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  Saturday morning I was at work in the ED of a large urban teaching hospital in a red state without a Medicaid expansion or a state exchange.  We are the second largest safety net hospital in the United States and at times we can see 300 patients a day in our ED.  We are affiliated with the school of medicine at our beloved state school and we all try very hard to take care of the people with what we have.  Sometimes that makes me and all my coworkers MacGyvers, but we get it done.

    As I walked across our brand new mezzanine to the cafeteria to get another large coffee and a scone, I was stunned to see over 200 people waiting in every possible seat, aisle way and corridor.  It was about 8am.  Moms, dads, kids - Mamaws not old enough for Medicare...this is the heartland after all.  They were all hanging out and waiting patiently for sign up day.  Sign up day. For ObamaCare.  

    There was no news media, which is typical for our redness and media skewing that is required to perpetuate that, except that we have been in the news so much since December when we opened in our new facility.  We had christened the new hospital with a mega million dollar private donation and raised the rest of the money ourselves and with the help of the community that we serve.  We had almost become 'used to' having any one of the 4 local news outlets here to talk about any and all topical health care issues; flu vaccines, visitation restrictions when the flu peaked, the latest GSW victim, (we had 8 in 12 hours one day - yay 2d amendment! We're one of the top fire arms net exporters but that's another post.) I hate to say that its regularity to see the news cams here, but today, not even one. Figures.  It's hard to perpetuate the drama of Obama if its a peaceful sign up on film for everyone to see. We can't have people signing up to pay for insurance because its not fitting in with the ' evil-socialism' meme.  If there had been room for the equivalent of a media tumbleweed to blow through, it would have, but it was just too packed.

     We had asked initially for trained administrative staff to act as volunteers to run the patient access points, but didn't get enough takers, I assume because they thought that people wouldn't show up. And a lot of our employees drive in from surrounding counties that are extremely red, the exact opposite of the bluey-blueness of the capital city.  I had up county co-workers tell me that it would flop because 'these people are so entitled. They're never gonna pay for anything.'  Yeah, right.

     After some number crunching or soul searching, it was decided to have the admin staff take the navigators course and bring them in on the clock.  Every floor where there was a patient access area was full, non-stop, all day.  People came to have someone explain the details to them, to have access to the internet because they don't have it at home, or to explain the criteria and to have the coverage options clarified. I'm waiting to hear what the final count was.  

     My take away was this; this impoverished community of inner city working poor is not a community of takers.  They wanted to sign up.  They wanted to make that first payment and get covered. And remember, we don't have the Medicaid expansion which means that there are plenty of people that are not quite 'poor enough' and have to do something, even if it means they have to make payments.  In a community where a $5 medication co-pay can be painful, this means something.  They are sick of having the spectre of a medical collections or bankruptcy hang over their heads, or the limitations of the county's 'Advantage' program.  And frankly, as an employed person living here under the tea-bagger-regime-of-refusal, I'm tired of paying higher premiums than any working person with employer based coverage in all of our surrounding states, even the other red ones. So I'm all for it. Welcome to the club of coverage.

     I'm especially sick of sending my tax dollars to DC and having them go everywhere but here, while we (our state) gives up some $5 million a day by taking the waiver to avoid accepting the expansion money and setting up a state exchange.  That's money that could get us some light rail, some pot hole fixes, some bridge repairs at the southern border and some quality public education but instead we're paying, barely, for health care that is woefully inadequate for hundreds of thousands of citizens of our state.  That's right folks, we get to give away yet ANOTHER year of uncompensated care.  Our state hospital association is trying to make the point, but it must be tricky to avoid stepping on all of those super majority (R) toes.  I could take the opportunity to go all scathing on the impact of our expansion failure on health care workers here, but that's fodder for another diary too.

     The good news is we had people show up on sign up day and that just doesn't jive with the Republican doom and gloom that the fake horror stories portend.  And now that these people signed up, they'll tell people they know, or work with, and they'll tell family members and church members and fish fry attendees or civic club colleagues.  It's making it clear that people do want to be covered. They came early on a weekend morning and waited. Some people had to stand because all the seats where taken.  And then they waited some more and they left with health insurance.  It was that important.

    The word is getting out there, and people want to be part of the program so they can participate in their own care.  That's a good thing.  I know it will be a long time before the loss of revenue that our state gave up corrects enough to salvage wages and all the rest we lost as health care professionals, but in the grand scheme of things, that's a bit less important than our patients getting covered, having access and getting the kind of care they deserve as citizens of our country.  Maybe it's not as newsworthy as I think it should have been, but I think its a thing.  And its working.  People have enough faith in the idea of getting everyone in the coverage pool that they are standing in line at 8 o'clock on a Saturday morning for it.  I'm glad I was there to see it, because it sure would not have showed up anywhere else.
     

Originally posted to CheetosnJams on Tue Mar 18, 2014 at 01:39 PM PDT.

Also republished by Community Spotlight.

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