As David Tuller and I explain in MedPage Today. Here is the gist:
Cowboys Need Healthcare Too
— Leaving people uninsured winds up costing society a lot more
by David Tuller, DrPH, and Steven Lubet, JD April 19, 2022
Most cowboys without medical insurance have opted to forgo it for some reason, despite the availability of nearly universal coverage under the Affordable Care Act (ACA). That choice fits the familiar image of rugged, government-disdaining individuals, suspicious of social welfare programs, especially in the deep Red western states. But even the toughest, most go-it-alone cowboy can still end up needing a doctor.
Butcher tells the story of a cowboy named Pete who works on the Crow Reservation in Montana. He suffered an accident while riding alone on the range, "but he managed to get to an emergency room, where he was treated for a broken nose, broken eye socket and broken cheekbone," and had his eyelid "stitched back together." Advised to take 12 weeks off, Pete was back riding the next day. "It could have been way worse," he told Butcher.
Assuming that Pete matches Butcher's profile of an uninsured loner, somebody still had to pay for all that repair work. The only emergency department on Montana's Crow Reservation is at the Crow/Northern Cheyenne Hospital, which is operated by the federal government's Indian Health Service. Like every hospital receiving government funds, the emergency department at Crow/Northern Cheyenne is required to treat everyone who presents with an injury, with or without insurance; it is even forbidden to ask about insurance during intake. So unless Pete had the money to cover the expenses himself -- highly unlikely on a typical annual income of $30,000 -- the chronically underfunded Indian Health Service was left eating the costs.
You can read the entire piece here.
Comments