Navigating the health care maze can be daunting
The 45-year-old
Walthan would like to move inside -- especially since it's been so cold and stormy lately -- but says shelter conditions are unbearable and "I'm safer out here." Motel rooms are too expensive and getting enough money together to rent something longer term is out of reach on her meager assistance check.
Despite the hardships, Walthan considers herself lucky. She knows how to access health care. Between safety net resources including
Dealing with the health care system has never been easy. For those with a basic education, solid grasp of English, a job offering access to health insurance, and some savings or regular income, you've already cleared some of the hurdles.
There's finding the right doctor, making an appointment, getting to the appointment, filling out forms on your current health and medical history, getting a release of medical information, making the most of your time with the doctor during the appointment, paying for the appointment, carrying out follow-up instructions and going to a pharmacy for prescriptions (if needed).
Second nature for some, daunting for many others.
"Given the highly fractured and -- to many -- inscrutable nature of the
"For patients to get timely, appropriate, affordable and quality care, they must be able to navigate the health care system. When it is too burdensome, patients and their caregivers respond by delaying or failing to get needed care or by seeking care in inappropriate but more easily accessible settings, such as emergency departments," the brief continued.
Federal law, under the Emergency Medical Treatment and Labor Act, or EMTALA, requires that anyone coming to an emergency department be stabilized and treated, regardless of their insurance status or ability to pay.
It takes a lot of time to explain how the health care system works to patients and their caregivers with limited English proficiency. There are numerous forms that need to be read and understood. People often sign those forms whether or not they understand them.
"Despite the system's effort to make things clear up front, the complexity of most situations leads to problems or miscommunications that need to be untangled later," AcademyHealth stated.
For the poor, the uninsured, the homeless, recent immigrants, people with physical disabilities or mental impairments, there is the health care safety net -- the resources and providers that organize and deliver a significant level of health care and other related services to vulnerable populations.
Immigrants especially -- often due to language and cultural barriers -- are among the most difficult for safety net providers to reach.
"People don't know what to do," said 55-year-old
Unable to find a job for someone with his background, a college graduate with a master's degree in geography who worked as a high school principal in his homeland, Sultan now works in a friend's smoke shop as a low-paid clerk with no benefits.
He qualifies financially for
He is quite happy with the health care both he and his family receive.
In the region covered by Health Plan of
But for many Pakistani immigrants in the county, Sultan said, "they need to know this information" concerning their options for health care.
"Nobody's outside the system," Sultan believes, "but they just don't know what to do."
Sultan is right up to a point. An immigrant who meets all eligibility requirements -- but is not in a satisfactory immigration status for full scope
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