everyone without choice, although this is what we are always hearing in the news today that people want to keep their choice. Insurance as it stands now is coupled to your employment and you get what they have to offer, and if you were to lose that job you lose your insurance. Cobra is sadly not the answer to bridging the gap because in most cases it is unaffordable.

Why insurance companies came up with the idea of employment based health care was to broaden their customer base and offset high risk patients. If that was not enough for them to offset cost the insurance through lobbying set up the pre-excisting condition clause to thwart obvious risks. All of which has made them money a lot of money and in contrast threw many of us in complete despair. To make matters even worst and to allow insurance companies to gain even more financially they came up with policies that are laughable. I just recently reviewed a policy from a friend who works for Burger King and was enraged by what I saw. With high co-pays, limitations, and capitations it would be better just to burn the policy to keep warm at least then it would be beneficial to the employee.

Outcomes from these money driven policies are devastating our heath care system. People will seek health care through emergency rooms but it has a high price tag which ends up on your credit report for non payment and is only for acute problems. Chronic conditions cannot be address in an acute setting so in the end you get the diagnosis and sent home with little to no help and a large bill.

The future has to hold these concepts for it to change and combat disparity. Quality and safety driven not financially driven. Pre-existing condition clause must be eliminated. True portability is only achieved when you can take your insurance plan from one job to the next. The very concept of insurance has humble beginnings to thwart catastrophe by pooling money together within a community and when catastrophe happens to one all contribute to eliminate the dispair of one or a few. Sadly as it stands now insurance companies are causing the disparity by doing everything they can do to eliminate the risk and by so doing leaving millions without any help or access to their health care needs. Furthermore, we must bring into public focus what we have learned with informatics and how it is changing the landscape of health care delivery and putting the decision making more in the consumer hands. A consumer driven market creates choices, lowers cost, and infuses competition. In contrast a business driven market creates monopolies and takes away choice.

Suffer The American Indians and Alaska Natives

Considering the rich background in the culture view of holistic healing, the statistics in fatality with American Indians and Alaska natives are most alarming. The disparities are the cause and there are many. Language, learning, strong ties to traditionally cultural healing, accessibility, and social class. It is social class that I will focus my post on.

From what I gleamed from my research Alcoholism is the leading decease and is the underlining reason for heart problems, diabetes, accidents, suicide, and birth issues from fetal alcohol syndrome. It is not surprising that alcoholism is so prevalent to these cultural groups do to their social class that being poverty and the poverty cycle we learned in the previous chapter. When basic access is not presented, limited education, and affordability are not present than despair and hopelessness begins to rise. Self medicating becomes the natural process and alcohol is unfortunately the leading alternative. The reason I believe is its legal status, accessibility and cheapness of the product.

When we as a government can increase accessibly and affordability with their cultural belief integrated within the healthcare institution I believe we will decrease the disparity.

Education has to heighten both in language as well with shared or similar beliefs. Meaning; showing the patient that the healing process although unorthodox to their tradition still has fundamental ties to their culture. As a caregiver it is paramount that you establish trust between you and the patient it is truly a learning curve between the patent and the provider.

Personally this condition saddens me being once an active alcoholic I understand the levels of despair you can be driven to, including suicidal thoughts that can result in death, and keeping in mind all the other health conditions that arise from heavy drinking.

Reference:

(Spector, Rachel E.. Cultural Diversity in Health & Illness, 6th Edition. 072003: Prentice Hall, 072003. 11.5).

A Holistic View of The Sick Roll

The perceptions of health and Illness influence the “sick roll” is so vast it is hard to address. However as I kept reading I was able to relate my personal experiences and conflicts I have had with my healthcare practitioner’s throughout the years.

First I think it is safe to say no one likes going to the hospital, easily explained by the setting being so highly structured and controlling. In this setting you are truly submissive to your practitioner. And as a patient I have felt in the dark of the process while in the hospital. Procedures, explanations were not forth coming. I have found the whole experience rather unsettling and to some degree fearful.

My main point that has affected my life the most is when I was diagnose diabetic. The conflict between me and my physician happened almost immediately. Once diagnosed a diabetic, it requires a complete life style change. Acclimating to the life style changes for me took about four years. It is assumed by society and practitioners alike that left altered from the recovery process you are pretty much left on your own. In my case I had another chronic disease not addressed which worsen my diabetes. I was a heavy drinker and with the nature of alcoholism I could not stop. With time and elevated lipids in my blood the Doctor knew I was drinking, he became very judgmental with me and later drop me as a patient. Wow, fired by your own doctor now that was a new experience. :-)

It never was a point that he, my doctor, was wrong, but his approach to the “sick roll” was rather unprofessional. Or perhaps he had a bias concerning alcoholism, for never did he offer me any help in this area other than do not drink. Later and on my own I addressed my disease of alcoholism and it is in remission and my diabetes is controlled.

My final thought, as it stands now you are very much on your own with the responsibility of your wellbeing and health. And for the most part it is the way it should be. However when a condition leaves you with such disabilities such as not doing the same job or unable to work; the system and insurance should continue the recovery process to the point of full acclimation to your new living style and conditions. To me we need a more holistic view of the recovery process and more sensitivity in the hospital environment to achieve better results for societies over all wellness.

Reference:

(Spector, Rachel E.. Cultural Diversity in Health & Illness, 6th Edition. 072003: Prentice Hall, 072003. 6.2.2.4).

We can Learn from the Asians

The Asian/Pacific Islanders seems to me to be the poster child of good health practices. I was surprised that within their heritage the physician is not paid once a patient becomes ill. This puts the attention on preventative care and maintenance of their health. Other statistics show us why in general Asians have a good health record. 39% of Asians hold a managerial and professional specialty jobs. They have the highest medium income of all other races including all native households. Education is high in the Asian race, 84% of Asians have high school education and higher. Also their healthcare practices are widely accepted in the United States, such as acupuncture, moxibustion, cupping , massage, and bleeding by using leeches. One more important factor is their healthcare training. In China healthcare students have the option of studying either Chinese or Western medicine. If they select Western medicine, a limited amount of Chinese medicine is also taught. Wow the combining of culture practices and beliefs how profound. Their current health care problems are basically the same as the white race, that being disease of heart, Malignant neoplasm and cerebrovascular diseases to name the top three.

In contras African Americans have greater healthcare disparities. A 22.1% of the black race lives in poverty. By now we all know the disparities cause by this social class and its effect on all races. Overcrowding in public housing in urban areas also contribute to poor healthcare conditions. Poor schooling and high crime rate also contribute to healthcare disparities within the African American race. Hurricane Katrina was an illuminating example of the inability of this social class to get out of harms way and to receive needed healthcare services. Most affected was the black race. Folk medicine and Voodoo are highly practiced within this race resulting in avoiding hospitals except for extreme emergencies. Also it seems clear that racism still plays a large roll in their healthcare disparities. Adding to this is there race based disease of sickle-cell; at present, statistics indicate that only 50% of children with sickle-cell disease live to adulthood. Some children die before the age of twenty and some suffer complications during their lifetime that are chronic and irreversible. Skin conditions are also a race based healthcare problem for blacks. There is a very low rate of enrollment in healthcare education among the African Americans. Besides disease of heart that effect all races, hypertension, cancer, aids, and STDs are higher than any other race.

My final thought is the magnitude of importance to know a cultures strengths, weakness, and beliefs. It is paramount to diagnosing, treatment, and a favorable outcome to a holistic healing.

Reference:

(Spector, Rachel E.. Cultural Diversity in Health & Illness, 6th Edition. 072003: Prentice Hall, 072003. 12.5.1).