Uninsured workers can't afford to get sick

September 01, 2006|By JEAN MARBELLA

The medical bills that come in the mail are almost comical, with their five-figure charges that dwarf what Brenda Bowman makes in an entire year.

"The working poor - that's me," she says with a good-natured laugh. "We're working, but we still can't afford things."

Like getting sick, for example.

Bowman seems remarkably cheerful for someone who, through no design or desire of her own, is the embodiment of the census figures that came out earlier this week. They showed that for people younger than 65, median income went down half a percent last year, while the number of uninsured went up - to 46.6 million Americans.

Who can begin to understand a problem so vast? Almost 50 million people who, when they get sick, don't have a regular doctor or clinic they can call and either have to pay out of pocket for what they need or throw themselves at the mercy of the nearest emergency room?

"You just patch yourself up," Bowman says, "and keep going."

Bowman was referred to me by Shepherd's Clinic, a Baltimore nonprofit that provides health care to the working poor - you have to be both. I had called the clinic to see if I could find someone who could reduce that 46.6 million figure to a single individual's experience.

(A small side note: Shame on the vandals who, a couple of weeks ago, bashed the front door and security light of the clinic - Shepherd's runs on donations and volunteers. The vandalism happened around the same time as the more widely publicized trashing of nearby City College, but police don't believe the crimes are related.)

At 48, Bowman hasn't had medical coverage for years. In the past, she either had coverage through her husband - he died 13 years ago - or, during the four years that she was on welfare, through the government.

But now, she's part of a growing group that has neither. She does temp work, and even her $7.50-an-hour job puts her over the minimum for Medicaid, the government assistance program. But the job has no medical benefits, and she can't afford insurance on her own.

The solution, as all her friends tell her, is to find a real job, with health care. But despite working off and on over the years, with time out to raise her now three grown children, she says hasn't been able to find a permanent job.

She began having headaches in May, and they grew increasingly severe - she couldn't sleep some nights the pain was so intense. Someone told her about Shepherd's Clinic, and she walked in one day, without an appointment. The clinic requires a co-pay, based on income level, and hers worked out to be an affordable $9.

When she was asked to rate her pain on a scale of one to 10, she said 12.

The clinic sent her to a nearby hospital, where they did a CT scan and found that she had bleeding in her brain, Bowman says. Three days later, she underwent brain surgery and spent a week recuperating in the hospital. Bowman said doctors told her they didn't know what caused the bleeding.

She returned to work several weeks later.

"I didn't have any leave of absence," Bowman says. "When you're a temp, you don't have anything like that."

She tries not to think what might have happened had she not heard about Shepherd's Clinic and realizes how very close to the edge she lives.

"You can get sick at any time," she says, "and the bills are astronomical."

Bowman of course can't pay the bills from the hospital, surgeon and anesthesiologist that turn up in the mail - she says she barely gets by as it is.

The good news is that things worked out for Bowman - there was a safety net in her case, and she got the medical care that she needed. It's not like she was turned away at the hospital door for not having an insurance card.

But the bad news is that there isn't always a Shepherd's Clinic available - it only can only afford to provide its services by limiting them to certain ZIP codes in the city.

And the worse news is, as the recently released census figures show, there are ever more people in Bowman's shoes, dependant on a catch-as-catch-can health care system for those without insurance.

As the Bible says, the poor ye always have with you. But here's something to think about as we head into the Labor Day weekend: another government report that I came across, this one released earlier this year by the Department of Labor, that shows another group whose numbers have been growing in recent years, to the point that there are now about 7.8 million of them. They are the working poor, people who work full time and yet still fall below the poverty line.

jean.marbella@baltsun.com

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