Those Who Lack Health Insurance Need Ingenuity

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http://www.truthout.org/issues_05/041105HA.shtml

 

Those Who Lack Health Insurance Need Ingenuity

By Michael P. Regan

The Associated Press

 

Monday 11 April 2005

 

Aging brings mounting fears of going broke.

 

New York - When Arnaud Durieux needed to get his teeth fixed about

six months ago, the freelance Web designer caught a flight from New

York to his native France.

 

Because he has no health or dental insurance, he figured this was

his best option to get good care at a good price, even factoring in

the cost to fly. The French dentist charged about $500 for the crown,

compared with the $2,000 he says it would have cost in New York.

 

" I usually go back about once a year. So while I'm there I get my

medical checkup and any dental work I need, " the 37-year-old Durieux

said. " It's still cheaper for me to get all that work done in France

than getting insurance here and doing it the American way. It's

unfortunate, but that's how it is. "

 

Durieux's is one of many unusual strategies that the 45 million

uninsured people in the United States employ in an attempt to keep

themselves healthy without going broke, as medical and health

insurance costs have soared in recent years.

 

Premiums for family coverage in employer-sponsored plans rose 59

percent between 2001 and 2004, according to the Kaiser Family

Foundation, compared with a 9.7 percent growth in consumer prices.

 

The escalating costs are expected to keep the ranks of the

uninsured growing for years to come. A study by researchers at the

University of California, San Diego, published last week by the policy

journal Health Affairs, predicts that 56 million people in the United

States - more than one in four workers - will be uninsured by 2013.

 

Young Can Take Risk

 

For many younger people who are uninsured, the good health that

usually comes with youth makes the risks tolerable. But as middle age

and the aches and pains that come with it encroach, so do fears of

huge medical bills from a catastrophic illness or accident.

 

" It worries me all the time. It doesn't settle well with me, " said

C.J. Holm, a 42-year-old New York woman who is looking for a part-time

job that offers health benefits until her new catering business brings

in enough money for her to afford coverage.

 

She beat ovarian cancer in the 1980s - but has had to skip regular

checkups because she can't afford them.

 

" When I think about it, I feel really guilty, " she says.

 

For Nancy Twigg, a 38-year-old author and newsletter publisher in

Knoxville, Tenn., being uninsured means looking up her symptoms on the

Internet when she gets sick, peppering friends who are nurses and

pharmacists with questions, and treating whatever she can with

over-the-counter medicines.

 

Samaritans Help Out

 

If disaster strikes, she has faith she'll be covered by a service

called Samaritan Ministries, a group of Christians who send money each

month to members of the network with high medical bills.

 

" We are happy to know that it goes to a family in need, rather

than a large insurance corporation, " she said.

 

When doctor's visits become unavoidable, she has found a doctor

who offers a discount to self-pay patients and recently gave her

$1,000 worth of drug samples to treat a shingles case.

 

" Had she not done this, I would have just had to tough it out, "

she says.

 

Toughing it out is an all-too-common phenomenon for people with no

insurance, according to Stuart Schear, director of next month's Cover

the Uninsured Week campaign, sponsored by the Robert Wood Johnson

Foundation.

 

Research shows that uninsured people usually put off care for as

long as possible, Schear said.

 

" If they are having a health problem, they try to see if they can

wait it out. Often that is to their detriment, " he said.

 

" It's estimated that nearly 18,000 people in the U.S. probably die

each year because they do not have health coverage, " he said.

 

Experts say most of the uninsured population is composed of people

whose employers don't offer benefits, but who make too much to be

covered by public-health programs and not enough to afford their own

coverage.

 

High medical bills are a leading cause of personal bankruptcy,

Schear said.

 

Yet there is a significant number who simply gamble they won't

incur medical bills high enough to justify the soaring costs of insurance.

 

Paul Keckley, a health-care economist and director of the

Vanderbilt Center for Evidence- Based Medicine, says research shows

this group of gamblers is about 15 percent to 18 percent of the

uninsured population and is definitely growing.

 

For some, " I think there's maybe a suspicion that modern medicine

is like modern food: There's a whole lot of chemistry and technology

involved, and if you can get natural in your approach, perhaps you're

better off, " he said.

 

He said other people for the most part are structuring their own

benefits. " Some will tell you 'I think I can negotiate directly with

the doctor or hospital and get a better deal.' "

 

Betting against Yourself

 

That's how Bonnie Russell, a legal publicist in San Diego, looks

at it.

 

" You've got to look at this stuff pragmatically, " she says. " I

knew that when I was younger I would be betting against myself. That's

what insurance is about, betting against yourself. "

 

But after being diagnosed with skin cancer recently and paying for

the treatment herself, she said she had " one of those gut-check

feelings " and was looking into insurance policies.

 

" After I got this I thought that, as time marches on, you've got

to rethink it, " she said. " But I had a good run. "

 

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