UNINSURED IN INDIANA
May 16, 2000

A joint survey between The NewsHour with Jim Lehrer and the Kaiser Family Foundation uncovers surprising facts and misconceptions about the uninsured. Health Correspondent Susan Dentzer travels to Indiana talk with people living without health insurance. The Health Unit is a partnership with the Henry J. Kaiser Family Foundation.

A Health Spotlight Report: Uninsured in America. May 23, 2000: Insuring Our Children in Indiana. May 16, 2000: Uninsured in Indiana. Take a Quiz Insuring Our Children A Historical Timeline State-by-State Kaiser/ NewsHour Survey: The Full Survey Survey Highlights Extended Interviews: Governor Frank O'Bannon Nancy Cobb Dr. Nancy Swigonski.     A Health Spotlight Report: Uninsured in America. The NewsHour's Health Spotlight. Browse the NewsHour's coverage of Health     The Kaiser Family Foundation The National Coalition on Health Care	SUSAN DENTZER: These are some of the faces and voices of America's fastest growing group of disadvantaged: The more than 44 million people without health insurance. SHANNON SANDERS: It kind of does make you feel -- as least me feel, you know, a little bit ashamed, like "I'm not as worthy as somebody else because I don't have health insurance." ROB SANDERS: You should be able to go to the doctor, if you need to go to the doctor. MYRTLE MacINTOSH: I may have to go to the emergency room, but I had to really, really, really be almost deathly sick before I go, because I know that that's going to be another bill coming to my house that I don't have the money to pay for. SUSAN DENTZER: Myrtle Macintosh, Shannon and Rob Sanders, they're from Indiana, where roughly one in seven citizens under age 65 does not have health insurance. Indiana Democratic Governor Frank O'Bannon says that shouldn't be the case, and he's appointed a commission to examine the problem. GOV. FRANK O'BANNON, (D) Indiana: Everyone should have insurance. It's a foundation for a productive, for a healthy community, for a safe community, and if we don't address those health care needs, then we'll be addressing problems later on. SUSAN DENTZER: For the past decade, the number of Americans without health insurance has been rising by about one million people a year. A new poll by the Henry J. Kaiser Family Foundation, in partnership with The NewsHour, shows that Americans are clearly concerned. More than half of those surveyed said they personally know someone who doesn't have health insurance. At the same time, many are confused about just who is uninsured. They wrongly believe that most of those without insurance are unemployed. But, in fact, more than eight in ten of the uninsured nationwide are workers, or their dependents. In Indiana, roughly 700,000 people are without health coverage, in a state whose total population is nearly six million. And that's true, despite the fact that for the past decade, just about everything in Indiana has gone right. For example, a booming economy has driven the unemployment rate to just 2.5 percent. Welfare reform has sent many back to work, and cut the number of those on welfare to just 20,000. But many who now have jobs don't have health insurance. That's typically because their employers don't offer it, or because their pay is so low they can't afford to buy it. Tamika Hughes is one of those people.
	Affording health insurance
	TAMIKA HUGHES: If I'm going to have insurance, I want to pay a reasonable amount. That is, not all my income is now going towards the health insurance, where it's going to make me live check-to-check. SUSAN DENTZER: Hughes is 28 and a single mother. She earns about $25,000 a year in her job at the Indiana Parent Information Network. That's a nonprofit agency that helps families of children who are disabled, or have other special needs. But the agency can't afford insurance coverage for its own workers. DONNA GORE OLSEN: It's demoralizing, in the kind of work that we do. That's what we do... We try to get health insurance for families. SUSAN DENTZER: The agency's executive director, Donna Gore Olsen, is frustrated. DONNA GORE OLSEN: The problem for a small employee group, particularly one that's not-for-profit, is that the rates are so high, and then you add to the mix, that out of the 15 employees, ten of our employees have children with special needs. SUSAN DENTZER: As a result, when the agency tried to obtain coverage for its workers last year, it got a rude shock. DONNA GORE OLSEN: We were told that in the cheapest plan that we could find, it would be $800 a month per employee family. TAMIKA HUGHES: This cost what, $225? SUSAN DENTZER: Tamika Hughes's son Travon has asthma, and is on several medications. Fortunately, his care is covered by a state program for children. Not so Tamika's when she's ill. TAMIKA HUGHES: If I'm sick, then the bills don't get paid, because I don't get paid. I try to go to work, and if I can't, I stay home, but I have no doctor. I mean, $45 for the visit and then, you know, additional for meds if I have to have antibiotics, so I really just play doctor at home.
	Temporarily without insurance
	SUSAN DENTZER: Shannon and Rob Sanders represent another group of the uninsured. For them, being without health insurance is a temporary glitch amid a transition. The Sanders recently moved from Seattle to the Indianapolis area and bought a new home, a fixer-upper. Rob Sanders, a former Marine, found a $15-an-hour job as a contract worker for a temporary agency. He chose not to take the expensive, but minimal, health insurance that the agency offered. Meanwhile, Shannon, a former Navy criminal investigator, had a pre-cancerous cyst removed last summer. She now sees a doctor every three months to check on any recurrence. SHANNON SANDERS: And that gets kind of expensive. That cost me $66 for each office visit, plus about $300 to $400 for the lab fees. SUSAN DENTZER: What's more, the Sanders's four-year-old son, Kyle, needs to have tubes removed from his ears that were placed there several years ago to combat chronic ear infections. But finding a doctor who will do the job has proved futile. SHANNON SANDERS: We can't find a doctor to actually see him, because we don't have health coverage, and even if we did, it would still cost us $3,000 to $4,000 to have the tubes taken out of his ears. SUSAN DENTZER: Rob Sanders has now been hired by EDS, a computer services company, but at less pay than he earned as a temporary worker, and the benefits he's now eligible for are expensive: $300 a month for family health coverage, with a $1,000 annual deductible. Still, the Sanders are buying the coverage for fear of what could befall them without it. ROB SANDERS: One major catastrophe, and we could lose the house, everything. It's not a good thing. SUSAN DENTZER: In contrast to the Sanders, there are millions for whom being without insurance is a long-term problem. According to the Kaiser/NewsHour poll, nearly six out of ten uninsured adults said they've been without coverage for more than two years. Tonya Alvarez is one of them.
	Off Medicare, without insurance
	SUSAN DENTZER: Alvarez, age 32, is a mother of four, and a former welfare recipient. She is now paid about $15,000 a year by the state to care for children in her home. She's been without health insurance since she went off welfare and Medicaid almost eight years ago. Since then, a cascade of medical calamities has profoundly changed her life. TONYA ALVAREZ: In 1994 I was in a car wreck. Basically, the man hit me, and no broken bones, nothing like that, but I tore the soft tissue in my lower back, and that's when everything just changed. SUSAN DENTZER: Years of profound physical pain followed, along with what was eventually diagnosed as a major depression. Her illnesses ultimately forced her to turn over custody of two of her children to her ex-husband. TONYA ALVAREZ: It was absolutely the darkest time of my life. SUSAN DENTZER: Alvarez soon found her way to a local clinic for the uninsured. With the help of medication and a therapist, the depression lifted. But she now owes the clinic about $500 for treatment. SUSAN DENTZER: How do you feel about not having insurance? TONYA ALVAREZ: I hate it. I hate it, because there's no security. There's no net to catch you when you fall. Sometimes I have got my prescription from Dr. Larosa and couldn't fill it for two or three days. Why? Because I didn't have the money. You know, it's embarrassing. SUSAN DENTZER: To find out how other uninsured people feel, we organized a discussion at Tonya Alvarez's Indianapolis church, the New Life Community Church of Truth. The dozen congregants who attended spoke at length of the strains of being uninsured. Kimberly Britt has three children and works two part-time jobs: For a cellular phone company and as a home health aide. KIMBERLY BRITT: I have too many outstanding bills, and that's just since I've been here in Indianapolis. It's more than a few hundred bucks. It's a whole lot of money. Matter of fact I wanted to file bankruptcy just to get it off my credit.
	Challenges facing single mothers
	SUSAN DENTZER: They spoke of a pervasive sense of injustice, that by working, they were playing by the rules, but the rules weren't rewarding them with health insurance. CRYSTAL BURKE: I'm 21 years old, and I have a daughter. She just turned six. And you know, like I say, I'm going to school. I go to school full-time. I'm in college and I graduate in May, thank God. You know, I work part-time, but it seems like the more you try to do what the government wants you to do, the more difficult they make it for you to get ahead. I mean, I... several times, I went to apply for Medicaid, and every time I went they turned me down. Every time I went they turned me down. SUSAN DENTZER: Crystal, do you know why? CRYSTAL BURKE: The first time they said I made too much, and I was only working part-time, making $6.50 an hour. HENDRICKS: You can't squeeze blood from a turnip. You know, you can't make me... You gonna make me live on the street over a $100 medical bill? And they want their money. They don't care if you have a newborn baby, and stuff. They want their money. They want their $100, even if you only made $130. SUSAN DENTZER: Americans clearly feel that the situation facing the uninsured is unjust. According to the Kaiser-NewsHour poll, more than eight out of ten think health care should be provided equally to everyone. At the same time, though, far fewer Americans are willing to do much to solve the problem. Only about four out of ten said they would pay $50 a month in higher insurance premiums, or taxes to cover the uninsured. And two out of ten Americans aren't willing to pay anything. We asked our church group what they thought it would take to persuade more people to take their plight seriously. MYRTLE Macintosh: If they would stop looking at us as numbers and look at us as people, then... and, you know put themselves in our positions…that we have to go from home to the emergency room and have to sit five or six hours, you know, don't have no insurance, and experience what we experience, then maybe they could see what we're talking about. SUSAN DENTZER: Indiana's Commission on the Uninsured is expected to issue a report and recommendations in about a year.