(Interview 6/2011. Oil on linen, 40 ins. x 30 ins.)
Update 2021
Sometimes people fall off without actually falling out.
I interviewed this subject in 2011. She was still raw from medical trauma compounded by a healthcare system incentivized not to care for her as an uninsured person. People in pain often want to tell somebody the whole story. They open up.
This subject was gracious, forthcoming and wonderful to talk to. Her youthful exuberance still shone through despite the double punch. First there's the sickness and then the stress of trying to save one's own life. I left the interview wondering why the healthcare system has to beat up so many people especially the young.
I reached out to this subject for an update but did not hear back. Some people do not want to revisit the past. They are too worn out. I get it. Some felt a moral duty to speak up just once (via this project) and be a part of the alarm sounding. That's all. Others may have moved on to much better circumstances and are not looking back. Some agreed to share their stories for the $100 thank you fee, I'm certain. They want to leave it at that. Some emails end up in the spam file. It's all fine.
I wrote the original stories like police reports thinking the readers would respond to just-the-facts. I was wrong. The more intimate, the more readers respond. Now I personalize the stories by using the subjects' first names. But I need their permission to do so. I do not have this subject's permission.
The Affordable Care Act was designed to help uninsured people backed into a corner by illness with no way to pay for medical care. What does being backed into a corner look like before healthcare reform? This young woman's story shows us.
(from a 2011 interview)
Certified Teacher Employed as Managing Director of Franchised Learning Center, Uninsured, Age 31
This subject had various jobs after graduating college, some providing health benefits and some not.
In 2009 she went to graduate school to become certified as an elementary school teacher. But she was unable to find a teaching job even with her advanced degree. She is now employed as a managing director of a franchised learning center. She also works part-time as a nanny, and she volunteers at a children's hospital in their child-life activity center.
This subject worked full-time as a managing director, but still could not afford the $180/month ($226.75 in 2021 dollars) employee contribution for health insurance through her employer. She moved to part-time work at the learning center, and continued her other part-time work as a nanny.
In 2009, two months after losing her health insurance coverage, the subject suffered from frequent urination and cramping. Her primary care doctor visit and tests cost $120. Her doctor referred her to a urologist who performed a colposcopy. The urologist bill and test cost $300. The doctor said she had interstitial cystitis. The subject had terrible side effects from the drugs she took for the condition. She stopped taking the medication.
Later that year, during an annual gynecological exam, the doctor discovered “little cysts,” and wanted to rule out endometriosis. The subject went to the local hospital for testing. She received a $5,000 bill. Already feeling financial pressure from paying student loans, the panicked woman called the hospital. The hospital reclassified her as charity care, and adjusted her bill to $1500 ($1,889.59 in 2021 dollars). She is still paying $50/month to pay off medical debt.
The subject wanted to be insured before getting more tests. She tried to purchase a single policy online before her hospital visit. The preexisting conditions documented in her medical records made her uninsurable. In all likelihood the for-profit insurers deemed her a bad risk. Her preexisting medical conditions were likely to result in medical claims that cut into profits. (The Affordable Care Act created healthcare exchanges where an individual can purchase a single policy without regard to her medical history. Online marketplace coverage started in 2014.)
In 2009, the subject's fiancée committed suicide. The subject knew she needed mental health care. Uninsured and unable to afford to pay for a therapist, she was lucky enough to have an aunt who offered to pay for her to get help. Today, the psychiatrist gives her free drug samples since she is uninsured and unable to afford the medicine.
In 2010 the subject experienced a stiff neck and shooting pain down her neck. She went to a walk-in clinic. The clinic doctor said she needed an MRI. Without insurance and already saddled with medical and school loan debt, the subject decided to sleep with a hot water bottle on her neck and take ibuprofen.
A week later the subject experienced a much sharper pain running down the other side of her neck. The subject's mother insisted she go to the emergency room to rule out meningitis. A CAT scan and blood work were very close to normal. The doctor said he would order a spinal tap if the subject were insured. A spinal tap would be very expensive and the patient would be stuck with the bill. He felt comfortable sending her home without one. Later, her psychiatrist determined that she had an allergic reaction to her medication. The subject received a $2,350 ($2,912.59 in 2021 dollars) bill for the emergency room visit.
The subject admitted to feeling numb and ambivalent. "I figure it's just one more bill to tack on to the rest. And if my credit wasn't already terrible from past due medical bills and student loans, maybe I'd be a little wearier."
The subject has used Planned Parenthood for routine gynecological check-ups. She feels she can “never get on top of things.” She has no savings and wonders how she will ever have a family when she lives paycheck to paycheck.