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  • From: bobf <bobford79 AT yahoo.com>
  • To: homestead AT lists.ibiblio.org
  • Subject: [Homestead] Health care article from today's NYT front page
  • Date: Wed, 18 Feb 2009 04:30:54 -0800 (PST)

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................

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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







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