Monday, April 20, 2009

Some Options for Medical Care

Having been a bit under the weather this week, I got to thinking about medical care. I have been extremely fortunate to have full coverage medical insurance practically since birth. Many people are not that fortunate and healthcare coverage is a major concern (it can also be a major cause of bankruptcy!). Here are some options for care when you get sick--both during "normal" times and during times of disaster:
  • Obviously if you are in a life threatening situation (chest pain, shortness of breath, in active labor, a serious infection, been stabbed, been shot, etc), go to the nearest emergency room. The EMTALA Act says that emergency rooms MUST treat you whether you can afford to pay or not. Of course you will get an armload of bills after your treatment, but at least you will be alive to deal with them. Note that in some disasters or TEOTWAWKI scenarios, many hospitals may not be open/staffed.
  • Your regular doctor. Hopefully you have a regular general practice doctor that can help you with general medical problems, chronic condition care, and preventative wellness checks. This is a less expensive option than an emergency room and hopefully, with preventative checks, your doctor will be able to find and treat problems while they are still minor. You may want to ask your doctor if he has a disaster plan, just to figure out if he would be available during a disaster situation.
  • Community clinics. These range from "free clinics" to "sliding fee scale" clinics, to "you must pay a set fee" clinics. If you do not have insurance, these types of clinics may be the first place to look for affordable care. Less urgent and chronic condition care is very common at these types of clinics. Ditto on the note about disasters and TEOTWAWKI.
  • "Urgent Care" clinics are springing up all over around our state. These are a less expensive option than an emergency room for urgent, but not life threatening, conditions. If you don't have insurance you will need to pay at the time of service and there is no way to tell if these places would be open during a disaster (I'm guessing no).
  • Lower level providers. In some cases, depending on your jurisdiction and what level of care lower level practitioners can provide, you may be able to get limited types of medical care from Physician's Assistants (PA), Advanced Registered Nurse Practitioners (ARNP), and Registered Nurses (RN).
  • Vets. For your everyday medical care/medical emergencies, vets will not treat you. There is a small problem with malpractice and providing care outside of their scope of practice that usually (as it should) stop them from treating human patients. This is not to say that veterinary care is not an option when TSHTF. Way back in the day in very rural areas, it was not uncommon for vets (and farmers who knew some vet skills) to provide antibiotics or sew up a gash on their (human) neighbors.
  • Home remedies. I can count the number of times my grandparents went to a doctor on one hand. This was probably because of the cost but also because they pretty much didn't trust doctors unless it was an emergency. What they did do, however, was tap into their huge knowledge of home remedies to treat just about any problem that came along. This is an excellent kind of knowledge to have at any time, but most especially during a disaster.
  • Specialized types of medicine. Homeopathy, herbal medicine, and Chinese medicine are considered "alternative" types of medicine however a billion Chinese can't be wrong. These types of medical practices are used to cure a wide range of ailments and most of the components of the medicines and treatments are available to anyone, not just licensed doctors. Note, however, that some of these treatments use plants and other natural items that can be toxic or fatal if used improperly so you really need to know what you are doing before you attempt to use these items.
  • Other resources: For other medical care information consider nurse hotlines which can provide information over the phone that may save you a doctor's visit. Also, Poison Control Centers can provide information on whether something that was ingested was poisonous and requires an ER visit or if the substance is actually non-toxic and not a problem.
  • And some tips: The best solution to a medical problem is to not have the problem to begin with so preventative care is important. Take care of your health by eating right, exercising, wearing a helmet and seat belt when needed, and generally staying away from situations that can make you ill (stress), injured (skateboarding), or dead (smoking). Getting some medical training is a great idea, so consider signing up for a first aid or EMT class. Make friends in the medical field; during a disaster there will not be enough of these people to go around (look at the situation in Louisiana during Hurricane Katrina). Get some reference books. "When There is No Doctor" is a classic tome and you should also have a book (with lots of color pictures) about the types of plants that grow wild in your area that can be used for medicinal purposes. Also consider planting some medicinal herbs in your garden.

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