By Shelley Kofler, KERA News
http://stream.publicbroadcasting.net/production/mp3/kera/local-kera-905964.mp3
Dallas, TX – Even before the recession Texas ranked first among states for having the most uninsured- 25%. It will take several years for the new federal healthcare plan to be phased in. So, this month during our Monday economy segments, we're going to take a look at what's available right now to North Texans who are struggling to find affordable healthcare.
Let's say you've been laid off from your job and your health insurance benefits are gone. You have limited income and need to see a doctor. What should you do? KERA's Shelley Kofler & Sam Baker take a look.
Shelley Kofler: One of the first things you should do, regardless of where you live is pick up the phone and dial 2-1-1. You will be connected to a social service counselor who can refer you to affordable healthcare providers in your community.
Then, if you live in Dallas or Tarrant counties you have another good option- the public hospital district and its network of community clinics. Parkland's services are available to all Dallas County residents because they support Parkland with their taxes. John Peter Smith is available to all Tarrant residents. If you don't live in Dallas or Tarrant counties you cannot, for the most part, use those public health services.
Sam Baker: I know we're going to talk about what's available to the other North Texans later. What's available through Parkland and JPS?
Shelley: Most everything: doctor visits, lab work, x-rays and physical therapy. They can fill prescriptions and provide care for long-term illness like cancer. Just be prepared to wait on the phone and in the clinics. I was on hold for more than an hour with one Parkland clinic, but got through to a real person in five minutes when I called another. And it's important to mention: public healthcare is not free. You will be expected to pay something. The amount depends on several factors.
I went to Parkland's newest community clinic to see how it all works.
Parkland's Irving Health Center is a busy place. In one part of the building Cecelia Gonzalez is keeping an appointment for a checkup and getting a prescription for diabetes medication.
Gonzalez: I generally pay about five dollars 5 per prescription which is great compared to what I hear some other people pay.
In another part of the building doctors and nurses staff a first-come- first-serve clinic for patients who need more immediate care.
Nearby, a lab technician is drawing blood.
Before the day is over an average 200 patients will pass through this modern looking lobby with its high ceilings, flat screened TV's and some 100 cushioned chairs.
About half the people waiting are here to meet with a financial counselor. That's the first step in applying for Parkland's low cost services.
Counselor: Can I see your ID?
Thirty-two year old Israel Garcia has injured his back. He's a restaurant server with no insurance. He called four weeks ago to get this appointment.
Garcia: If I knew I had insurance I would have gone to the doctor sooner.
Reporter: You waited?
Garcia: Yes. I waited until I had enough. My back has been giving me a lot of problems. I have pain every day. It is going up to my neck.
Reporter: Have you gone to the doctor in the past?
Garcia: No, not since I was a child not that I can remember.
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The financial counselor asks Garcia for a lot of information: for current check stubs and income; place of employment; the size of his family; proof he lives in Dallas county.
Counselor: And is this your current address?
If Garcia, a single Dallas County resident, earns less than $14,400 a year there's a good chance he'll qualify for Parkland's least expensive program. An office visit would cost just $10. If Garcia earns more than that but less than $21,000 he may qualify for the assistance program that charges $20 for an office visit.
Garcia thinks he meets the income requirement but there may be another that will prevent him- and many others- from getting help at Parkland.
Counselor: I need to verify if you're in your probation period for the insurance
If Garcia's employer has offered him health insurance, and he didn't enroll, for whatever reason, he will not qualify for Parkland's low cost care. As a Dallas resident he can use Parkland services, but he'll have to pay full price. An office visit may then cost around $180- instead of $20.
Collette White: We don't like to just send people away with no option so we do have a list of clinics where we can refer patients
Clinic administrator Collette White urges patients not to be discouraged and to talk to a financial counselor even if they don't think they'll qualify.
White: Come in and sit down with one of our staff members because we do have other options. You may not think you qualify for something but we do have 91 programs we screen for.
White also wants to encourage the newly unemployed who may be reluctant to seek help to use Parkland.
White: It is very important to take care of your health in a primary care setting versus letting pride get in the way and getting too sick and ending up in the emergency room.
Johnny Cantu says he overcame his pride after losing his job as a forklift driver and the insurance that came with it.
Cantu: It's a humbling experience.
Cantu's wife Leticia needed care for an ongoing condition that may require surgery. They made an appointment by phone to see a financial counselor. That took a month. It took another six weeks for the first doctor visit Leticia will have today.
Cantu: If it wasn't for this I don't know what we'd be doing now. There aren't many options after you lose your benefits at work.
After the doctor's exam Leticia joins her husband in the lobby.
Leticia Cantu: Esta muy bien.
The couple waited nearly five hours before seeing the doctor. For future visits she'll be able to make appointments. Johnny and Leticia Cantu are grateful and pleased
Cantu: She said the wait time was a little more than we planned but as far as the cost and the way they treat you it is very excellent. Their care is very good. It was the best ten dollars she's spent
Sam: What do you do if you can't wait six to eight 8 weeks to see the doctor?
Shelley: There's the emergency room, of course, but that should be your last option. Once you've qualified for care you can go to Parkland's walk-in clinics which are first come first serve.
Nearly the same procedures apply for John Peter Smith facilities in Tarrant County. Income requirements are a little different. Remember, it will take about four weeks to get the initial appointment to meet with a financial counselor so don't wait until you're sick. Enroll as soon as you know you may need their care.
Sam Baker: It's pretty clear a lot of people will earn too much to qualify for public healthcare but they can't afford it on their own. As you said - they can call 2-1-1 to find low cost clinics in their communities. Next Monday we'll have a report about additional options.
You can find more information at KERA.org/economy