What it’s like being poor and needing medical attention

It is a hard thing, but educational, for middle-class people to experience what it’s like being poor.

Flying back last March from a visit with our daughter in Florida, my wife developed a serious fever. It was Saturday night — our family physician was not working — so at 11 p.m. I drove her to the University of Kansas Medical Center emergency room.

The waiting area was crowded, whole families, elders slumping in their chairs, many children playing on the floor or sleeping in parents’ arms.

We waited like all those others. Poor folks, they mostly were. We waited as hours passed, midnight, and the next hour, and the next. By then we had been awake for 20 hours. We could bear it no longer. When we got up to go home, the attendant promised he would get us in. After another half-hour, we rose again to leave.

“Please stay!” he said. “I’ll get you in!”

And he did. Then we learned from the excellent emergency staff why we and others waited so long. Many patients there suffered only minor ailments, a bad cold or an ugly skin rash, but couldn’t afford a family doctor.

I had thought that federal Medicaid covers all poor people, but I was wrong. Under the Emergency Medical Treatment Act signed in 1986 by President Ronald Reagan, the hospital must treat everyone at least briefly. But that emergency care is the only medical refuge for many thousands of poor Kansans.

Another group of working people there were too “rich” to win coverage from Medicaid in Kansas, but too poor to buy insurance. That is because our conservative Kansas governor — unlike governors of 30 other states — refused to expand Medicaid, though it’s funded almost entirely by the federal government.

The Kansas Health Institute reports that our state has some of the stingiest Medicaid income constraints for adults in the nation. Kansas denies Medicaid care to individuals with incomes above $11,770. The expanded program under Obamacare raises the income level to $16,243. It would open Medicaid to 150,000 additional Kansans, some of whom were waiting with us that night.

Melika Willoughby, an aide to Governor Sam Brownback, wrote an email to allies praising the governor’s opposition:

“Medicaid Expansion creates new entitlements for able-bodied adults without dependents…This isn’t just bad policy, this is morally reprehensible.”

Hasn’t conservatism come a long way since 1986 — from President Reagan’s big-hearted new entitlement opening emergency rooms to poor folks, to this fresh conservative voice saying another big-hearted policy is immoral? The Kansas Hospital Association reports that our poor citizens and our hospitals have forfeited nearly $1.6 billion in expanded federal Medicaid payments since January, 2014.

Lee Norman, chief medical officer at the hospital, said if more poor people had Medicaid, they could get family doctors, steering them away from very expensive emergency care.

“I’d be happy to see Medicaid expansion,” he added. “Then we wouldn’t have to write off as bad debt $30 million a year for patient care.

What a lot my wife and I learned, thanks to that long wait with poor folks in the KU emergency room. That final plea from the attendant, “Please stay!” might have saved her life. The X-Ray revealed a fist-sized lump of pneumonia in her upper right lung. Had we gone home Saturday night, delaying treatment to Monday, I fear she might have died.

She spent three nights in the hospital being treated with intravenous antibiotics and came home well.

This story was originally published December 28, 2016 at 9:44 AM with the headline "What it’s like being poor and needing medical attention."