Despite the best efforts of health care professionals, dedicated nurses and the work of those in hard-pressed community clinics, the fact of the matter is the United States is still falling behind other developed nations in terms of access to health care.
According to a Commonwealth Fund study last year, the U.S. fell behind in almost all of the 72 metrics measuring the health care systems of Canada, France, Australia, the United Kingdom, New Zealand, the Netherlands, Sweden, Germany and Switzerland.
Compared to all of these developed nations, the U.S. ranked last or close to last in access, efficiency, equity and health care outcomes, despite spending the most money on health care.
Taking a step back from the ideological debate about access to health care, let’s instead take a look at how this poor accessibility affects the people.
Nearly 30 million Americans go without health insurance, many of them without health care altogether. Seventeen percent of Washington County residents do not have insurance, while about 14 percent go without in Johnson City, according to conservative estimates from Ballad Health. Even if Medicaid was expanded in Tennessee, it’s still likely that many of these folks — some of whom have chronic health issues — would remain without health care.
Considering those who do have health insurance, it’s also important to note those who do have different health care plans still often find the costs for certain procedures to be expensive, especially if they go over their annual cap.
For many of the uninsured folks, just having the option of going to a community clinic like the Johnson City Community Health Clinic is a godsend. Still, patients often find themselves frustrated with the quality of care, the wait times and the cost of services.
The sheer volume of uninsured patients alone who visit community clinics must also be overwhelming for the staff.
There are typically about 20 or more people in the community clinic at any given time. Patients can expect to be in the clinic for hours waiting to see a doctor, even with a scheduled appointment. Low-income patients who are considered indigent still get billed for very expensive medical costs; even on a sliding scale, they simply can’t afford it.
Health care in the United States is astronomically expensive. There are virtually no price ceilings for many of the services and goods provided to patients, and a single aspirin for an emergency room patient can cost about $30. A single visit to the emergency room can cost thousands upon thousands of dollars for uninsured patients, and a simple saltwater IV can run you up to $800 in some places.
Every year, the Press covers the Remote Area Medical Clinic when humanitarian medical volunteers come to the area to help the poor and uninsured. The amount of uninsured, low-income people who rely on these free medical and dental services is baffling. Frankly, it’s hard to imagine it’s happening in a developed nation, much less one that postures itself as the global epicenter of modern civilization.
Because of this lack of equity and access, medical and dental tourism among Americans continues to be on the rise as uninsured rates spike back up and Americans look to options elsewhere as feasible ways to save money on health and dental costs. Some folks have actually found that it’s cheaper to fly elsewhere and get a few teeth pulled than to stay here and get the dental procedure from a dentist in their region. (That’s assuming it’s possible to take time off work to do so.)
Looking at our RAM clinics, overwhelmed community clinics and the phenomenon of American medical tourism, maybe we need to take a step back from the ideological rhetoric and truly ask ourselves difficult, systemic questions about how to provide care for low-income Americans.