Close-up look at the uninsured
|
During the lunch hour, Dr. Katie Broner remembers the story of the teenage girl who came in with sore legs. The doctors are giving me a glimpse of the 45 million Americans who have no health insurance. It is the highest number ever, according to a U.S. Census Bureau report.
“She came from a working family that had no insurance,’ Broner says of the teenage girl.
“She was in here getting a physical and was complaining about pain in both legs. I said, ‘Let’s get an X-ray.’ It turned out she had been in a car accident awhile back and had hurt both legs. Her family didn’t want to go to San Francisco General because they had gone there once and got a $1,000 bill that they were still paying off.
“When the X-rays came back, I couldn’t believe it — both legs were fractured. This girl was walking around somehow on two broken legs.’
Then there was the guy a couple Mondays ago with an acute infection in the throat that can close off the airway.
“He waited through the weekend to come in here on Monday because he has no insurance and didn’t want to face a bill from the (San Francisco) General,’ Broner says. His condition was so dire by the time he arrived at St. Anthony’s that Broner had to call 911.
“I’m surprised he didn’t die,’ she says. The man ended up at S.F. General after all, courtesy of a pricey ambulance. His throat was drained and his airways cleared. Now, because he delayed treatment for fear of the medical bill, he faces an even higher one.
The number of Americans without health insurance climbed in 2003 for a third straight year, according to the Census Bureau report. It would be unfair, though, to place all the blame on employers.
Insurance premiums rose 14 percent last year, six times the rate of inflation. Experts say that health premiums have become a bigger financial burden for businesses than energy.
Employers have responded by hiring fewer full-time workers, cutting health benefits, or shifting more of the insurance costs to employees. Thus, some people face a choice that is no choice: Paying high insurance premiums or feeding their families.
In 19 states, parents who make as little as $9,300 per year earn too much to qualify for Medicaid. In most states, Medicaid isn’t available at all to adults who are neither parents nor disabled.
St. Anthony’s, one of several free clinics in San Francisco, handles 14,000 patient visits a year. This is its 48th year. The folks here say they would like be out of business before they finish another 48.
So how do we solve the health care crisis so their wish comes true? I don’t know. But we won’t get very far if our presidential candidates and media spend this valuable pre-election period obsessing about who did what in a war that ended 30 years ago.
The lunch hour is now almost over. The doctors still have paperwork to finish and sandwiches to eat before the doors are opened again. Health care issues are pretty boring. But the cabdrivers and laborers and bookkeepers waiting outside might have a different point of view.
Broner stands to return to her office. “The personal price they pay,’ she says, “is horrendous.’
Joan Ryan is a columnist for the San Francisco Chronicle. Her e-mail is joanryan@sfchronicle.com.