Understanding the Health Care Needs of the Medically Indigent of Grayson County, The Eagle Feather

A little over half (56%) of the population in Texas is covered by private insurance, one-fifth of the population is covered by public insurance, and the remaining one-fourth of the population remains uninsured without any kind of coverage. The rate of the uninsured increased from 3.6 million in 1990 to 4.8 million in 1999. With the cost of health care rising, the number of uninsured is predicted to go up to 6.9 million by 2010. The two main sources of public coverage in Texas are Medicare and Medicaid. Medicare covers patients who are over age 65 and selected disabled adults. Persons eligible for Medicaid include low-income children, low-income parents who are on welfare, low-income pregnant women, low-income adults and children with severe disabilities, including blindness, and low-income elderly. The low-income, non-disabled adults who are a large portion of the uninsured population are not covered by Medicaid. Private insurance is insurance not provided by government funding, but bought by individuals and employers. With the growing cost of health care, fewer employers are buying coverage for their employees. For every dollar increase in health insurance, groups of employers are opting out from providing coverage to their employees. In Texas, it is the responsibility of the county to provide health care to the medically indigent. This is done in three ways: through a hospital district, a public hospital, or county indigent health care programs. Hospital districts can collect taxes for hospitals and programs for the medically indigent. County funds partially support public hospitals. Services received from non-tax-funded providers are paid by county indigent health care programs. Hospital districts and public hospitals fund hospitals and health care providers directly. Nonprofit clinics that are not government-funded aid in taking care of the medically indigent. These organizations are tax-exempt but are often limited in the services they can provide due to funding constraints.

My research shows that age, married status, current health status, food, clothing, and housing are needs that are directly related to getting health care. People between the ages of 18 and 44 reported having the most difficulty obtaining health care as compared to older elders who reported being covered by Medicare or Medicaid. Married respondents are more likely to be able to get needed health care than are unmarried respondents. Married respondents are often covered by their spouse’s insurance and hence have a better chance of being covered. Competing needs of food, clothing, and housing hinder people from getting health care as these needs are often given a higher priority over health care.

With nearly 21% of people in the United States uninsured (Kaiser Family Foundation, 2004), we can no longer afford to ignore the problem. Several initiatives and programs in counties around Texas have set up alternatives to aid the medically indigent. One such initiative is the Grayson Volunteer Health Clinic that was set up in February of 2003 to provide primary care to residents of Grayson who lack insurance coverage or the money to pay for health care out of pocket (Grayson Volunteer Health Clinic, 2005). Services of the clinic include preventive medicine, physical examinations, treatment of minor and non-emergency illnesses, monitoring of chronic health problems, dental treatment and evaluation, and dental referrals to other resources. Since the clinic opened, they have served more than 1,000 patients. Patients pay a nominal fee based on their family income. Grayson County has only a county indigent health care program and so there is a huge need for indigent health care. While conducting the focus group of the patients of the clinic, many of them reported that the clinic is their only source of care and some said they are grateful to the clinic for saving their lives. Because this clinic is not a government agency, it is often limited by financial constraints and is in dire need of funds so that it can continue to provide primary care to the uninsured. The clinic administrators face a problem when one of their patients requires a surgery or another service that the clinic does not provide. An innovative solution to a problem like this has been implemented by the Buncombe County Medical Society (BCMS) called Project Access (Buncombe County Medical Society Foundation, 2005). Project Access is a partnership among government, doctors, agencies, and residents of the county. The program matches patients with adequate medical care. Programs such as the Grayson Volunteer Health Clinic and Project Access provide innovative solutions to the problems of the medically indigent. Such programs have been effective in improving access to health care for a large number of uninsured and we should actively support such programs so that we can unite to solve a nationwide problem.