Homestead mailing list

[bobf <bobford79 AT yahoo.com>]

I know for many of us, fear of the loss of health care coverage is a primary 
concern.  I hate HMOs and I hate the idea of the federal government becoming 
mine and everyone else's HMO.  But, I don't know how we fix the problem.  
Even with insurance, my wife and I spend a significant amount on health care. 
 This article is geared toward people younger than most of us, but might be 
interesting to someone who has young adults as children or 
grandchildren................

--------------------------------------------------------------------------


For Uninsured Young Adults, Do-It-Yourself Health Care 

 Fred R. Conrad/The New York Times

Alanna Boyd, 28, received bills totaling $17,398 after being treated for 
diverticulitis at a Manhattan hospital in October. Ms. Boyd is one of the 
nation's 13.2 million uninsured young adults. 

CARA BUCKLEY

Published: February 17, 2009 

They borrow leftover prescription drugs from friends, attempt to 
self-diagnose ailments online, stretch their diabetes and asthma medicines 
for as long as possible and set their own broken bones. When emergencies 
strike, they rarely can afford the bills that follow.



Santiago Betancour, 19, outside the Community Healthcare Network’s mobile 
unit, which offers free medical consultations. He said he has started 
avoiding fast food in an effort to stay healthy. 

“My first reaction was to start laughing — I just kept saying, ‘No way, no 
way,’ ” Alanna Boyd, a 28-year-old receptionist, recalled of the $17,398 — 
including $13 for the use of a television — that she was charged after 
spending 46 hours in October at Beth Israel Medical Center in Manhattan with 
diverticulitis, a digestive illness. “I could have gone to a major university 
for a year. Instead, I went to the hospital for two days.”

In the parlance of the health care industry, Ms. Boyd, whose case remains 
unresolved, is among the “young invincibles” — people in their 20s who shun 
insurance either because their age makes them feel invulnerable or because 
expensive policies are out of reach. Young adults are the nation’s largest 
group of uninsured — there were 13.2 million of them nationally in 2007, or 
29 percent, according to the latest figures from the Commonwealth Fund, a 
nonprofit research group in New York. 

Gov. David A. Paterson of New York has proposed allowing parents to claim 
these young adults as dependents for insurance purposes up to age 29, as more 
than two dozen other states have done in the past decade. Community Catalyst, 
a Boston-based health care consumer advocacy group, released a report this 
month urging states to ease eligibility requirements to allow adult children 
access to their parents’ coverage. 

“There’s a big sense of urgency,” said Susan Sherry, the deputy director of 
Community Catalyst. She described uninsured young adults as especially 
vulnerable. “People are losing their jobs, and a lot of jobs don’t carry 
health insurance. They’re new to the work force, they’ve been covered under 
their parents or school plans, and then they drop off the cliff.”

If Governor Paterson’s proposal is approved, an estimated 80,000 of the 
775,000 uninsured young adults across New York State would be covered under 
their parents’ insurance plans. That would leave hundreds of thousands to 
continue relying on a scattershot network of improvised and often haphazard 
health care remedies. 

In dozens of interviews around the city, these so-called young invincibles 
described the challenge of living in a high-priced city on low-paying jobs, 
where staying healthy is one part scavenger hunt and one part balancing act, 
with high stakes and no safety net.

“For a lot of people, it’s a choice between being able to survive in New York 
and getting health insurance,” said Hogan Gorman, an actress who was hit by a 
car five years ago and chronicled her misadventures in “Hot Cripple,” a 
one-woman show that was a hit at last summer’s Fringe Festival. “There was no 
way that I could pay my rent, buy insurance and eat.”

Nicole Polec, a 28-year-old freelance photographer living in Williamsburg, 
Brooklyn, said she has attention deficit hyperactivity disorder and has a 
client who procures Ritalin on her behalf from a sympathetic doctor who has 
seen Ms. Polec’s diagnosis. Ms. Polec’s roommate, Fara D’Aguiar, 26, treated 
her last flu with castoff amoxicillin — “probably expired,” she said — given 
to her by a friend.

When Robert Voris last had health insurance, in 2007, he stockpiled insulin 
pumps, which are inserted under the skin to constantly monitor blood-sugar 
levels and administer the drug accordingly. He said the tubing for the pump 
costs $900 a month, so lately he has instead been injecting insulin with a 
syringe. But Mr. Voris, 27, a journalism student at the City University of 
New York who works at a restaurant in Park Slope, Brooklyn, is constantly 
worried about diabetes-induced seizures like the one that sent him to the 
hospital last summer. (Because it happened at work, his boss covered the 
ambulance and other bills.)

“That’s definitely the concern: what happens if I have to pay for this?” he 
said. “And the answer, I guess, is credit cards. Hopefully it won’t happen 
until I find a job that actually gives me insurance, which probably won’t 
happen anytime in the near future, given the way the economy works.” 

Most family insurance policies cut off dependents when they turn 19 or finish 
college, and many young adults start out in New York cobbling together 
part-time or freelance work with no benefits. To qualify for Medicaid, a 
single adult can earn no more than $706 a month — less than what a full-time 
minimum-wage earner makes. Yet the average insurance premium for a single 
adult is $900 a month, according to a spokesman for the State Insurance 
Department. 

“At this point, I can’t really justify it monetarily,” said Ian McElroy, a 
musician who moved to Bushwick, Brooklyn, from Omaha, last year. “It’s not 
like I think I’m invincible, I’m 29, the world can’t touch me. It’s the very 
opposite of that. I’ve got to make rent and eat.”

With insurance out of reach, Mr. McElroy has taken to playing doctor, using 
online resources like WebMD, which offers medical news, descriptions of 
various diseases and drugs, and discussion groups. As he spoke, Mr. McElroy 
was icing his feet, which, one day in January, had become cripplingly 
painful; he was unable to walk.

“I think I have plantar fasciitis,” he said. “I’ve been laid out for two 
weeks.”

(Even if the Paterson proposal passes, Mr. McElroy, like Mr. Voris and Ms. 
Polec and her roommate, would not qualify because their parents live out of 
state.) 

Internet diagnoses, self-medicating and trading prescriptions, of course, 
come with potentially dangerous side effects. Dr. Barbie Gatton, who has 
worked in emergency rooms throughout the city since 2002, said she often sees 
young people who have taken the wrong antibiotics borrowed from friends.

“We see people with urinary tract infections taking meds better suited for 
ear infections or pneumonia — the problem is, they haven’t really treated 
their illness, and they’re breeding resistance,” she explained. “Or they take 
pain medicine that masks the symptoms. And this allows the underlying problem 
to get worse and worse.”

There are clinics throughout the city that provide the young and uninsured 
free or cheap snippets of medical help, like the Community Healthcare Network 
mobile unit, which was parked in the East Village one snowy night. Lindsay 
Bellinger, 26, who does administrative work through a temp agency and lives 
in Astoria, Queens, said she relied on the mobile unit for pap smears and 
tests for sexually transmitted diseases.

“This takes care of gynecological work,” Ms. Bellinger said. “And I get a 
visit to the dentist from my parents as a Christmas gift.”

Levon Aaron, who has asthma and works as a bouncer at a West Village bar, has 
not had insurance since he was 19. Mr. Aaron, now 23, said that his asthma 
attacks had been less frequent since he began playing handball and working 
out, but they had not gone away. He tries to use his inhalers sparingly, but 
four times in the past year he has found himself out of medicine during a 
severe attack and landed in the emergency room.

In the hospital, he gets a prescription for a new inhaler, which costs about 
$30 to fill. But his outstanding bills total about $3,000, he said, an amount 
he cannot fathom paying. 

Mr. Aaron was one of several young adults who said living without insurance 
meant trying to take better care of themselves.

“I’ve stopped eating fast food,” said Santiago Betancour, who is 19 and lives 
in Rosedale, Queens. “I’m eating rice, vegetables and fruits. And when I get 
sick, I exercise to sweat it off.”

Of course, there are those who do feel invincible, like Eric Williams, who is 
24, unemployed and currently in the middle of a six-week snowboarding 
adventure in Wyoming, Montana, Colorado, Utah, British Columbia and 
California. Mr. Williams said by cellphone near Bozeman, Mont., that he 
looked into buying health insurance before he left, but abandoned the idea 
after being unable to find anything for less than $400 a month. Instead, he 
is just trying to be careful, though not always with success.

“I’ve hit a couple of trees,” Mr. Williams said. “But I’m trying not to.”




http://www.nytimes.com/2009/02/18/nyregion/18insure.html?hp