By Suzii Paynter March
Once upon a time a city on the Brazos decided to settle into a system of confusing and expensive organizations and barriers that made it hard for citizens to get health care. It worked.
In Brazos Town, more than 4,500 people now visit the two hospital emergency rooms every year — the most expensive and least consistent care in town. Better yet, more than 1,000 people visit the emergency rooms 4-12 times a year, and these are not the true frequent flyers.
In Brazos Town, if you have a seriously disabled child born and cannot cover the astronomical cost of their essential care, you can wait six years for your child to be eligible for state insurance services.
The base for most insured folks are employers. Some employers offer health insurance — at least to their full-time employees. Other employers, however, thought insurance was getting too costly for their budget, so they started hiring more and more part-time workers who are not eligible for coverage. The employer saves money, the health of the community suffers.
“We added 100 new jobs!” They cheer. “So great for Brazos Town!”
Others remind us that 50 full-time employees lost health insurance for themselves and their families.
So more people go without Insurance even while working. If you do not have a good full-time job and an employer with health insurance for you, you can apply for lower cost state health insurance, but to do so you will have to quit your job, lower your income to less than $400 a month, sell your car (no assets allowed for eligibility) and re-apply every six months. Of course, this state insurance is available only if you are a child, disabled, the mother of an infant, or pregnant. Single? Working for $400 per month? Without kids? Nevermind.
Caring for the record number of uninsured people becomes a problem. A program is started in Brazos Town to train 12 doctors a year. It is as if someone said, “Let’s put the burden of caring for all these folks on these trainees!“
Three classes at a time were in town, and this team of doctors in training and other training colleagues set up clinics where they practice for their training and care for Brazos Town folks for some services. There are waiting lists for services and referrals to specialists from these clinics, and some specialists are available only for those with insurance from employers or every six months from the state.
The hospitals, the City, and the County budgets all chip in to help pay for the clinics and the the doctors in training, but these clinics that started out for training are busting at the seams and costs are growing every month. Fundraisers cannot raise enough money. And the City, County and hospitals have their own health-related costs, too, like emergency services, the county health office, epidemiologists for deadly pandemics, and programs for special populations.
Last year, Brazos Town endured the pandemic like every place else. Some predictable outcomes showed that people worked together and pulled together, but the toolbox for services to everyone was exhausted, as were the health care professionals trying to serve Brazos Town.
Sometimes there is wisdom in the right question: One 10-year-old child said to her mother at 8 p.m. after a day in the emergency room, “Mama, can’t we have a simple way to fix my asthma that doesn’t go to the ambulance place?”
“No,“ Mama replied. “This is the Brazos Town way.”
(Brazos Town, all these incidents and more have come across my inbox this year.)