The Access to Care Issue

There are many angles by which to approach the question of access to care. When most people think of this subject they immediately jump to the insurance issue. And we all know the two sides there, and if you're a regular reader, you know which side I stand on. True emergency care is one thing. Routine medical care is entirely different.

But when I think about access to care, I think about it literally. The real issue is whether someone is able to obtain health care, regardless of how it gets paid for. I really don't wish to ever hear anyone say they don't have access to health care - mostly because they, in fact, do. Most states have at least one, some multiple, academic medical centers, and those are largely fueled by non insured beings.

But here's the kicker. They offer hospital discounts, sometimes up to 100%, for people of low income status. They, and even most privately funded/insured institutions, allow patients to be set up on a no interest payment plan. In my experience, with multiple institutions, they don't really care how much a patient pays down their bill every month, as long as they pay something.

It is not an exaggeration for me to say that most of the patients coming through our resident clinic are self pay - no medicaid, no Blue Cross, nothing. And yet we see them, we take care of them like any other. For those who care about their eyes, they will make the three hour drive to our clinic knowing that we don't care if they don't have insurance, so long as they pay around $25 at check in and pay their bill eventually. I know it can be difficult for people in very rural areas to have access to every physician they need. But you can't expect a physician to be in every nook and cranny in every state, can you? No.