The Emergency Room

images Most of Rochelle’s family use the hospital emergency room as their family doctor.  Many don’t have health insurance and wait until there is an emergency to go to the doctor.  Rochelle’s children are covered by Medicaid; Rochelle is covered by a very basic city indigent care program. Texas only offers Medicaid to children, pregnant women, and the old or disabled; her mother has Medicaid due to disability.  When Rochelle became full-time at her employment with the grocery store she was eligible for insurance coverage through them but chose to stay with the basic care provided to her free by the city.  It is by no means similar to the insurance coverage she would have received had she opted in to her company’s insurance plan.  She is now making more money, but she is still in financial trouble because she has three children to support; she did not think she could afford the insurance and never researched whether or not The Affordable Health Care law would help with the payments. At 29 she also feels somewhat invincible and is content that her children are covered by Medicaid.  Rochelle’s income is low enough so she won’t have to pay a penalty tax due to lack of insurance coverage, however.  Her experience has simply been that one goes to the emergency room when one is sick and then, when one can’t afford to pay the bill, one just doesn’t.  She never went to the doctor when she was pregnant with her first child.  “I was in denial,” she told me.  She first went to the doctor when she went into labor.

Rochelle’s mother is a good example of what a lifetime of being without health care can do.  She is 51 years old but looks 20 years older.  She has been on dialysis for at least three years.  “High blood pressure wrecked her kidneys,” Rochelle told me.  Just recently she had to be taken to the emergency room due to heart palpitations and a pulse that was racing at 190 beats per minute.  The emergency room treated her and released her; Rochelle thought her mother had a follow up appointment but was somewhat unsure.  She wasn’t sure what had caused the problem.  When Rochelle comes over for this week’s interview we will discuss the situation in more depth.  She needs to see how she could be in her mother’s situation in twenty years if she doesn’t get involved in better health care.  At age 29 she has borderline high blood pressure, is considerably overweight, and eats a very unhealthy diet.  The emergency room does not provide basic health care, though the current governor of Texas is on record as saying that he considers it a reasonable health care solution for the poor.. And this is the norm for those living in the culture of poverty.  Rochelle has started earning a little bit more money, but it is hard for her to understand the value of some of the options available to those who live outside of poverty.  Perhaps if she recognizes she could be in her mother’s situation she will be more open to some of these options.  On the other hand, it is understandably hard for someone who is finally beginning to experience a little economic leeway to tie it up in medical insurance she can’t really believe she needs.