Helping Out

Normal left hand from Radiopaedia (without a bump)

This last week I ran into a guy in clinic that made me thankful for Idaho voters. We were able to help him out. You should know about this. It’s not about politics or policy, just about how we were able to help out a hard-working guy.

He was in his work insulated coveralls since he had gotten in a couple hours on a chilly October morning before his appointment. He’d made an appointment with our clinic since he’d heard we offer a sliding scale fee structure.

About 16 months ago on a job he had been holding a board for a brace and another guy shot a nail into the two by four. The tip of the nail had come through the board and embedded into his left hand. He was able to wiggle his hand off the nail and it hurt like heck, but with a bandage in his glove he kept working. It got real swollen over the next week but never infected so he figured it would be ok. The swelling and pain went down, but over time the wound developed a small lump that kept getting bigger.

It was on his left hand on the thumb side of the junction of the pointer finger knuckle. It would hit on things when he grabbed them and it was now, when I saw it, the size of a marble. It felt really solid, not like a fluid-filled abscess or cyst. His finger moved just fine. He wanted it taken off. I didn’t blame him. I could see how it would get in his way and be a problem.

The trouble was, I am not the right doctor to take that lump off. Hands, especially fingers are tricky to work on. He needed to see an orthopedic doctor, maybe a hand surgeon.

“Do you have health insurance?”

He looked at me blankly, a young healthy working man. “No sir, that’s why I came to you guys (meaning the clinic with the sliding scale fees).”

“Did you file a workman’s comp claim?”

“Naw, I just kept working.”

I explained to him the delicacy of dealing with this part of his body. I could recommend a local orthopedic doctor that might see him for a reduced amount, but I expected the surgery would include hospital or operating room costs; probably thousands of dollars all added up.

The physician assistant was in the room with us looking at the bump. He asked, “Can you wait until January?”

The young man looked at him a bit confused.

“Next week you can sign up for Medicaid here in Idaho and coverage will begin in January. You’ll have health insurance.”

“Heck, I’ve lived with it this long.”

I warned him if it got red or painful or started swelling more he should come back in, but given his situation it was fine to wait.

Idaho voters did the right thing for this guy and their fellow citizens last November when they overwhelmingly passed Proposition 2, Medicaid expansion. The Idaho legislature did the right thing this last session when they were putting on all those waiver sideboards. They mandated that none of their sideboard waiver applications would delay the enrollment of those eligible under the Medicaid expansion initiative. The Idaho Department of Health and Welfare has been doing the right thing for the last ten months and preparing to enroll the newly eligible for Medicaid health insurance.

This isn’t the story of a life saved or a bankruptcy averted. It’s just a small story of how health care can be of service when a bump gets in the way. But it’s also a much bigger story of how we can make decisions to help out our fellow citizens. It made my day.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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