Uninsured? Hope you can wait…

Editor's note: This post is the first of two posts related to the health care safety net to coincide with Colorado Safety Net Clinic Week, August 22-26, 2011.

Gustavo came to visit before going to grad school in Washington, but he became sick with a dull, sustained pain in his abdomen that soon escalated into sharper pain. He didn’t have health insurance, and his school health plan wouldn’t be active until the semester started.

Like most 21-year-olds, I know little about navigating the health care delivery system or how the uninsured may (or may not) receive care.  I called three safety net clinics in Denver. After waiting on hold for fifteen minutes each time, I heard the same thing:

“We can’t take new patients, so we’ll have to put him on a waitlist. It’s two to three months long.”

No one gave me a referral or suggested any options. How could anyone wait that long to see a doctor? I have health insurance, and when I need to schedule an appointment at my medical home, I typically get seen within three days.

After working for two months at CHI, which monitors and studies Colorado’s safety net system, I have a better understanding of the reasons behind this discrepancy.

Safety net clinics in Colorado, which treat the uninsured, the underinsured and those on public health insurance programs such as Medicaid and the Child Health Plan Plus (CHP+), have dwindling resources at the same time they are facing a growing patient pool because of the economic downturn.  These clinics often don’t have the resources to accommodate all those who seek care.

One type of safety net provider, community health centers (CHCs), treats a third of all Medicaid enrollees, a quarter of individuals enrolled in CHP+ and a third of the uninsured. Almost 20,000 Coloradans were on a CHC waitlist in February, according to an article by the Colorado Community Health Network. Thousands more could be on waitlists for other types of providers.

Gustavo’s condition intensified, and he considered going to an emergency department (ED), but the cost was prohibitive. Gustavo was experiencing first-hand what millions of people in the U.S. face every year: the choice between risk and money that causes many to gamble with their health.

This story has a happy ending. Gustavo improved during the rest of his Colorado stay, at least enough to avoid the ED. After getting coverage and being treated in Washington, he is much better now. I can’t help thinking, though, about all those still waiting.

Westley Mori is a research analyst at CHI.