Breaking the Bank to Survive

One-fifth of state's population lacks insurance, forcing some into debt


by Kathleen Wilson,
Ventura County Star
kwilson@VenturaCountyStar.com
October 10, 2004

Doug Horn went broke trying to stay alive.

The insulin-dependent diabetic said he charged more than $10,000 in medical bills on his credit cards because he had no health insurance. By the mid-'90s, he was bankrupt.

"I was using those credit cards just because of regular checkups, regular care needed to maintain a healthy lifestyle with diabetes," the 42-year-old Newbury Park resident said.

Without insurance, the part-time photo and video editor said he's had to devote his energies to survival.

"It makes me extremely angry. I've got friends in similar age groups that have already done OK with their lives. I've been basically keeping my head above water just to stay alive."

Across California and in Ventura County, officials estimate 20 percent of the population lacks health insurance. At the Conejo Free Clinic, where Horn gets help qualifying for some free prescriptions and insulin, virtually no one is insured.

"Ninety-nine percent of the people that I see claim to have no insurance," said Teresa Seeley, an executive assistant at the clinic that serves 40 people a week.

Seeley said these patients don't qualify for government programs, which are targeted largely toward the elderly, the disabled and low-income children. Nor do they have the private insurance that many people get through their employers. They're construction workers, self-employed business people, massage therapists, hairstylists, clerks, part-time workers and adult students no longer covered under their parents' insurance.

"They're working middle-class folks who cannot afford to pay for insurance," she said. "Their companies don't offer insurance or the insurance plans are really limited to emergency hospitalization only and no medication coverage."

Around the county and the state, the uninsured often pay cash for medical care and hope they can stay healthy. But if serious illness strikes, they face hospital bills that can take decades to pay off, experts say.

Others find their only resort is bankruptcy court. There, the destitute can get their debts discharged every six years, albeit with a black mark on their credit ratings.

Janet Lawson, an Oxnard attorney who deals almost exclusively in bankruptcies, said 20 percent of the personal bankruptcies she sees are driven by catastrophic medical bills.

"I tell people the bankruptcy court is the last great provider of healthcare coverage in America," Lawson said.

Coverage for all

Now, though, an effort is afoot to provide coverage for all.

In the first of three conferences convened on the future of healthcare in California, a panel of experts agreed last week that universal coverage is the most pressing issue.

"Our intention is really to do something," Assemblyman Keith Richman, R-Northridge, said after the first session ended in Los Angeles.

"None of this is easy to decide, and it's going to generate political opposition, no question. (But) the healthcare crisis is just worsening -- the large number of uninsured, the increasing cost of healthcare for everyone. There are between 6 to 7 million people uninsured. It's critical we come up with answers to address that problem."

Richman and Assemblyman Joe Nation, D-San Rafael, chaired the series of conferences that opened Monday at the University of California, Los Angeles. They plan others Nov. 18 at California State University, Fresno, and Dec. 1 at UC Berkeley in the series sponsored by the RAND Corp. and The Communications Institute.

Then, the politicians said, they will introduce legislation to deal with the most critical healthcare issues.

The UCLA session brought together various players in the healthcare industry. Representatives from the drug giant Pfizer Inc. and insurer WellPoint appeared along with healthcare economists, the head of the state Department of Health Services, scholars at the RAND think tank, the president of the Cedars-Sinai Health System, the chief nurse executive of UCLA Medical Center and the director of the Los Angeles County Department of Health Services.

Officials representing labor, physicians, business and an African-American health initiative were present as well.

Cost rises quickly in California

Experts from RAND said the cost of healthcare is rising rapidly nationwide and even faster in California, where it consumes $150 billion a year and 15 percent of the state's output. The annual cost of private health insurance premiums rose by 12 percent in California last year and by 11 percent in the nation.

Even with that increase, a RAND survey in 12 metropolitan areas in the United States suggests that many are not getting recommended care. One-fourth of diabetes cases and nearly 60 percent of blood pressure cases were uncontrolled, according to the study published last year in the New England Journal of Medicine.

Although the speakers generally agreed on universal coverage, they argued about how to get there. Among the ideas were tax credits, a sales tax devoted to healthcare, government-run insurance, purchasing cooperatives for small businesses and vouchers that would pay for either full-rate or bare-bones plans.

The two legislators said they were encouraged by the consensus over universal coverage.

"People from very diverse viewpoints agree healthcare is essential," Nation said. "The essential disagreement is how we get there."

Copyright 2004, Ventura County Star. All Rights Reserved.


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