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From: Martha Livingston <[log in to unmask]>
Date: 26 September 2014 05:08:17 BST
To: Ruth Charmaine White <[log in to unmask]>
Cc: Kenneth Thompson <[log in to unmask]>, Alex Scott-Samuel <[log in to unmask]>, Spirit of 1848 <[log in to unmask]>
Subject: Re: [spiritof1848] Access to health care for uninsured Americans
Reply-To: <[log in to unmask]>

Dear All,

About the “Economist” Obamacare article: 

Well, I could quibble with the “1-pager” appellation for what is in fact a 3-page article, but more problematic is the argument itself. After a nod to single-payer national health insurance as the only real solution (with co-pays to discourage ‘overuse,’ not an actual problem in the U.S. system), the author leaps into the morass of trying to ‘fix’ Obamacare's market-based non-solution. How? By eliminating employment-based health insurance and throwing all American employees onto the individual market - as regressive as it gets. Large employer- and union-based group plans have been able to wrest ‘discounts’ from the insurance gargoyles totally unavailable to individual shoppers. Unionized workers have foregone decades of wage increases to protect their health benefits; these would disappear, uncompensated. 

The author’s ignorance of the reality of the U.S. system is betrayed by the description of their being no problem with having to pay $1000 out of pocket. Apart from what’s wrong with the whole ‘skin-in-the-game’ argument, most insured Americans look back on the days of mere $1000 out-of-pocket maximum yearly deductibles as the ‘good old days.’

For shame. We need single payer national health insurance.

Cheers and solidarity,

Martha

On Sep 25, 2014, at 10:35 PM, Ruth Charmaine White [log in to unmask] [spiritof1848] <[log in to unmask]> wrote:


What do you think about the pharmacies getting into front-line, low-intervention, cash business? Certainly increases access and is low-hassle.

This week's Economist has a great 1-pager on Obamacare.



Ruth C. White, PhD, MPH, MSW
Clinical Associate Professor
School of Social Work
University of Southern California
1150 S. Olive St., Suite 300
Los Angeles, CA 90015-2211
Office: 213.821.0900
Cell: 206.371.7099
My page: ruthcwhite.com
Twitter: @ruthcwhite

Author: Preventing Bipolar Relapse
Editor: Global Case Studies in Maternal and Child Health

On Sep 25, 2014, at 5:42 PM, "Kenneth Thompson [log in to unmask] [spiritof1848]" <[log in to unmask]> wrote:

 

Don't know of a brief guide. 
Maybe easier to say what uninsured have access to. 
Primary care at federally qualified health centers if there is one around.   They can get some clinic care and inpatient care at the remaining public hospitals and some non-profit hospitals have some charity care. There are a few free clinics. 

There are some states that cover mental health care and meds for the uninsured. 
They can get emergency care- even the undocumented- if it's an emergency. Labor and dialysis is covered as an emergency. Some states will cover prenatal care. 

Of course in addition to whether someone has insurance or not is the issue of the availability of services.  Rural folks can be in trouble with this. So can ethnic minorities.

There are some pharmaceutical companies that provide some free medications to poor folks. And some p harmacies provide some common meds for free or very little money. 

The effort is to get uninsured people on insurance and benefits - usually medicaid and or Medicare or some of the new Obamacare products. 

It's a mess

If everyone who can gets insured under Obama care the only remaining uninsured will be undocumented people or the libertarians who refuse to engage with obamacare because it's government. 



Ken Thompson MD
4127608483
Sent from my iPhone

On Sep 25, 2014, at 7:31 AM, 'Scott-Samuel, Alex' [log in to unmask] [spiritof1848] <[log in to unmask]> wrote:

 

Is anyone aware of a very simple guide which shows on a state by state or a national basis, what aspects of primary, secondary and tertiary health care uninsured Americans of different incomes / social classes, ages, sexes and/or morbidities have access to? 

I'm obviously aware that other dimensions of inequality may moderate access so if such dimensions are relevant it would be good to know about them too

Thanks, Alex



*************************************************************************************************
Dr Alex Scott-Samuel,
Honorary Professor, School of Medicine, Pharmacy and Health, Durham University; 
Senior Lecturer, Department of Public Health and Policy, University of Liverpool; 
Director, IMPACT - International Health Impact Assessment Consortium; 
Director, Liverpool Public Health Observatory
(+44)(0)151-794-5569/5570    @buzhna
*************************************************************************************************
Non-cooperation with evil is as much a duty as is cooperation with good - Gandhi



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Posted by: Ruth Charmaine White <[log in to unmask]>
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Martha Livingston, Ph.D.
Professor and Chair, Public Health 
SUNY College at Old Westbury
Box 210
Old Westbury, New York 11568-0210
(516) 876-2748
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