Recent articles and editorials on lack of access to health care should serve as a wake-up call for consumers, providers and legislators. Ten percent of Iowans have no insurance and more than 87,000 used IowaCare last year. Those referred from this area to the program must be seen in Iowa City, which is prohibitive for people with no car.
Patients have been refused coverage because of monthly income that exceeds the limit by $10. Medications and medical devices remain financially out of reach for most uninsured and many insured patients. The fate of these thousands in the IowaCare rolls upon the program’s termination after 2013 remains unclear.
Free clinics provide service for the uninsured, but they provide no surgical care and no consistent access to specialists. They are largely staffed by non-physicians as fewer doctors volunteer. Project Access, the Cedar Rapids program for specialty care referral, provided for 11 patients per month over the last four years. This did not begin to address the number in need.
By federal law, physicians and hospitals do accept all patients for emergency hospital-based care, yet they bill the uninsured at a higher rate than insured patients. How many insured individuals could afford to pay their entire hospital bill out-of-pocket?
By accepting these inequities in access and affordability of care, physicians, employers, hospitals and insurance companies are all part of the problem. They need to become part of the solution.
Mary Kemen, MD
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