HCA 205 Discussion What’s Bothering Trevor?

HCA 205 Discussion What’s Bothering Trevor?

HCA 205 Discussion What’s Bothering Trevor?

The patient, Trevor, has lost his job, and this caused him to lose his health insurance. Since Trevor has no cash to put up front to be seen by his PCP or by a caregiver at the urgent care, I think the best option for him is to go to the ER because there, he will get the care that he needs and he will be bill later. Also, he would have ended up at the ER even if he had some cash to pay up front because of the Heart attack. Most PCP would send patients experiencing heart attacks to the ER so they can be seen and monitored by specialists until they get discharged. This option would be way more expensive because not only Trevor will spend money at his PCP office, he will also get billed by the hospital.

By not purchasing his medications, Trevor is not complying with his treatment plant, which makes the situation more complicated because not only he is stopping the evolution of his care plant, but also, he is putting himself more at risks of having another heart attack.

Trevor’s wife should take him to the ER as soon as possible because the ER is open 24/7 and the nurses do the triage to find out who needs immediate care and who can be seen later. With the symptoms that Trevor is experiencing, he will be clear that his case is very serious, and that he needs immediate medical attention. 

About Quality care, I think the physician should have spent a few minutes with Trevor just to talk about Trevor’s medical conditions and answer any questions Trevor might have. The physician should also encourage his patient and make him understand his role in the care team. 

 Reference:

Batnitzky, A., Hayes, D., & Vinall, P.E. (2018).The U.S. healthcare system: An introduction [Electronic version]. Retrieved from https://content.ashford.edu/Links to an external site.

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Guy, great post. Yes, from reading the situation of Trevor, it is clear that he cannot afford his meds, and the best option would be for him to go the emergency room to get treatment, which he will still be given a prescription to file upon leaving, which puts him right back at square one, because he has not the funds to pay for it. From my understanding, his wife is working, and in some cases, some things call for a sacrifice. For instance, his wife could ask her boss to put in some more work hours to get the money for her husband, or they could let a bill go, and pay for meds, and then try to put in some more hours to pay the bill at a later date, with the late fee, before the next bill occurs. There are many way to look at this situation. Furthermore, as I have indicated to other students, the healthcare system is about money, not morals. That is why “Obama” put the affordable healthcare act into law, because people were not able to pay for the cost of high meds, and some folks died, because they went without medicine. This is sad. Sure, some doctors, healthcare systems, etc, may care about people, but they never overlook the money. A few months ago, Jeff Sessions did a news conference regarding a healthcare sting operation, set up by the FBI, which many doctors and healthcare providers were arrested,m because they prescribed wrong meds on purpose, diagnosed people with the wrong conditions on purpose, which kept them coming back, and paying for more treatment. You never know when this is taking place. You have to be careful in the healthcare field also. 

HCA 205 Discussion What's Bothering Trevor?
HCA 205 Discussion What’s Bothering Trevor?

For the patient Trevor he was laid off and his wife works part-time, this means they could qualify for assistance for healthcare or mediciad.  For his medical problems now he could found a doctor that took a payment plan. If this didn’t work he need to go to the E.R. before his symptoms worsen which could cause long term health problems and a higher bill.

For the family his wife is worried that is could be something serious, and upset that they can’t afford his health care.

These days healthcare professional have more & more families with high deductible, this means they can’t afford to pay uofront. This means they can’t ran efficiently with months late medical bill payments. It then results in them shoving medical debts to collections agencies as quickly as possible.

Cost-  Trevor can use a patient billing advocate to pay his hospital bill, but not taking filling prescription will cause him to keep having recurring health problems.

Access- Despite the long wait time at the E.R Trevor needs to decide if he feels like it nessary to see a doctor now or can it wait?

Quality- This means the doctor go over instructions and hopefully the patient follows them. If not the patient health could worsen and healthcare cost will increase

Reference:

http://money.usnews.com/money/blogs/my-money/2014/05/25/what-to-do-when-you-cant-pay-medical-bills

Unfortunately, Troy wouldn’t have qualified for Medicaid.  Medicaid is only given to children, pregnant women, the disabled, and the elderly.  What Troy could have done was be pro-active and try finding another job during the time he wasn’t working.  I know sometimes it isn’t as easy as it seems but there are temp agencies that have work.  As far as his insurance issues, Troy didn’t have a choice but to go to the emergency room.  That was the only realistic solution.    The Hospital where I live has the patient advocate program that you mention.  If you cannot pay your emergency room visit.  They will send you paperwork and you provide proof of income and they pay 90% of your hospital bill for you.  However, this still does not fix Troy’s frequent visits to the emergency room.  

             You are right.  Troy knows that he has no other option but to wait.  He has to decide if his health is worth sitting in the waiting room.  More than likely; when the staff see his name come up with the symptoms, he will be seen as a priority patient. Troy could have gotten help for his medication by looking online for prescription savings cards or coupons.  They would have paid for a percentage of his medication.  Or, he could have asked for a cheaper brand of the medicine.  Troy also is responsible for the quality of the service he gets.  I agree with you,  If the patient does not listen to the Doctor’s instructions, then they can’t blame anyone but themselves.

Good job on your post! Something things that you talked about I would agree with you on, like the payment plan. As far as the cost of his medication, he could tell the doctor or nurse the he can offered the medication, and see if there are other options for him, so that he can take medicine to get better and not make things worse. For access, a lot of time patients don’t really know what is going on with their body, and if their sickness/illness is urgent or not. So for Trevor to decide if he needs to see a doctor now or wait, would not be a very good idea. If he would have decided to wait he could have died. He needs to ask medical professional what the best things would be to do. For the military, if we can’t be seen on base at our clinic, we have to talk to a nurse on the phone telling her/him what is wrong with us, and that is when they decided if it can wait or if we need to go to Urgent Care or the ER. As far as the quality, I do believe that the doctor should go over the instructions and what the patient should do, but it is up to the patient to talk to the doctor if they don’t understand, and if they have question to get them answered. Also, when you leave the hospital normally the doctor will give you a paper to follow so you don’t get confused or forget. With medication there is always instructions on the bottles to tell you when to take and how.

After reading the simulations I was able to determine a lot of things that could have been done differently to address Trevor’s illness. So I decided to brake each simulation done by each option as seen below. 

Option #1: 

It was good that Trevor contacted his Primary Care Physician’s Office (PCP) first to see if he could be seen instead of going to the Urgent Care or ER. He should have though applied for government health insurance such as Medicaid before he got sick, because it would have been cost effective and access. If he would have had Medicaid he wouldn’t have had to go to Urgent Care and pay before being seen. Trevor’s wife was working part time, but it never said if she had insurance or not. If she had insurance she could have put him on her insurance. The receptionist should not have rejected him, although he couldn’t pay upfront, she could have offered a payment plan or had him apply for private insurance and then receive the payment later, like the ER does. This would have demonstrated quality care, reduce the cost and provide access. Trevor should have been listening to the physician at the hospital when they were explaining his medication to him. If he would have been listening, he would have known how important it is for him to take his medicine and to follow-up with his cardiologist. Because he wasn’t listening and wasn’t planning to take his medicine or go to his follow-up with his cardiologist, now his health could be at risk. 

Option #2 

As far as Travis being seen at Urgent Care, he would have run into the same situation as he would have at the Primary Care Physician’s Office (PCP) with not having insurance and having to pay upfront. So, I would say the same thing I did about the insurance as I did with option #1. Also, his wife could have drove him to the ER instead of having Urgent Care getting an ambulance to drive him to the ER. That is just more money that they would have to pay for using the ambulance. His wife should have told him to not wait until his follow-up appointment with his cardiologist to take his medicine, and she should have gotten him a physician to explain the purpose to why he needs to take the prescription. 

Option #3 

Trevor and his wife should see if the hospital can give him sample medications, so that he will still be able to take his medication since he can’t pay $200.00 for the medication at the pharmacy. Also, his wife has insurance it could possible cover some of his bill for medication. Trevor didn’t really want to go to the ER, because of how long the wait would be, but any place you go you tend to have to wait to be seen. Sometimes Urgent Care have about the same wait as an ER does, it just depends on how busy they are. Things that could have been done differently for quality are the Physician could have explained what the medication will do for him and the instructions of taking it instead of just giving it to him and leaving. Normally the physician will ask the patient if they have any questions or concerns. Since the physician didn’t explain what Trevor was supposed to do with the medication, and she was too busy with another patient, that is when the nurse should have gotten another physician to help this man. Instead Trevor had to go home upset and not knowing anything about the medication, and he ended up not taking it, which that could affect his health. Trevor being closest to the hospital and with finding out that the Primary Care Physician’s Office (PCP) was closed and with both the Urgent Care and the PCP he wouldn’t have been able to be seen because of the cost and no insurance, he should have gone straight to the ER. 

Reference: 

Batnitzky, A., Hayes, D., & Vinall, P.E. (2018). The U.S. healthcare system: An introduction [Electronic version]. Retrieved from https://content.ashford.edu/ (Links to an external site.)Links to an external site.

I agree with almost everything that you said about Trevor, but I would like to mention one thing about what you said regarding the government health insurance. I know that everyone living in the United States can apply for the government health insurance, but there is no guaranty that everyone will get it because many people do not qualify for it. Also, those that are qualified have to wait for the application to go through and it takes many days or weeks to get your coverage.  Another point that I wanted to highlight is that not everybody likes to apply for any type of government assistance; especially when they have a decent life like Trevor had before losing his job. In overall, my point here is that maybe Trevor did not want to apply for the government health insurance because he could afford an insurance through his job or maybe he was told that he was not qualified for it.

I like your post because you great ideas as to what Trevor should have done.  For you said in order for him to have the Medicaid insurance he should have applied earlier to be signed in for health insurance. I will say it does not work this way. First, Trevor just lost his job prior to his ailment. With him working , it was certain he could not have been accepted for the program because he was making or having income from his job, he was not disabled or bedridden. Many of us have tried to apply for this medicaid program but turned down. Secondly, I disagree with the issue of his wife driving him to the ER. Calling for an ambulance is the best option when you feel you are having an emergency situation, his wife might not be able to perform the basics like Cardiopulmonary Resuscitation in case he needed one. Also, an ambulance with the siren can cover a long distance in a few minutes despite the traffic light getting red at some points and there is no speed limit for an ambulance unlike Trevor’s wife who would have real difficulties to catch up with time of a patient in a serious medical condition. To add, the issue of sample medication is not a good idea. If it is supposed to be refilled, will he depend on sample medications?, and actually no dictates to the medical staff if you want sample medications from actual medications.

Patients in America are greatly affected by lack of insurance coverage. Individuals living in the rural areas have limited access to medical insurance since their employers fail to offer healthcare coverage. The effective health care system is getting challenged due to poor health outcomes which contradict the high costs which make most families resort to seeking medical care abroad. The anti-collectivist healthcare system is inequitable since it excludes those unable to pay for services (Ginter, Jack, and Linda, 16). Most of the health facilities are located in the urban American rather than places with the greatest needs. The healthcare professionals are also insufficient to attend to the population. For instance, 10% of all physicians work in urban America, yet only one-forty of the American population live in these areas. Fixing them requires an increase in access to primary care and insurance coverage, equitable distribution of health care professionals to both rural and urban, and encouraging employers to offer insurance cover to their employees.

Ginter, Peter M., W. Jack Duncan, and Linda E. Swayne. The strategic management of healthcare

For the patient Trevor even though he was laid off from work about six months ago. He should be able to contact his local department of human service and see if he qualifies for emergency health insurance services by his state, in a specific situation Medicaid might be able to retro back 90 days from the start date of his Medicaid application.

For the family standpoint, the wife has a part-time job, and she has some income, but since they are married, they both might qualify for the emergency Medicaid assistance or try to possible try the marketplace for an insurance plan based upon the family size and income ratio of the family.

Healthcare official and facilities have a number of different avenue, offering the patient a no insurance pre-pay plan, financial assistance, hold chargers for 30 days as Medicaid pending.

Cost- He should be able to get generic brand medication at low cost, ask to give any medication at the hospital and explain that he has no insurance or limited amount of money to purchase the medication.

Access- The emergency would be a reasonably accessible option because he would not have to wait for an appointment to be possibly turned away for lack of insurance or his inability to pay for services

Quality- Regardless of the different scenarios that were given to justify Trevor options quality would always be a downfall for the patient, and healthcare professional because there is no follow-up care so quality cannot be determined.

I like your post,  but we have some little differences in the manner at which  Trevor ‘s situation would have been handled. Take the case of generic or low brand medication. For instance, if a physician prescribes Ibuprofen 500mg, he has a reason for that milligram to be high. You as a patient will not force a doctor or a medical staff to change only to what you can afford, Then if what similar to it is what you can afford but might not be effective in treating a disease, then how will you survive?. Some times, we look for family members to come in and help or go register in charity organizations which helps at reduced prices for medical services rendered but might not be closer to your residence when it concerns emergency. Also, there might be some discount already added for prescription medications and that price is final. Some medications are no doubt really expensive, but we cannot do without them. To add, her wife’s part time job will not qualify for health insurance from her employer. They could have searched for charity or community based health organizations that will care for individuals without health insurance.

The present health care system in America is very complicated despite the countries wealth. Like the case of Trevor who was laid off his job six months ago, became unemployed and his wife waitressing as part time and attending college and insurance coverage is difficult to care for part time workers. No insurance nor can they afford to purchase one.

    The concerns and issues of the patient is that; he has three options when he is sick. Either he pays upfront a $150 per visit for a physician, or a $50 copay and insurance needed or pay upfront because no insurance and the third option is he has a prolonged illness, goes to the Emergency room, has no insurance , has a prescription which cost  $200 but decides not to fill it because he is poor and unemployed. In each option , there at least something to sacrifice. I t happens to many patients who contemplate daily on how to this issue when it concerns insurance.

      From the family, most often if no one in the household has insurance, then there  is a probability that none will have as people could put others in their plans. If Trevor had insurance  even through his job, then he could have included even his wife, then the wife too could not have one because she was on a part time job.

      As for health care professionals, the concerns and issues are the prices of  prescription medication, insurance copay and the cost of hospital stay.

     What could have been done differently in relation to cost is; reduce the insurance premiums so that many people can afford to pay whether they are working or not . Like in the case of Trevor, he could not pay because he was laid off and became unemployed. Also the cost of Emergency room (ER) visit should be slashed and no upfront payment be made before an ill person should see a physician. Although we have a system of high income, but we should realize that not every one is on that level.

   On quality, with the recent technological development and innovation health care should become available to all not only the rich and influential in society. Take the case of “medical tourist”, that is, people who come to benefit from America’s prowess in modern health care, but there are still many who move out for cheaper health care cost in countries like France, Britain, India etc. Trevor never had the opportunity to have quality care because of his financial situation.

     As for access, there shouldn’t be anytime that someone cannot access a medical facility especially the ER because he or she is scared of the medical wait time and the the bill that will ensue. The ER is for everyone who feels he or she needs an urgent care. Trevor should not have hesitated to visit the ER . he could not comply by buying what has been prescribed to him as medication. This was as if he did not have  access to the ER. But the manner in which things are done are makes things difficult.

Good job on your post. It caught my eye when I was reading it, because some of the things you said was different than how I viewed things. As far as cost, it never said if his wife had insurance or not. Even though she was working part time, some part time jobs do offer insurance it just depends. With quality I understand where you are coming from with wanting to make health care available for everyone, but the issue with that is the US healthcare system is expensive, and the reason why is because technology and how advanced US medical/medicine is compared to other countries is one of the reason why the healthcare is expensive. With that being said by lowering cost, as nice as that sounds, would not really be possible, because test, medicine, and everything is to expensive. Someone at the end of the have to pay for what others did not pay for. Nothing can be free in this world, even when it comes to peoples health as much as that sounds sad. When it comes to access, I understand what you mean that people should be able to access a medical facility at all times, and that is why the ER is 24/7. I believe that other facilities are only open curtain hours, because the ER is already 24/7 and some of those place can’t do urgent medical conditions like an ER can do.  As far as the ER wait time and the bill that goes with it, the ER has a long wait but so does Urgent Care sometimes. Medical tries to help the person that is in most need first and break it down that way. For Trevor the best for him was going to the ER because he didn’t have any insurance and if he would have went anywhere else he would have had to pay out of pocket. The good thing is though, the ER tends to work with people that can’t pay their bill by setting up payments. I understand what you mean by it can be difficult how things are done, but hospitals and pharmacies can’t just hand things out for free. As far as the medication that Trevor needs, he could ask if they could give him samples, since he can’t afford the medication or if there is another option for him to take his medicine without it being so expensive. 

I agree that it would be very hard for Paul or his wife to qualify for any type of healthcare insurance considering the situation Trevor and his wife is in.  Paul would not qualify for Medicaid or Medicare.  Medicare is only available to pregnant women and children.  Medicare is only available to people who get a disability check and then they would have to purchase part A or B.  I think they would qualify for Medicaid.  The healthcare system in America is in a dire situation right now and it makes it hard for the poor working class citizens.  The emergency room is the only option.  Urgent care won’t accept Trevor.  Urgent care does not operate like an emergency room.  Thus the cycle of going to the emergency room is an ongoing cycle.  Trevor could apply for assistance through the emergency room department if they offer it.  In my city, the hospital will allow you to fill out paperwork and they will put you on a payment plan or subtract a substantial amount of your bill, depending on your income.  But someone has to make the difference up somewhere.  Those people are the people who do purchase insurance through the healthcare market.  As we can see,  healthcare goes up every year.  Even if you have a job that offers a benefits package if you have a wife and children you are going to pay at least $300 dollars a pay period for a decent healthcare plan.  When I worked at a job that offered me a benefits package, I paid $175 every two weeks just for me but I always make sure to pick a payment plan that allowed for a low deductible, low doctors and medication copays.  Health insurance is very expensive.  That was in 2014.  Now I have the affordable care act.  I don’t have a choice because I have health issues and I need health coverage.  

           As far as quality health care, I think America is behind.  In Trevor’s case, Trevor was partly responsible for the healthcare he received because he didn’t pay attention to what the doctor was saying and when the doctor left he had questions.  Some doctors do come and go really quickly, especially if they see that you don’t have insurance and all people should be treated the same regardless if you have insurance or not.             Trevor was looking at the amount of time he would be spending in the ER and not his overall health.  That is not a good thing.  His health is more important.  His wife was worried and he was not thinking about her.  When a loved one is affected, it affects everyone involved and I don’t think patients think about that. 

The patient, Trevor has no other option.  He must go to the ER.  The patient had no insurance or funds to cover the cost up front. Therefore, the first two options are out.  They would have sent him to the ER after they found that he had a heart attack so that he could be monitored.  I am assuming that he did not purchase short-term or long-term disability with his job.  If he had the disability would have paid towards insurance premiums.  Then he would have qualified for Cobra coverage for whatever time frame is allowed by each state. I am certain that this information is given when you take a new job. If you do not understand, then it is extremely imperative to ask the hiring manager questions regarding this.

     The family should have gone to the ER earlier than a week out. They may not have had to purchase medications if done prior.  Possibly they could have been able to afford healthcare through the college a basic plan may have been affordable.  They could have checked out Medicaid for the family.  They could have been able to receive that if they had done their “homework” after being laid off.  Then it would have already been in place. 

     While in the ER Trevor’s family should have had health care professionals there to inform them of services that are available for financial assistance.  Possibly then he would have left with his medication and more information on services that are available in the community to aid the family.  Clearly, someone in health services would have informed the family that Medicaid is an option for them.  Not necessarily for the pre-existing at this point. 

     I feel that in most cases involving all aspects that a lot of information is just assumed to be known.  The lack of asking questions and even realizing what questions to ask sometimes for the patient and the family are just lost. This is an area that in the workplace and in the healthcare field that something needs to change.

Reference:

Batnitzky, A., Hayes, D., & Vinall, P.E. (2018).The U.S. healthcare system: An introduction [Electronic version]. Retrieved from https://content.ashford.edu/ (Links to an external site.)Links to an external site.