HWC Part1

Uploaded by awiderworld on 03.10.2011

Hello everyone and welcome to A Wider World where we celebrate the abilities of all.
I'm Elizabeth Kelly.
In 1966 civil rights icon Martin Luther King, Jr.
said: "Of all the forms of inequality, injustice in healthcare is the most shocking
and inhumane".
So, why does health insurance matter?
People without insurance are more likely to go without preventive care, to delay or
forgo medical care, and to die prematurely.
When sick, the uninsured may turn to emergency rooms for care, where oftentimes they are
charged more for services than insured patients.
And when uninsured patients can't afford their medical bills, the cost of this care is
passed on to the insured in the form of higher premiums.
So, who are the uninsured?
By and large, it is working Americans or their family members.
It also includes the growing population of more than 3 million Americans who are also
According to the National Conference of State Legislatures website, the number of people
without health insurance has increased steadily since the beginning of the century, now
totaling about 47 million Americans.
It's really scary, it really is.
Because we're talking about people that at one time had health care, had jobs, had
And to be able to deal with that and they have families.
Then after a while they take on another form of
life because they can't cope with the system and some of the demands that are placed on them.
And the way they're treated.
The system has to change.
And I'm afraid it's going to get worse instead of better because I think there's going to be more
money eliminated especially from Medicaid.
And I know there's going to be money eliminated from Medicare.
So people are not going to be receiving better health services in the future.
They're going to be receiving worse health care services.
Our huge challenge is of course the uninsured.
The next challenge is multiple, multiple diseases that the patient comes in with.
Many times even when they have insurance, many people don't follow up and see a physician on
a regular basis.
So when they hit our door, they don't have one thing wrong with them, they have five!
Medically indigent---that's a new term coined to indicate those either without health
insurance or with inadequate coverage.
The decline in employer based coverage, the high unemployment rate and the slow economic
recovery have created huge obstacles to receiving regular and necessary healthcare
We have people coming in the door now who were always employed and are not employed
Trying to pay house rent or mortgage and trying to put food on the table well guess what
goes first...that insurance.
I think a lot of people are not getting medical care, just basic medical care, from my experience
We see people coming in daily needing referrals to doctors, need prescriptions, just need
basic care as well as extended care.
I think people don't realize it's a really cumbersome system sometimes, the resources are not
there and we need more of them.
We need to let people know they can get them and qualify for them.
No one should not qualify because they make $5 more than the limit.
I think it's going to get even tougher with all the cutbacks and the things that are going
The help is not going to be there.
And that's the sad part about it.
And to see someone who needs the help and not be able to help them, that's sad.
And individuals who are homeless, a common cold is one thing but then it leads to
bronchitis, pneumonia, and sometimes even death.
That's sad when the basic service could prevent things from going on any further.
Jim Stewart is the shelter manager for the HOPE Warming Center a seasonal, cold weather
homeless shelter in Pontiac, Michigan.
Nightly the shelter deals with the consequences of no health coverage and its impact on the
homeless guests that stay there.
Well we do our best to keep an eye on folks and to attend to their needs as they come up.
We have had a number of ambulance runs for different kinds of things.
We have a nurse that comes in on Thursday nights and she identifies some problems with
the guests and through her we try to keep an eye on them.
These people tend to be pretty challenged.
Their health isn't the best.
So we've had everything from people that could be having a heart attack to people that
could be overdosing, alcohol poisoning....any number of things that ...
We send them in an ambulance and sometimes we send them in a cab, too, to hospitals and we also
try to connect them with medical services.
I started volunteering as an RN at HOPE about three years ago.
I come her llle once a week and I try to triage essentially the patients.
If they need medical care I try to send them to wherever that care.
Sometimes it's in a hospital.
Sometimes it's in a clinic.
My experience with referring patients has been very very frustrating, especially when I
started out.
I scoped out all the clinics, called them up asked who they would see, when they would see
They assured me they would see our guests and then they didn't.
They would refuse them.
Finally the second year we got some help from Marlene Mullin who is on our board and who is a
nurse practitioner, and she kept insisting that these people would see our guests definitely.
And they didn't.
Finally this year we got very very assertive and started calling and meeting with these
Explaining the problems we were having.
And finally we've gotten some results.
But the frustration with our population and the indigent population is that you have to
make an appointment with the clinic, sometimes 6 weeks in advance, and you have to have
certain qualifications.
Either you should not be insured with some of these clinics or you should be insured with other
Or you have to be the working poor.
So it's really very complicated.
So if you cannot track through the system, you're not going to get medical care.
Gary Crookall and his friend Jim Evans are homeless and uninsured.
In the winter time they live at the HOPE Warming Center.
Well, we're partners on the streets and that.
Walking about with tennis shoes during the winter and stuff.
No place to go...get wet and cold.
Try to warm them up, get wet and cold again.
Many times we'd get our socks wet.
There were many times we didn't even have socks.
Had no way of getting any.
And that's what started with the frostbite.
Last Dec 12 of 2010 we had a big storm.
Of course being homeless, I walk on the streets all the time.
I'm used to my feet being numb.
So my feet got wet and cold and they were numb but I assumed well that's typical.
So I made sure I was wearing dry socks and stuff.
I didn't really notice it at first.
Then a few days later I went to take a shower and my toes were black.
My feet were starting to turn black and I had red streaks going up my leg, so right then I
knew I had a serious problem.
So I was admitted into POH.
I had the warming shelter call emergency and they took me there.
My feet were in terrible shape.
There were about 4-5 doctors that came in looked at it and they all concurred and they said
that some amputation was going to need to be done.
So after that they did processing on me, put me in a room, got me on antibiotics and
all that.
They waiting a couple of weeks before they did the first operation because they were
waiting to see how much of my feet they could save.
I saw what he was going through.
I visited him a couple of times.
Jim was in the hospital and I was in the warming ctr.
My feet started hurting like crazy.
So I got with Mr.
Jim Stewart, the head person here and so he asked if I wanted to go to the hospital and I
said, "yeah, I want to go".
I was in for a few days and my feet were turning black at the time.
They released me.
An I would say it was a couple of weeks after that my toes started turning black.
Jim was still in.
I thought...I got to do something about this.
So I went back in again.
And approximately 12 days later they operated and took three toes away.
I got an infection and had to go back in again.
Like Jim said, I feel I was released too early and I think that not having insurance has
something to do with it.
I had no insurance and actually I was quite worried about that because I didn't know what kind
of care I was really going to get.
I was really surprised because they were really caring and they were really careful.
It's not like they rushed into it and amputated my feet right away.
They gave me time and tried to save what they could on them.
I was actually very impressed by that because I was in the hospital for a total of three
weeks the first time with no health insurance and I know that must have really racked up a
I think one of our biggest problems with health care in general is that we are always
talking about keeping hospital dollars down.
This is a very expensive institution to run.
And you also have to understand that anyone who walks in our door we treat...no matter who
you are, race color or creed if you have insurance, don't have insurance, we don't treat
anybody any differently.
I think considering I had no insurance, I was really pleased with the care that they gave me.
They were very kind, compassionate and I even mentioned it to the doctors and
I know that I am probably a burden on the hospital because I don't have any insurance but the
doctors told me, "don't worry about the money.
The most important thing is that you get better."
There was a woman doctor and she was so curious how I got frostbite.
I said, my friend well he's next door and he's 10x worse than I am.
She went out and then said: I want to make sure you get some shows that are waterproof.
Because out tennis shoes had holes in the sides and stuff.
And she just said that and I thought OK maybe they had a closet somewhere in the hospital
and they'd find me something.
I went somewhere in the hospital for x rays or something .
I come back an hour/two hours later.
A brand new box on the floor at the foot of my bed, socks, underwear and gloves, and even
bought him (Jim) something and never met him.
My nursing staff and my social services staff ..an example of things we do particularly in the
dead of the winter.
No one would get out of here without a coat if they come in without one.
We have a coat closet.
They can't afford a walker.
They can't afford a cane.
We're always stashing stuff like this in this little closet that people donate or we pick up.
This we do because we know it will get them out in a safe manner.
There just should be more resources out there for these people.
But hospital care and length of stay is restricted by diagnosis.
If a client is medically stable and has insurance, then he or she may recuperate further in a
post hospital skilled nursing setting or receive help from a visiting nurse in the home.
But what if you don't have insurance?