Programs aid uninsured workers

Tuesday, July 17, 2007 | 12:00 a.m. CDT; updated 7:43 a.m. CDT, Thursday, July 10, 2008

NORTH KANSAS CITY — Jeremy Eden was in pain, physically and mentally.

The 28-year-old had been told that he needed surgery to treat severe pain from diverticulitis, a digestive disorder in the large intestine. Because his job didn’t provide health insurance but paid him enough to make him ineligible for Medicaid, Eden couldn’t afford a colonoscopy.

Then Eden was directed to a new program called Northland CARE/MetroCARE, which connects patients like Eden with primary or specialty care physicians willing to treat them without compensation. It’s the latest attempt in a patchwork effort to address the need millions of low-income people have for access to medical care.

Northland CARE/MetroCARE got Eden in to see a gastroenterologist, who recommended other treatments before he considered surgery. For six months, the doctor would see Eden again if he needed another appointment. After that, his needs would be evaluated further.

The program is modeled on others across the country designed to mend a hole in the medical safety net, which leaves thousands of people unable to get care or forced to go to emergency rooms, endangering their health while driving up costs for doctors and hospitals.

“For people like me, there really is nothing else,” Eden said. “Just because you fall into the middle class doesn’t mean you would be able to afford ungodly expensive procedures. If not for them, my treatment would never have happened, I would have just tried to deal with the pain.”

Northland CARE/MetroCARE began recruiting doctors in January and officially opened May 1. Doctors who commit to treating a specific number of uninsured patients are matched with patients from Clay, Platte and Jackson counties needing their services. Eligible patients are connected with either specialists or primary care physicians, depending on where they live.

Northland CARE/MetroCARE does financial screening and gathers all relevant medical records before connecting a patient with a doctor. The patients get a medical card that proves they have been screened for eligibility. After the doctor visit, a nonpayable claim is generated by Blue Cross/Blue Shield. The program also provides doctors with a summary of the charitable care they have offered through the year.

Northland CARE/MetroCARE is patterned after WyJo Care, which finds specialty care services for uninsured low-income patients in Wyandotte and Johnson counties in Kansas. The national need is big. In June, the Centers for Disease Control and Prevention said about 43.6 million people are uninsured in this country. While many doctors are willing to treat the uninsured, they said they are often reluctant because of potential liability and worry of being overwhelmed by patients who can’t pay for their treatments.

Gary Pettett, past president of the Metropolitan Medical Society of Greater Kansas City — a partner in the Northland CARE/MetroCARE program — said such efforts allow doctors to provide some free care without “coming in and finding 100 people in the waiting room.”

The concern over liability was partially removed in July when Gov. Matt Blunt signed a law that expanded the State Legal Defense Fund to pay judgments for specialists who provide free care.

“That’s really relieved doctors who were worried about (liability), and it relieved their conscience,” Pettett said. “Some practices had told their doctors they couldn’t treat the indigent because of the liability issue. (The law) removes that barrier.”

Doctors have responded enthusiastically to the Northland CARE/MetroCARE program, with about 140 signed on, said Karen Dolt, executive director of Northland Care Access. Hospitals, other medical personnel and safety clinics have begun referring patients, but the group is still trying to recruit surgeons, she said.

Doctors and patients also have been enthusiastic about WyJo Care, the Kansas program that provided organizational help to Northland CARE/MetroCARE, said Jacque Amspacker, executive director of the Medical Society of Johnson & Wyandotte Counties.

“(The doctors) say ‘this is why we went into medicine, to help people,’” Amspacker said. “And patients are really appreciative that we go out of the way to help them. Some of them have been sick for awhile but just didn’t know where to go.”

While about 28,000 people in the two Kansas counties would be eligible for the program, it’s capacity likely is only about 650 patients, said program director Rule Smerchek.

Others involved with both programs say more needs to be done for the low-income uninsured.

“By no stretch of the imagination is this a solution to the indigent poor problem, it’s not big enough,” Pettett said. “But it is a commitment from the professional community to step up and be part of the solution for the metro area.”

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