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Financial ruin is too often the companion of illness

When I first met him two years ago, Ernie Follett was an upbeat 70-year-old who wanted to help develop safe recreational programs for teen-agers who live in the East Lake area of Pinellas County.

We served on a committee together, and I soon learned that Ernie was a man who had no patience with roadblocks. Hand him a situation stalled at a roadblock, and Ernie would go over it or around it or tunnel under it to get things moving.

Last week I saw Ernie again for the first time in a year. He was bruised and hurting from too many collisions with a roadblock he can't conquer. And though he tried hard to sound optimistic, the Ernie I saw was clearly afraid of the future.

Ernie Follett is going to die. He knows it, he just doesn't know when. He has congestive heart failure, which means his heart can't do its job. He tires easily and is short of breath. His lungs fill with fluid. He has had heart attacks and seizures. Last summer he endured prostate cancer and radiation treatments.

Ernie is being kept alive by a smorgasbord of prescription drugs. He handed me a list of 14 drugs and other medical products he uses, most of them daily. One day the medicines will no longer do the job. Then he will have to loosen his tenacious grip on life and slip away.

But he doesn't want to die just because he doesn't have money in the bank to buy medicine. And that's what is about to happen.

Ernie Follett is caught between the cracks in America's health-care delivery system. He apparently makes just enough money not to qualify for Medicaid or other assistance programs. But he doesn't make enough to pay for the $600 worth of prescription drugs he must buy each month if he wants to continue living.

Before he got sick in late 1989, he had thousands of dollars in the bank. He lived in a condominium with a golf course view. He drove a Cadillac. Life was sweet, and he shared a lot of his good fortune with others through volunteer work for several charities. He had no reason to believe that ruin lay down the road.

Today his money is gone. So is the Cadillac, replaced by less luxurious transportation. So is the golf course view. Now he has a less expensive condominium. He and his 68-year-old wife, Diana, limit themselves to $50 a week for food, and they live simply. Still, his Social Security check and the salary his wife earns at a department store aren't enough to pay the bills. There is a lien against his home. He owes $40,000 to hospitals and doctors. Last week he and Diana visited a counseling service to get some help with a budget, but they still don't have enough money to buy all of Ernie's medicine.

Ernie assumed that somewhere there would be help for him. He was wrong. He called everywhere. He sat through hours-long interviews, filled out voluminous applications, even enlisted the help of U.S. Rep. Michael Bilirakis, R-Palm Harbor. I spent two days on the telephone following leads with no success.

I found that there are lots of desperate people like Ernie, but not all of them are sick. Some of them are the administrators of government assistance programs or free clinics that don't have enough money for everyone. They are crying along with the clients they are having to cut loose, knowing those clients may die without help.

Just last month, 1,145 people in the Pinellas-Pasco district of the Department of Health and Rehabilitative Services (HRS) were notified that they no longer are eligible for benefits that had paid for their medicine and their transportation to treatment facilities. The state Legislature cut the financing.

"We had people calling up in tears," said Noreen Hemmen, an HRS program supervisor. "We had people saying they might as well commit suicide. There is nothing we can do."

There are a couple of things that would help increase Ernie's chances of qualifying for assistance. He could get rid of everything he owns. Or his wife could quit her job. But Diana has some health problems, too, and needs the health benefits her job offers. And Ernie can't stand the thought of Diana being left with nothing when he dies.

One of the people I contacted on Ernie's behalf had some advice for him: Commit a crime. In jail you will be given your medicine. When you get out, commit another one.

Ernie already has thought of that. It is only one of the macabre ideas that have come to him during sleepless nights. He also is thinking about skipping pills. He wonders how many he can miss without winding up back in the hospital and making his financial situation worse.

He's a proud man, but he cries a lot now. He grapples with when and how to let go of life.

"I don't want to give up," he says. "I've got too good a life to give up."

I wish the Washington politicians could feel Ernie's pain. I wish people who look down on those who need help, people who think they always will be able to pay their own way, could hear Ernie's story.

In God's name, how long can our society continue to let people suffer so?

Diane Steinle is editor of editorials for the North Pinellas editions of the St. Petersburg Times.