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COVER STORY:
Medically Uninsured
October 31, 2003    Episode no. 709
Read This Week's November 7, 2008
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BOB ABERNETHY, anchor: Now, a special report. All over the U.S., the costs of health care have been going up so fast companies, big and small, have had to cut back or cut out medical coverage for their workers, and insurers have raised health care premiums -- an average of 22 percent this year. That is more than many low-income employees can afford, so the total number of Americans with no health insurance at all is now more than 43 million.

In Baltimore, Maryland, Lucky Severson translated those overall numbers into individual stories, beginning with a disabled homeless man named Dave Scheihing.

LUCKY SEVERSON: Dave Scheihing is living an American nightmare, one that began in circumstances many Americans find themselves in.

Photo of Dave Scheihing DAVE SCHEIHING: I was working and I didn't have insurance, and I got sick.

SEVERSON: Six years ago, 31-year-old Dave Scheihing was working at McDonald's when he was disabled with a series of strokes. Because he had no insurance, within two years, he owed the hospital almost $70,000.

(to Mr. Scheihing): What happened then?

Mr. SCHEIHING: I was paying on it but I had to sacrifice either rent or prescriptions, and I couldn't pay on bills when I was paying for prescriptions. So eventually I lost my home.

SEVERSON: For the past several years, Dave Scheihing has been living in and out of homeless shelters, which he says are generally unsafe and drug-ridden. So he spends most nights on the street. He will not forget the blizzard of 2002.

Mr. SCHEIHING: It was a miserable experience. I mean, walking around wet, smelling. People don't want to be associated with you. I just really wanted to be left alone. I was just so miserable. I couldn't get the bills paid. I couldn't get ahead. I couldn't get a job. This is where I sleep, right here.

Photo of Scheihing on street SEVERSON: This is his latest street home in downtown Baltimore.

Mr. SCHEIHING: It gets cold at night because the floor is marble. It gets cold.

SEVERSON: Through it all, he says, he has continued to pay collection agencies.

Mr. SCHEIHING: Whenever I had a job, if it was nothing more or nothing less than $5 or $10 -- whatever -- I paid on that bill.

SEVERSON: Dave Scheihing may be an extreme example of the cruel consequences of being uninsured, but his predicament is not unique. Consider this -- eight out of 10 people without health coverage come from working families, but their job doesn't come with health insurance or they can't afford it, so they are vulnerable.

Getting health care is less of a problem for the poorest in America, because many are covered by Medicaid and other government programs. Those hurting the most are low- and middle-income workers. Ron Pollack, with Families USA, says many Americans have the wrong picture of those who are uninsured.

Photo of RON POLLACK RON POLLACK (Families USA): A lot of people think, thought, well, the uninsured are poor, they're lazy, they are minorities -- who knows what the pejorative term might be? The reality is ... the overwhelming majority of people who are uninsured are in working families. The stereotype about the uninsured is way off.

Unidentified Man: Mom, you give consent right here. And your current employer?

CHRISTIE LILES: Self, I clean houses.

SEVERSON: Christie Liles is married with three children. Her oldest daughter works a full-time and part-time job and still can't afford health insurance. Her husband is trying to start a new company.

Ms. LILES: None of us have insurance right now. So until he gets going with that and I am only cleaning houses -- so until we can afford the price of insurance, because I heard it is a thousand a month right now, so you know we can't afford that.

SEVERSON: She brought her youngest son Jordan, with a high fever, to this clinic in Orlando, called Shepherd's Hope, one of several operated by St. Luke's Lutheran Church. The Reverend Brian Roberts says volunteer doctors treat 15 to 19 patients at this clinic one night each week, and could treat more if more doctors were available.

Photo of BRIAN ROBERTS Reverend BRIAN ROBERTS (St. Luke's Lutheran Church): Our Lord has called us to love our neighbors as ourselves and to recognize that there is a moral call to assist those who have a need, and this is clearly a need.

Ms. LILES: This is my last one I got to look after. He's in high school.

SEVERSON: (to Ms. Lilies): Well, that must be a worry?

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Ms. LILES: It is a worry. It's horrible, right. I did sign up for the school insurance, but that is only accident insurance if he got hurt in school or in a sport.

SEVERSON: The number of uninsured Americans rose last year to over 43 million. That may be one reason polls show that 60 percent of Americans "worry" that they will find themselves without insurance sometime in the future.

Mr. POLLACK: The situation is getting worse. First, health care costs are rising very rapidly. Secondly, more and more employers are passing on those costs on to their employees, who increasingly find those costs unaffordable. Third, the unemployment rate is high. And since most people get their health coverage through their jobs, if they are unemployed, they're less likely to have health coverage. All those things are resulting in huge increases in the number of people who are uninsured.

SEVERSON: Even in places like Orlando, where most everyone wears a smile, many companies are either passing health costs on to employees or reducing or dropping employee coverage altogether.

Photo of CARLOS VELEZ Dr. Carlos Velez is one of the volunteer doctors at St. Luke's clinic. He says he donates his services because he realizes that but for the grace of God, he could be in the same situation.

Dr. CARLOS VELEZ (Volunteer Doctor, Shepherd's Hope): It's probably a way of helping and paying back. I'd probably be in a similar situation too. I think there is a need out there.

SEVERSON: Dana Andrews is afraid her father will lose his construction job if he gets much sicker. He's been too embarrassed to seek help, until she finally persuaded him to come to St. Luke's clinic.

Photo of DANA ANDREWS DANA ANDREWS: He is a hard worker and committed to his job and, you know, works Monday through Friday. And just can't afford medical insurance. I mean, he is very embarrassed, and rightfully so.

SEVERSON: The Institute of Medicine estimates that 18,000 uninsured Americans die needlessly each year because they can't afford to see a doctor when they're sick.

Photo of hospital ER So many sick, uninsured Americans are crowding emergency rooms, where they are rarely denied treatment, an increasing number of community hospitals are closing down under the financial burden. And for those who do end up in an emergency room, and then a hospital bed, like Dave Scheihing, the bills keep coming -- if not from the hospital, from the collection agencies.

But lately things are looking up. Dave got a job with a local church that helps feed Baltimore's homeless, writing grant applications. And he has been questioning some of those hospital bills.

Mr. SCHEIHING: I started asking for itemized lists on these bills and to explain to me what a mucus retrieval kit is. Because I don't remember having one, and so then they would have to explain to me what it was.

SEVERSON (to Mr. Scheihing): And it is?

Mr. SCHEIHING: It was a box of Kleenex.

SEVERSON (to Mr. Scheihing): $200?

Mr. SCHEIHING: They charged me $200 for a box of Kleenex.

SEVERSON: The hospital said it was an error, but Ron Pollack with Families USA says even with no errors, the uninsured often pay more for medical care than the insured.

Mr. POLLACK: If you are insured, then your insurance company may well have some arrangement with the provider that's designed to keep the costs down. And, of course, if you're not in a group you don't get the benefits of the economies of scale or any kind of bargaining that has been done on your behalf. So the irony is that people who are uninsured normally pay higher prices than people who are insured.

SEVERSON: So far, Dave has found 42 errors in his hospital bill, amounting to thousands of dollars. With the errors, and the $23,000 he has paid so far, his overall medical debt has been reduced to about $14,000.

Mr. SCHEIHING: I feel that there is definitely light at the end of the tunnel. I can see myself getting out of this situation.

SEVERSON: He says he prays every night for a national health plan that will cover all Americans, and he's probably not alone. Recent polls show that an increasing number of Americans favor some sort of universal coverage, even if it means higher taxes.

For RELIGION & ETHICS NEWSWEEKLY, I'm Lucky Severson in Baltimore.

ABERNETHY: Things have indeed begun to look up a little for Dave Scheihing. He still owes many thousands in medical bills, but he has found an apartment he can rent.

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