Barter typically permit sufferers to pay for well being care they in any other case couldn’t afford

When a patient’s insurance benefits expired, he traded the continued use of a pool for his work as a therapy assistant. (LARGE STOCK)

When Orly Avitzur first met the patient, a 59-year-old supermarket manager who had been injured in a fall at work years earlier, he was in severe lower back pain and was on his way to spinal surgery. He was 50 pounds overweight, had poorly controlled high blood pressure, and was so out of shape that he was visibly short of breath.

Avitzur, a medical advisor to Consumer Reports, recommended pool therapy, and the patient responded like the proverbial fish to water, losing all of his excess weight and experiencing periods of pain relief for the first time in years. But his physical therapy insurance was running out and he couldn’t afford to continue. Avitzur suggested they offer to help out as a therapy assistant in exchange for free use of the pool, and the pool manager accepted the deal.

Recourse to the age-old art of bartering has helped at least some of the nearly 49 million Americans who are uninsured, and the millions more whose health benefits are so minor that they often cannot afford care. (Fortunately, the situation for many of these people will change significantly in 2014, when full implementation of the Affordable Care Act gives millions of Americans access to comprehensive and affordable health insurance.)

Not just for country folk

Although historically more common in rural areas, where it was not uncommon for doctors to be paid with chickens or wooden string, bartering occurs in other settings as well. Avitzur has looked after a patient who traded his carpentry skills for physical therapy sessions and heard stories from colleagues who traded their services for those of contractors, electricians, hairdressers and even a chimney sweep.

While much of the dealings between doctors and patients are one-off, organized barter seems to be growing. In Kingston, NY, the annual O + Festival features performances by approximately 40 bands and exhibits by dozens of artists receiving medical care over the course of a weekend. (This year’s festival is scheduled from October 11-13, with an encore in San Francisco in November.) The festival does not provide direct health care, but acts as an intermediary. It connects artists with health services, including general physical therapy; dental examinations; Blood pressure, hearing and eye tests; and psychological screenings as well as vouchers for follow-up visits.

In New York, the Lincoln Medical and Mental Health Center enables eligible artists – actors, dancers, musicians, poets, writers, and anyone else who makes a living by creative means – their services for doctor visits, laboratory tests, hospital stays, emergency care, medical and surgical procedures , Dental care, prescriptions and other services. A similar program has been in place at Woodhull Hospital in Brooklyn since 2005.

In Arkansas, the Bono Barter Clinic is promoting that you can trade for health care with “something you made, grown, or produced, or a service you provide.” At the Maple City Health Care Center in Goshen, Indiana, patients who cannot afford medical care can volunteer time with community organizations instead.

Exchange tips

If you want to participate in a medical barter, here are some suggestions on how you can do so safely and legally:

● As with any medical service, ensure that the doctor or clinic credentials are correct.

● Negotiate reasonable fees and make sure the values ​​are the same on both sides of the trade.

● Put your agreement in writing and keep track of all your transactions.

● Barter dollars are the same as real dollars for tax reporting. If you are in direct barter for products or services, you must include the fair market value of the business received on your tax return.

● If you work in a company or trade, you may be able to deduct certain costs that you incur in completing the work that has been swapped. You can obtain details from your tax advisor.

Copyright 2013. Consumers Union of United States Inc.