Case in point, was the patient I saw this week, who was employed and who fell off his porch back in 2004, sustaining a fracture of his left tibia and fibula of the lower leg. He had surgery to correct it, but in the interim, he lost his job due to being unable to work, and thus, his benefits. Back in the fall, he re-injured the leg and now needs to have hardware removed and the bones fused. He is in horrible chronic pain, and no orthopedic surgeon will touch him. He has no coverage. He can't pay for the surgery or an expensive hospital stay. So, what does he do? He takes numerous trips to the ER when the pain becomes too unbearable, and receives a prescription for maybe 10 pain pills. Why doesn't he see his PCP? He has no PCP, as he's still in the "process" of applying for Medicaid, and thus can't afford to see a primary care physician. Oh, did I mention he has hypertension too which is untreated? What happens if this man has a stroke? I'll tell you what happens. He gets taken by EMS to a hospital, is admitted and given the very same care as an insured patient, but there is no one to pay the bill. Who pays? You do. You and I do. And the bills keep getting higher and higher and higher to somehow compensate for those with no way to pay.
As I noted on her blog, this is my frustration with the discussion about healthcare. We already provide a "public option" but it is the least efficient possible, and one that certainly discourages people like this patient to get the care they need. The FB conversation I had with the woman convinced that anyone who criticizes tax cuts is, in fact, a "liberal," included the kinds of suggestions that people would be better off negotiating directly with doctors for their care. All fine and good for the head cold and even a simple break (I imagine) but unmanageable for chronic and expensive care.
One other thing here, btw, is the specter of "moral hazard" thought coming into play. One of the conservatives I speak with is very concerned that this new healthcare subsidize people who don't "try." That FB woman said something similar, that this new ACA would lower the incentive for people to work hard to get their own care.