“There’s really not enough education out there for people to navigate the system.”

Patty* helps a variety of medical specialists at Bronson Hospital as a part-

time assistant. She takes care of patients after surgery, works with casting and

splinting or other wound care, helps with patient pain management, and monitors

drug use. She is also a retired hospital administrator who used to be in charge of

quality management, regulatory bodies, and joint commission; in addition to the

certification of health care facilities. Given her experience with health care and

hospital administration, she has seen a wealth of patients and has a broad

knowledge of the Affordable Care Act and its provisions.


Patty immediately got into problems concerning the insurance system,

mentioning that there are several groups of patients: there are people who are

insured and educated, people who are unaware, people who know how to obtain

insurance but choose not to, and people who are borderline eligible – those who

want to obtain insurance but do not qualify. When discussing the general lack of

knowledge about insurance opportunities, she stated, “There’s really not enough

education out there for people to navigate the system. Most of the people I know

said that they couldn’t, and it’s very hard for the elderly. It’s such a big change for

them with technology and everything, and it’s hard for them to transition” She

claims that this issue is one that the government cannot fix. There is also a problem

in the insurance system regarding patients with preexisting conditions. In 1995,

Patty had an experience where she got dropped from her insurance plan. Being

involved in health care, she called the state and fixed the problem. But this is not

possible for everyone. She stated, “Me knowing the healthcare system, I [knew]

what to do. Other people wouldn’t know what to do to correct the situation.”

She believes that many uninsured individuals do not take care of their

medical conditions properly. She claims to see a lot of patients with conditions that

could be easily managed by a primary care provider, such as diabetes, mild pain,

carpel tunnel syndrome, or simple colds. However, these patients are uninsured or

unable to afford health care and they go to the Emergency Room instead. There,

they receive free treatment. According to Patty, hospitals do a lot of charity care

with money that they do not have. She noted that, “Healthcare facilities lose too

much money; especially the little hospitals because they can’t afford to do all of that

charity care.” It is difficult for Emergency Room physicians to turn down these

patients because of litigation.


Patty is optimistic about the ACA and its perceived benefits, though. She

believes that charity care will go away and “everything will be scrutinized more,”

with the ACA improving the way the government spends money. She thinks that the

fact that the ACA expands Medicaid is a “big plus” because “[she] think[s] that

[borderline uninsured people] are the people who suffer the most.” Speaking from

firsthand experience, she thinks that the coverage for preexisting conditions is a

“huge plus.” She also thinks that the ER will become more efficient. She said, “We’re

so used to just taking care of everything” and it will take people time to get used to

waiting for the treatments of minor ailments.


Patty believes that Kalamazoo is a special city that has a lot of potential for a

transition into a healthier community. She noted, “I think Kalamazoo for health care

is very progressive for being the size town it is by virtue of having Stryker and Pfizer

and then all the other companies like MPI that are leaders. They’re supportive for

their supplies and research. And I think as far as the health care, they have a lot

more to offer in this size town than in most towns. [Kalamazoo has] two big

hospitals, [it] has Stryker, and [it] has Pfizer that compliment the health care

services for the hospitals.“ She refers to Kalamazoo as “the other Michigan” as far as

the resources it has to offer compared to the rest of the state. She thinks that the

ACA will affect everyone in the same fashion, but it will “make Kalamazoo even

better” in that “the people who don’t have anything now will have something.”


*name changed to protect confidentiality

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