By Dave Ranney
KHI News Service
KHPA board member Garen Cox was among members of the agency”s staff and board who listened to comments Wednesday at Silver City Health Center in Kansas City, Kan.(Dave Ranney/KHI)
KANSAS CITY, KAN., July 25
A couple months ago, 62-year-old Guadalupe Rios took herself to the emergency room at the University of Kansas Medical Center.
“I”d had a real bad stomach ache for like four days,” she said. “It got to the point where I just couldn”t take it anymore. I didn”t want to go because I don”t have insurance. But I had to go.”
Rios, who”s single, said she was in the emergency room from 9:30 a.m. to 10:30 p.m.
“At 10:30 they took me up for some tests. They said my potassium levels were low, very low. They were worried about me,” she said. “I left at 8:30 the next morning.”
Her bill: Around $6,000.
That”s more than half of what Rios, a gift-shop clerk, earns in a year.
The hospital turned Rios” account over to Lathrop and Gage, the law firm that handles its overdue bill collecting.
“I agreed to pay them something every month. I want to pay my bills,” Rios said. “They said I didn”t have to go to court, but I got a $97 bill for court costs anyway.”
Rios shared her story with Kansas Health Policy Authority officials Wednesday during the group”s “Health Reform Listening Tour” stop at Silver City Health Center, a small safety net clinic in Kansas City.
“I just wish there was health insurance I could afford,” Rios said, afterward. “I don”t want to be a problem. I want insurance. I”d have it if it was there and I could afford it.”
Rios said she learned last month that “one of my ovaries is bigger than other and I might have to have surgery. But I”m not going to do it. I can”t afford it.”
Because she”s uninsured, Rios said she is not privy to the lower rates offered by medical providers and negotiated by insurers. She”s expected to pay the full amount.
“That doesn”t seem fair to me,” said Vickie Mathis, business office coordinator at the health center. “It”s like she”s being punished because she”s poor. It doesn”t seem right to me that someone who”s insured gets a lesser bill than someone who”s not insured.”
Though she”s poor, Rios can”t get on Medicaid because in Kansas, eligibility for childless adults is limited to those whose incomes fall below 37 percent of the federal poverty guideline.
Rios earns about $11,000 a year; 37 percent of the poverty guideline is $3,778.
“This is a lot of what we see here,” Mathis said. “People can”t afford health care because they don”t have the money and they can”t get insurance.”
Mathis said most of the clinic”s patients are employed.
Four of the clinic”s patients shared their stories with the health policy authority panel.
“What I heard each of them say was that they wanted to be able to buy health insurance, but they can”t afford it,” said health policy authority executive director Marcia Nielsen.
The first day of the listening tour also included a meeting hosted by the Greater Kansas City Chamber of Commerce and Embarq, a session with Leavenworth area health officials at Cushing Memorial Hospital, and a session at the United Methodist Church in Atchison.
Other concerns expressed during the day:
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Throughout the region, emergency rooms and safety net clinics are seeing increasing numbers of undocumented immigrants, all of them uninsured.
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Leavenworth emergency rooms cannot keep pace with the number of patients with chronic mental illnesses showing up for care. “We have no place to send them,” said Lynn Lemke, director of mental health services at Cushing Memorial Hospital in Leavenworth. “They need to be in an acute-care setting
like a psych unit, but we don”t have one and we can”t start one because the funding isn”t there.”
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At some point, people
insured as well as uninsured
will have to be held accountable for not doing what their doctors tell them to do. “Things like diet and exercise or not adhering to medication regimens, or not taking your hypertension medicine, or not checking your glucose, or not seeing your doctor when you”re supposed to
are there to be consequences or will the system always accommodate our bad choices?” asked Bill Bruning, president of the Mid-America Coalition on Health Care. “This is a very scary thing to talk about; it could be draconian. But where we”re going now is not supportable over time, so, really, there may not be an option.”
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Schools need to begin teaching children how to take control of their health. “I think we lose sight of the fact that we”ve come to live in an “illness culture” and not a “prevention culture,”” said Laura McCrary, health access project director for the Mid-America Regional Council. “We really expect medicine to take care of all our problems
our diet, our lack of exercise, or not following medical regimens. That has to change. We have to take responsibility for ourselves.”
None of the comments surprised E.J. “Ned” Holland, senior vice president of human resources at Embarq and a member of the health policy authority board.
“Health care in this country is a colossal mess and needs to be fixed,” he said.
The listening tour resumes Thursday in Wichita.
-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
dranney@khi.org
or at 785-233-5443, ext. 128.