Increase in uninsured adds urgency to care debate

Upstate groups say more residents seeking help with medical costs
The nation's uninsured — a growing class of people whose recession-fed ranks have swelled to 46.3 million — are central to the health care debate in Washington.

And questions about how and whether to get them covered are as vexing and emotional as they come.

Should those without health insurance be required to buy it, and should they receive government subsidies to help with the cost? Will they get coverage from private insurers or a new government program? And how much should they have to pay?

Nearly 60,000 adults in Greenville County were without health insurance last year, new U.S. Census Bureau data show, and that number is likely higher this year, experts say.

A total of 59,425 people between 18 and 64 were uninsured in 2008, while another 15,853 people younger than 18 had no insurance.

“That doesn't surprise me at all,” said Russell Stall, executive director of Greenville Forward, whose health assessment survey last year revealed that 37 percent of the county's residents were medically underserved. “I'll bet it's over half now.”

In Pickens County, 14,450 adults were uninsured, according to the census. United Way of Pickens County president Julie Capaldi believes those numbers are higher now.

“Somebody called this week, a working person, who broke a bone in her foot and needed to go to an orthopedic doctor but she couldn't afford to pay for the doctor because she had no health insurance and therefore couldn't go back to work,” she said. “And many more people are underinsured. They have an astronomical deductible. It might as well be a million dollars. It's a crisis.”

While Congress and the White House wrestle with finding answers, the uninsured say they are waiting scared.

Patrick Bruce, 61, of Isle of Palms, said the fact that he's been uninsured since his 2002 heart attack and triple bypass is “always in the back of my mind.”

He says he eats right, doesn't smoke and exercises — efforts he hopes will keep him healthy until he qualifies for Medicare in four years.

“I hope this health kick that I'm on works,” he said.

Others worry about missing cancer screenings that could save their lives or fear that one accident or serious illness will leave them with a lifetime of debt. Some wrestle with whether it makes more sense to save for retirement or pay for health insurance.

“We are the only democracy, the only wealthy nation that allows such hardship for millions of its people,” President Barack Obama told a joint session of Congress on Sept. 9, in an effort to jump-start his revamp of the health care system.

Obama has conceded that his plan wouldn't cover all of the uninsured. It also wouldn't provide insurance to illegal immigrants.

Republicans such as House Minority Leader John Boehner of Ohio argue that the government can't afford to spend up to $1 trillion on health care changes. But Obama has pushed for a government-run “public option,” saying such a program would help bring costs down for everyone by giving insurance companies some competition.

“Every day, 14,000 Americans lose their coverage,” Obama said. “It can happen to anyone.”

Numbers from the U.S. Census Bureau for 2008 illustrate the point. About 27 percent of adults age 18-34 are uninsured. About 13 percent of those 35 or older are also uninsured. More than half of the uninsured are minorities.

Being uninsured isn't just about being out of work: About 27.8 million people without coverage are working, either part or full time.

In South Carolina, Spartanburg County had 39,494 uninsured adults last year, Anderson County had 25,168, Oconee had 10,824, and Laurens County had 8,116, according to Census Bureau estimates.

Greenville Hospital System expects charity care to grow from $78.7 million to $88.2 million at least partly because of the economy.

Cannon Memorial Hospital saw a 33 percent increase in the financial assistance it provided to needy patients in the fiscal year ending in August, spokeswoman Amanda Dow said.

Greenville Free Medical Clinic has seen a 30 percent increase in patients in recent months, and almost half of them are new, said executive director Suzie Foley.

“I know that every day I arrive at work there are more people asking for help, many for the first time,” she said. “We're averaging between 35 and 50 new patients a week.”

Stall said Greenville Forward is particularly concerned about the newly poor who don't know how to navigate the system to find the care that is available. “That's a real challenge if you haven't been in the situation before,” he said.

Foley says free clinics hope there's some remedy in reform, whatever shape it takes.

“Nobody has a crystal ball to see what the final product looks like, but whatever it is, it won't be quick,” she said. “And we're seeing such increased demand right now and most plans discussed won't meet all the needs for all the people. There will still a vulnerable population that is without access to care.”

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