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No health insurance and headed for poverty

Published Oct. 9, 2005

The health care crisis is nothing new to Janice Walker. She ran into it 19 years ago with the birth of her son, LaRue Nickelson.

LaRue was born with a cleft lip. He went on to develop scoliosis, epilepsy, a heart murmur, hearing, orthodontic and speech problems. He has had 26 operations and could face more. He also needs psychiatric treatment for the emotional problems caused by his medical conditions.

Once a $33,000-a-year grocery store executive with excellent benefits, Walker has been riding the same recessionary cycle of employment and joblessness that millions of Americans have come to know.

Currently, Walker is unemployed and has no insurance. Because of her son's problems, she says she can't get an individual policy at any price. And Walker has an added challenge: If she takes a job that does not offer health benefits, her income will make her son ineligible for the state medical program.

Even when she had a good job and insurance, medical expenses ate up at least one-fourth of her take-home pay.

"It used to be manageable but miserable," she said. "Now, I really can't tell you how we're going to make ends meet."

Janice Walker and her son illustrate how the health insurance crisis has pushed some Americans into poverty.

They are the kind of family President Clinton talks about when he says Americans shouldn't have to choose between their jobs and their health benefits. He has stressed the need for "portability" _ meaning that Walker could move from one job to the next without fear of losing coverage.

The Clinton plan would emphasize primary and preventive care, something that Janice Walker doesn't have now. It also is likely to offer security for LaRue. A gifted jazz guitarist and student at St. Petersburg Junior College, he wants to make music his career. But, as his mother notes, music jobs usually don't come with group insurance. Under the Clinton plan, he could buy insurance at a price tailored to his income.

But Walker, who favors a single-payer system similar to Canada's, says her experience in the business world makes her think that being forced to cover employees' health care could force businesses to eliminate jobs. While she thinks her health insurance situation could improve under the Clinton plan, she's not so optimistic about her employment prospects.

A lot of Americans have similar fears. But the White House spokesman for health reform, Bob Boorstin, said warnings of job loss from the reform plan are exaggerated. Health reform could just as easily trigger job growth, he said, as insurance cost controls make hiring more affordable and the security of permanent insurance encourages people to start their own businesses.

Supporters of changing the health care system say one of the system's worst features is that it discourages people from working _ people like Janice Walker.

Currently, the state Children's Medical Services program pays for LaRue's treatments related to his cleft lip because Walker's income _ $200 a week in unemployment benefits _ is so low. They also qualify for the state's Medically Needy program, but only in months when their medical costs exceed $588.

Walker, 42, does not get Pap smears, mammograms or dental care, even though she is losing her teeth to advanced periodontal disease. When she is ill, her only recourse is the emergency room.

Last year, her son's medical bills totaled $19,000. Since she had a job with the federal Resolution Trust Corp. for most of the year, insurance paid $15,000 of that. But the RTC office here closed this year, and she lost her job and the benefits.

Walker says her best hope is for a federal government job she has applied for that would start in the fall. The pay is lower than what she has made before, but the government health plan covers pre-existing conditions, she said.

In the meantime, Walker does her best to get by and insists on paying her bills, however slowly. But she shakes her head at the futility of the situation.

"I send $5 a month to everyone," she said. "Do you know what it must cost them to handle all those $5 checks?"