[Marxism] For Uninsured Young Adults, Do-It-Yourself Health Care (NY Times)

["farmelantj@xxxxxxxx" <farmelantj@xxxxxxxx>]

February 18, 2009
For Uninsured Young Adults, Do-It-Yourself Health Care
By CARA BUCKLEY

www.nytimes.com/2009/02/18/nyregion/18insure.html

They borrow leftover prescription drugs from friends, attempt to self-diagnose 
ailments online, stretch their diabetes and asthma medicines for as long as 
possible and set their own broken bones. When emergencies strike, they rarely 
can afford the bills that follow.

âMy first reaction was to start laughing â I just kept saying, âNo way, 
no way,â â Alanna Boyd, a 28-year-old receptionist, recalled of the $17,398 
â including $13 for the use of a television â that she was charged after 
spending 46 hours in October at Beth Israel Medical Center in Manhattan with 
diverticulitis, a digestive illness. âI could have gone to a major university 
for a year. Instead, I went to the hospital for two days.â

In the parlance of the health care industry, Ms. Boyd, whose case remains 
unresolved, is among the âyoung invinciblesâ â people in their 20s who 
shun insurance either because their age makes them feel invulnerable or because 
expensive policies are out of reach. Young adults are the nationâs largest 
group of uninsured â there were 13.2 million of them nationally in 2007, or 
29 percent, according to the latest figures from the Commonwealth Fund, a 
nonprofit research group in New York.

Gov. David A. Paterson of New York has proposed allowing parents to claim these 
young adults as dependents for insurance purposes up to age 29, as more than 
two dozen other states have done in the past decade. Community Catalyst, a 
Boston-based health care consumer advocacy group, released a report this month 
urging states to ease eligibility requirements to allow adult children access 
to their parentsâ coverage.

âThereâs a big sense of urgency,â said Susan Sherry, the deputy director 
of Community Catalyst. She described uninsured young adults as especially 
vulnerable. âPeople are losing their jobs, and a lot of jobs donât carry 
health insurance. Theyâre new to the work force, theyâve been covered under 
their parents or school plans, and then they drop off the cliff.â

If Governor Patersonâs proposal is approved, an estimated 80,000 of the 
775,000 uninsured young adults across New York State would be covered under 
their parentsâ insurance plans. That would leave hundreds of thousands to 
continue relying on a scattershot network of improvised and often haphazard 
health care remedies.

In dozens of interviews around the city, these so-called young invincibles 
described the challenge of living in a high-priced city on low-paying jobs, 
where staying healthy is one part scavenger hunt and one part balancing act, 
with high stakes and no safety net.

âFor a lot of people, itâs a choice between being able to survive in New 
York and getting health insurance,â said Hogan Gorman, an actress who was hit 
by a car five years ago and chronicled her misadventures in âHot Cripple,â 
a one-woman show that was a hit at last summerâs Fringe Festival. âThere 
was no way that I could pay my rent, buy insurance and eat.â

Nicole Polec, a 28-year-old freelance photographer living in Williamsburg, 
Brooklyn, said she has attention deficit hyperactivity disorder and has a 
client who procures Ritalin on her behalf from a sympathetic doctor who has 
seen Ms. Polecâs diagnosis. Ms. Polecâs roommate, Fara DâAguiar, 26, 
treated her last flu with castoff amoxicillin â âprobably expired,â she 
said â given to her by a friend.

When Robert Voris last had health insurance, in 2007, he stockpiled insulin 
pumps, which are inserted under the skin to constantly monitor blood-sugar 
levels and administer the drug accordingly. He said the tubing for the pump 
costs $900 a month, so lately he has instead been injecting insulin with a 
syringe. But Mr. Voris, 27, a journalism student at the City University of New 
York who works at a restaurant in Park Slope, Brooklyn, is constantly worried 
about diabetes-induced seizures like the one that sent him to the hospital last 
summer. (Because it happened at work, his boss covered the ambulance and other 
bills.)

âThatâs definitely the concern: what happens if I have to pay for this?â 
he said. âAnd the answer, I guess, is credit cards. Hopefully it wonât 
happen until I find a job that actually gives me insurance, which probably 
wonât happen anytime in the near future, given the way the economy works.â

Most family insurance policies cut off dependents when they turn 19 or finish 
college, and many young adults start out in New York cobbling together 
part-time or freelance work with no benefits. To qualify for Medicaid, a single 
adult can earn no more than $706 a month â less than what a full-time 
minimum-wage earner makes. Yet the average insurance premium for a single adult 
is $900 a month, according to a spokesman for the State Insurance Department.

âAt this point, I canât really justify it monetarily,â said Ian McElroy, 
a musician who moved to Bushwick, Brooklyn, from Omaha, last year. âItâs 
not like I think Iâm invincible, Iâm 29, the world canât touch me. Itâs 
the very opposite of that. Iâve got to make rent and eat.â

With insurance out of reach, Mr. McElroy has taken to playing doctor, using 
online resources like WebMD, which offers medical news, descriptions of various 
diseases and drugs, and discussion groups. As he spoke, Mr. McElroy was icing 
his feet, which, one day in January, had become cripplingly painful; he was 
unable to walk.

âI think I have plantar fasciitis,â he said. âIâve been laid out for 
two weeks.â

(Even if the Paterson proposal passes, Mr. McElroy, like Mr. Voris and Ms. 
Polec and her roommate, would not qualify because their parents live out of 
state.)

Internet diagnoses, self-medicating and trading prescriptions, of course, come 
with potentially dangerous side effects. Dr. Barbie Gatton, who has worked in 
emergency rooms throughout the city since 2002, said she often sees young 
people who have taken the wrong antibiotics borrowed from friends.

âWe see people with urinary tract infections taking meds better suited for 
ear infections or pneumonia â the problem is, they havenât really treated 
their illness, and theyâre breeding resistance,â she explained. âOr they 
take pain medicine that masks the symptoms. And this allows the underlying 
problem to get worse and worse.â

There are clinics throughout the city that provide the young and uninsured free 
or cheap snippets of medical help, like the Community Healthcare Network mobile 
unit, which was parked in the East Village one snowy night. Lindsay Bellinger, 
26, who does administrative work through a temp agency and lives in Astoria, 
Queens, said she relied on the mobile unit for pap smears and tests for 
sexually transmitted diseases.

âThis takes care of gynecological work,â Ms. Bellinger said. âAnd I get a 
visit to the dentist from my parents as a Christmas gift.â

Levon Aaron, who has asthma and works as a bouncer at a West Village bar, has 
not had insurance since he was 19. Mr. Aaron, now 23, said that his asthma 
attacks had been less frequent since he began playing handball and working out, 
but they had not gone away. He tries to use his inhalers sparingly, but four 
times in the past year he has found himself out of medicine during a severe 
attack and landed in the emergency room.

In the hospital, he gets a prescription for a new inhaler, which costs about 
$30 to fill. But his outstanding bills total about $3,000, he said, an amount 
he cannot fathom paying.

Mr. Aaron was one of several young adults who said living without insurance 
meant trying to take better care of themselves.

âIâve stopped eating fast food,â said Santiago Betancour, who is 19 and 
lives in Rosedale, Queens. âIâm eating rice, vegetables and fruits. And 
when I get sick, I exercise to sweat it off.â

Of course, there are those who do feel invincible, like Eric Williams, who is 
24, unemployed and currently in the middle of a six-week snowboarding adventure 
in Wyoming, Montana, Colorado, Utah, British Columbia and California. Mr. 
Williams said by cellphone near Bozeman, Mont., that he looked into buying 
health insurance before he left, but abandoned the idea after being unable to 
find anything for less than $400 a month. Instead, he is just trying to be 
careful, though not always with success.

âIâve hit a couple of trees,â Mr. Williams said. âBut Iâm trying not 
to.â


Copyright 2009 The New York Times Company

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