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Doctor reduces fees for laid-off workers

Dr. Michael Rosenfield

TEXT OF STORY

Kai Ryssdal: For the 3.5 million people who have lost their jobs since this recession started, it's not just the loss of a paycheck they have to worry about. Most Americans get their health insurance through their employers, too. So when the pink slip comes, the new budget calculations a lot of people have to make include how to pay the medical bills. One Seattle doctor is helping his patients try to do that. From KUOW in Seattle, Ruby de Luna has our story.


RUBY DE LUNA: Dr. Michael Rosenfield is physician with a small family practice in Seattle. About nine months ago, he and his staff noticed that some regular patients stopped coming in. Others hadn't picked up their prescriptions. And more patients were heading to the emergency room. He remembers a parent who took her baby to the ER for an ear infection.

MICHAEL ROSENFIELD: And I read the report carefully, and I kept thinking to myself, there's nothing here that would make me feel like it would be an emergency situation.

When Rosenfield's staff called the mom, they found out her husband had been laid off.

ROSENFIELD: She felt that she wasn't going to be able to be seen because of lost insurance.

It became clear to Rosenfield the economy was affecting his practice. So he sent out letters to his patients and introduced a new payment plan for those who lost their health insurance. They don't get billed. But they pay upfront, usually between $40 to $60 for each visit, depending on their financial situation.

Rosenfield: Good morning. How are you?

Risha: I'm good.

A patient named Risha has been coming to Rosenfield for more than a decade.

RISHA: When I got the letter, I got a sense of relief.

Risha lost her health insurance when she was laid off two months ago. And she has a thyroid problem. That got her scared.

RISHA: What would I do if, you know. Would our entire savings be wiped out because of one trip to the emergency room?

Risha wasn't the only one thinking "what if." Rosenfield was bracing to take a financial hit. But it's actually saving him money. It's reduced the amount of paperwork he has to file. And since patients pay him directly, he spends less time chasing after insurance companies for reimbursements.

ROSENFIELD: Let's say they pay $50 when they're seen. That's $50 that we can deposit into our account without having to touch the account five times before getting reimbursed.

The new payment plan was also a way to make sure that patients don't skip on medical treatments. Rosenfield worries about patients with chronic illnesses like diabetes. He says they may feel fine, but they may not realize their diabetes is in fact out of control.

ROSENFIELD: And they would end up with a sore on their foot and have to have an amputation, they would have renal failure and to see that the potential for their health care just to fall apart would be devastating.

And costly. The Kaiser Family Foundation estimates that as companies continue to cut jobs, as many as 6 million Americans could lose their health coverage this year. Rosenfield says the reduced fee is a small program, but it's his way of helping out.

ROSENFIELD: Our job is to treat people not just for the laceration or for the diabetes, but to help treat the fear. And if we can do that by telling them you can come here, it's OK, we'll see you for an amount that's affordable then you've treated a part of what's wrong with them.

About 150 patients have used Rosenfield's new payment plan. But some patients have told him their jobs may not be secure for long, and they might take him up on his offer of help.

In Seattle, I'm Ruby de Luna for Marketplace.

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