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Partners

August 16, 2004

E-mail story

Print

No insurance is a roll of the
dice

Photos

Stricken

(Lawrence K. Ho / LAT)

Related
Stories

More
choice, at a cost

August 16, 2004

Times
Headlines

Industry
Scrambles to Ease Pump Pain

Ready
or Not, Missile Defense

No
insurance is a roll of the
dice

For
HDTV, an Ad Campaign of Olympic
Proportions

O.C.
Treasurer Warns County of Pension
Risk

more
>

By
Daffodil J. Altan, Times Staff Writer

When Jenna Zies moved to Sacramento, she took a few
temporary jobs, then found work as a substitute teacher. The job
didn't come with health insurance, and she figured she could go
without coverage for a while.

"I looked into [insurance] but
thought it was just too expensive for me to afford," said the
27-year-old, who was spending most of her money on rent,
transportation and school loans. "I was 25. I didn't think I would
have a health crisis."

She was wrong — as are many Americans
who count on remaining healthy while they don't have medical
insurance.

One afternoon in December 2001, Zies was talking to a
student when her words came out in an incomprehensible garble, "like a
backward tape recorder." Then, she said, her left arm went
numb.

After two days of trying to cope with the symptoms on her
own, she drove herself to the hospital emergency room, "not thinking
about the costs because I was so scared." The preliminary diagnosis:
a mild stroke. Her trip to the emergency room left her with a $3,000
bill.

Zies was among an estimated 54.8 million working
Americans who were without insurance for at least three months
during 2002 and 2003, according to a recent study by Families USA, a
Washington, D.C.-based health policy advocacy group that supports
healthcare reform.

Although this is a diverse group of
working Americans, many are finding themselves wrestling with the
same question: How important a priority is health insurance among
all of life's expenses?

For many, the consequences of going
without health insurance don't seem as immediate as cutting back on
grocery bills, going without car insurance, or missing a rent or
mortgage payment. So they decide to take a chance — a calculated
risk that they won't face a serious and costly health crisis — and
forego health coverage for months or years at a time.

The most
likely group to take that chance are young — and relatively healthy —
adults ages 18 to 24, according to the Families USA survey. The second
most likely group to forgo insurance is people ages 25 to
44.

"In terms of figuring bills out, young people feel like
they're less likely to be sick. They have a tougher time getting
coverage in the workplace and paying for it on their own," said Ron
Pollock, executive director of Families USA.

The statistics
run counter to the image still held by some Americans that the
uninsured are mostly poor, nonworking people. Indeed, it is
estimated that more than 80% of the nation's uninsured are
employed.

"There's no question that this problem is reaching deeper
into the middle class and working families," Pollock said.

In
California, one out of five people under age 65 is uninsured at some
point during a typical year, said Richard Brown, director of the
UCLA Center for Health Policy Research. In fact, most Californians
probably have a family member, friend or co-worker who lacks health
insurance, though they may not always be aware of it. "You may not
know it if they haven't talked about it or if something catastrophic
hasn't happened," Brown said.

With the cost of health
insurance and prescription drugs on the rise, employers are shifting
more of the cost to workers while scaling back benefits — or, in the
case of many small businesses, eliminating coverage altogether. As a
result, many workers — nannies and substitute teachers, artists and
skilled laborers — are finding themselves in hospital emergency
rooms without health insurance.

Which is where Zies found
herself.

The emergency room doctors told Zies she had most
likely suffered a mild stroke. She needed to see a specialist, they
said, and undergo more tests. "I knew I couldn't afford those tests," Zies
said.

When the bill came, she realized she'd have to get
insurance. However, Zies had difficulty finding insurance because of
her health situation. After two months of looking, she found a plan
and received the MRI and the treatment she needed.

Eric
Moore, 33, of Los Angeles has a similar tale. In 2002, Moore, a
recent UCLA graduate, was earning $7 to $10 an hour working as a Web
page designer. His part-time jobs didn't offer health benefits, and
a private insurance policy would have cost him about $125 a month,
which he thought he couldn't afford.

"I just didn't think,"
he said. "I thought I'd be OK."

Then, one day, Moore
developed pain in his leg. Because he lacked insurance, he didn't see a
doctor right away. A month later, he was in the emergency room with a
massive blood clot in his leg.

In hindsight, the insurance
would have been a bargain compared with the $14,000 bill he faced
after a four-day hospital stay to treat a pulmonary embolism. Unable
to find full-time work, Moore has moved back in with his mother, who
gave him $2,000 to help with the bill. He is slowly paying off the
remaining $12,000 with income from temporary jobs.

For the 5
million working Californians without health insurance, the options
for finding affordable coverage are scarce. Those without chronic
medical conditions that might result in an insurer denying them
coverage can opt for what's known as "catastrophic" insurance plans,
which cost a few hundred dollars a month, don't cover routine doctor
visits or prescriptions, but do cover things like stays in a
hospital's intensive care unit.

Several Internet-based
companies, such as eHealthinsurance.com and Insure.com, allow people
and small businesses to compare prices for a range of plans from
different carriers. Most insurance companies also offer short-term
insurance (usually for a minimum of six months), which people can price
for themselves on their Internet sites. A site operated by Georgetown
University's Health Policy Institute at http://www.healthinsuranceinfo.net/
has information for all 50 states on the types of insurance and what
to do in case of serious illness.

This is "something that
touches so many people and affects them at one time or another,"
said UCLA's Brown, whose daughter, a self-employed artist, went
without health insurance for several years until she injured her
back. She finally managed to get coverage shortly before her
herniated disc ruptured and she went in for surgery — an event that
would have put her in severe debt without insurance.

If you want other stories on this
topic, search the Archives at latimes.com/archives.

Article
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