Published: October 08, 2006 12:59 am            

Going without health insurance leaves thousands stressed, at risk

FAIRMONT — Steve Santini works as a laborer but on his salary, he cannot afford premiums for the health insurance that his company offers.

Luckily for the Fairmont resident, he qualifies for treatment and prescriptions at Milan Puskar Health Right in Morgantown.

But there is a cloud in his silver lining.

“I’m getting a new position and some wage increases, and I’m going to go through a period of time where I make too much money to avail myself of Health Right’s services,” he said.

The raise will not be enough to allow him to afford the insurance premiums, either.

“That’s one of the cracks there.”

Santini, 59, takes a long-term prescription and does not know how he will be able to afford it after his salary goes up. But he expresses gratitude for all the help he has gotten from Health Right, which guided him through a bad period of his life.

“Now I’m a full-time employee and I pay taxes,” he said.

Santini is one of about 238,000 West Virginia residents who does not have health insurance, according to numbers provided by the West Virginia University Institute for Health Policy Research. Different statistics show that between 18 to 22 percent of state residents do not have health insurance.

Marion County’s rate is higher than that in both Monongalia and Harrison counties, too, with an uninsured rate of 22.8 percent compared to 19.3 percent and 18.2 percent in Mon and Harrison, respectively.

Karen Lantz, of Grafton, hates not having health insurance.

“You can’t just go to the doctor’s anytime you need to go,” she said.

She used to work as a home health aide before she had a car accident. But even when she worked, she could not afford the premiums.

“It was so expensive, I would have been working just to pay for health insurance,” she said.

Lantz has found a doctor who allows her to make payments when she does need care, and he even lowers his fees for her. But once when she needed a procedure, she had to scrape up $600 in cash before he would perform it.

“I was upset about it because I didn’t have the money,” she said. “Having to go beg and borrow, it degrades a person.”

Jo Baker of Fairmont suspects that doctors might have removed her gall bladder a few years ago if she had insurance.

“They decided it wasn’t that bad,” she said. “My stomach still hurts — I have to be careful what I eat.”

Baker also avoids going to the doctor unless an illness or condition gets really bad. Recently, she had the flu, but she decided to ride it out.

“A lot of people without insurance go to (the hospital) and don’t pay the bills,” she said. “That just ruins their credit.”

Some hospitals do not refuse anyone, although efforts are made to collect payment or find a way to cover those costs.

“We treat people regardless,” said Bill Case, director of public information for the Robert C. Byrd Health Sciences Center, speaking for WVU Hospitals in Morgantown.

In 2004, WVU Hospitals spent nearly $10 million on “charity care costs,” according to its Web site, www.health.wvu.edu.

The Web site also directs patients to an office where they can talk to financial counselors about payments, financial assistance and offering help applying for federal and state programs.

Kerri Myers of Anmoore just filed papers requesting to be treated at a different hospital through a charity program, “in case I ever get hospitalized or go to the ER,” she said.

She works as a respite therapist, but because she is considered an independent contractor, she does not qualify for health benefits.

Her three children, ages 6, 8 and 10, are covered under the West Virginia Children’s Health Insurance Plan (CHIP), but she has been struggling to get by without a plan.

She hopes that will change soon. She’s engaged to be married and wants to have another baby. Her fiancé has health insurance, but it would cost more than $400 a month to add a family to his policy.

“We’re not going to be able to do it,” she said.

If she cannot find insurance through a company that offers it to the self-employed, she probably will look for another job that provides benefits.

In the meantime, she worries about doctor bills and tries to avoid going herself when she can.

“I feel like I am letting my kids down by not having insurance,” she said. “I have to suffer through being sick. What if something happens to me? If I have an illness, I have to take money from my kids to pay for medicine.”

E-mail Mary Wade Burnside at mwburnside@timeswv.com.

        

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