Mama's Got a Plan:

Maternity Care, Health Insurance, and Reproductive Justice


Don’t buy it!

 

Myth! Myth!

One myth that refuses to die is that patients who refuse a test or procedure Against Medical Advice (AMA) will be billed for all care up to that point, which their insurance company will not cover as a result of the refusal. Since shouting NOT TRUE! NOT TRUE! NOT TRUE! isn’t – or shouldn’t be – as persuasive as evidence, we incorporate a reference to published research in the cartoon itself, and provide this complete citation to the free full-text article:

G.R. Schaefer, et al., Financial Responsibility of Hospitalized Patients Who Left Against Medical Advice: Medical Urban Legend? J Gen Intern Med. 2012 Jul; 27(7): 825–830. https://doi.org/10.1007/s11606-012-1984-x

Should I sign the form?

Hospitals and health systems usually require patients to sign a form acknowledging that they are taking an action AMA, such as discharging themselves from care. This documentation protects the provider from liability in the event that some harm befalls the patient as a result of the refusal. However, a patient’s right to refuse treatment is not conditioned on their signature. In other words, there is no requirement under state or federal law that patients sign such a form.

Why the big deal?

Misconceptions are one thing. But willfully using falsehoods in order to override patient informed consent is quite another. If a health care provider has to resort to effectively threatening a patient with bankruptcy in order for the patient to consent to a course of treatment, then that provider is clearly not thinking of the patient’s best interests or rights. It is not very different from ensuring “compliance” by raising the specter of Child Protective Services intervention or playing the Dead Baby Card.

Takeaways

  1. It’s a myth! Patient refusal of a treatment or procedure will not cause a health insurance carrier to refuse coverage or payment.
  2. Providers who use this myth to attempt to coerce their patients are acting unethically and in violation of the laws of informed consent.

Image Credits

Frame 2.
  • Photo of pregnant person and physician is by Bokskapet.
Frame 3.
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Not you too?

190409 me too too.jpg

Image Credits

 

Updated April 9, 2019, to add copyright designation.


Cry havoc

This cartoon was created in memory of Palestinian medic Razan al-Najjar, killed in Gaza.

Images and credits


Catching up cartoons

The following cartoons were published on Facebook before they were posted here. Without further ado …

Subject-consent-object (SCO order!)

 

The usage “consent the patient” is one that horrified us when it first came to our attention. If any verb should be an active one, “consent” is the one.

Image credits

“Doctor Visit” is by mohamed mohamed mahmoud hassan, shared under a Creative Commons license. We added the facial features, which were chosen from assortments provided here and here. The framed picture is courtesy a collection of fantasy landscape cartoons.

 

Medicaid work requirement

The Michigan Legislature has decided to prioritize removing health care from expanded Medicaid recipients who are not working sufficient hours. They were able to do so because the federal government urged states to apply for waivers in order to allow exactly this kind of proposal.

Medicaid was not established in order to force people in need to abandon their families and work sub-subsistence-level service jobs; rather, its purpose is to provide health care for those who cannot afford to purchase it, even with the subsidies that the Affordable Care Act provides (so far!). When one of the Senators behind this bill claimed that “work improves health,” we were moved to create this cartoon.

For those who require a translation for the ironwork behind the Senator: Arbeit macht Gesundheit.

Michigan Governor Snyder has not yet signed the bill, which was enacted on June 7, 2018. We encourage him to veto this measure and instead throw his support behind federal proposals to institute Medicare for All.

Image credits

The Senator and his podium are from an image entitled “Presentation,” by Mani Amini.  The audience is from a FEMA photo, in the public domain.

 

Non-Apology

So many non-apologies arrive in the passive tense, don’t they? Another cartoon in the Bureau of Apologies series.

This image only suggests the offensive words issued by the doctor representing the American Birth Doctors Association (ABDO). The real-life context in which a major professional organization suggested that women control rising maternal mortality rates by using condoms (!) is described here.

Image credits

The doctor and his podium are both from PlusPNG.com.


Separation and selection

What kind of country ….?

immigrant selection

We’ve seen this before.

Images and credits

  • The Statue of Liberty photo is by Andrew Weber. The blue sky background has been replaced. The photo is in the public domain.
  • The Border Patrol guard photo is by Josh Denmark, posted on Wikimedia Commons. It is in the public domain.
  • The image of the Border Patrol logo is from Wikimedia Commons. It is in the public domain.
  • The American flag is from cliparting.com, shared under a Creative Commons license.


Abandon reality

When the current political reality is so unsatisfactory, it seems only reasonable to try something else.

 

Images and credits

  • We borrowed the gent in the cape from Rebels Market, an online “Counterculture Megastore.” While goth and steampunk aren’t exactly our style, we were quite taken with this black brocade coat.
  • The nondescript building of Frame 2 is really a Navy Department Office in 1918 or 1919.
  • The photo of the Oval Office is from the Clinton Administration.
  • The staffer in the black suit is from pixabay.com, shared under a Creative Commons license.
  • The photo of Mr. Trump is from the U.S. embassy in Uruguay.
  • The forest trees wallpaper behind Mr. Trump’s photo is by elias_noessing, shared under a Creative Commons license.
  • The hand holding Donny & Ahmed is from clker.com, shared under a Creative Commons license.

Finally, inspiration for this cartoon’s concept came from the work of Ben Katchor. Seek out his comic-strips – you won’t be disappointed!