[classichasclass]

I can't say this for every state, but this is exactly the case in California: if you can't afford TB treatment, you're still covered. Every health jurisdiction has a TB control program, some very large, and every jurisdiction with cases gets state money to ensure those cases are treated. That goes for relatively uncomplicated active TB through horrid multi-drug resistant cases. That goes for citizens and immigrants alike. Some of the best TB docs in the state work for local health departments. I've treated cases for over 15 years. We want you to succeed. We do not want you bankrupt for a disease you had the bad luck of getting, and we don't want you to give it to other people in the process, because we're the ones that have to clean up the mess.

It's precisely because we'll bend over backwards with treatment coverage, free doctor visits, rent assistance, helping apply for short-term disability or Medicaid, home directly observed therapy, you name it to break down those barriers, that when I walk into court and say this person needs to be confined until they're no longer communicable, it's not because they can't afford it. We've done everything we could do to avoid getting to this point. Now they're a danger to the public, and we can't let that go on.

Source: public health TB physician

[smnrchrds]

> if you can't afford TB treatment, you're still covered.

Does this help in the hypothetical case OP is mentioning? Or does the government coverage kick in only after the person has been made to spend every last dollar that they have on the mandatory treatment and are now left penniless?

[classichasclass]

Again, can't speak for places other than California, but here TB treatment is not like Medi-Cal where you have to spend your assets down first. We'll see you because it's emergent, and we'll ensure your treatment is complete because it's necessary. We'll bill your coverage if we can but we'll never bill you. If you have insurance, you can see them, or you can still see us. I have Kaiser patients who would rather come in because it's easier to get an appointment and we handle everything for them.

This is not necessarily true of other diseases. But TB's legal complications plus its serious nature make it essential to handle it this way. It's cheaper for the local health department, too: think of what has to go into evaluating and testing all the people who ended up with a preventable exposure. I remember a case in which we tested over 5500 people because it was a nurse and they weren't detected for six months.

[marcus0x62]

> If you have insurance, you can see them, or you can still see us.

Outside of an HMO, what does this mean? You cannot “see” or be treated by most insurers in the United States. You “see” a licensed provider, then some time later find out what, if any, of the charges billed by those provider(s) are covered by your insurance plan.

[classichasclass]

Obviously it means you can see the provider they cover, whomever that is.

[marcus0x62]

Then maybe say that instead of confusing payors and providers.