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Hunter Stuart

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Even With Universal Health Care, People Can Slip Through the Cracks

Posted: 06/24/2012 10:37 pm

Growing up in Concord, Mass., I was close friends with a boy my age named Jeremy*. In sixth grade he was the darling of Concord Middle School: he was handsome and charming, a star hockey player and a champion freestyle skier.

In high school, he and I stayed close, although I went to a private school in Boston and Jeremy went to Concord High. We used to skateboard together almost every day. We went swimming at Walden Pond in the summer and took the train into the city to see concerts together on the weekends.

Jeremy dropped out of school after he turned sixteen and got a job as a food-runner at the nicest restaurant in town. He also worked construction part time -- he was terrific with his hands. He could lay a roof on a house or build a stairway before he turned eighteen. His work was solid, careful. He started earning a lot of money and became financially independent at an age when the rest of us still had to ask our parents for twenty dollars to go to the movies.

Jeremy earned his GED and went to college in Colorado, where he could ski when he wasn't in class. He had it made -- until he ran out of money and had to withdraw from school.

When that happened, he moved back home and got a job, and began saving up so that he could finish getting his college degree.

But he never did.

Jeremy and I lost touch over the years. It's mostly my fault, for not calling enough, for leaving my hometown for New York City, and never looking back.

But I caught up with Jeremy recently in Manhattan, and the story he told me of the past two years of his life was shocking.

Here's what happened:

Out of Luck

Jeremy had a job as a line-chef at an upscale restaurant in Maynard, Mass., until he broke his leg in a skiing accident. This was during the winter of 2011.

The doctors at the local hospital put a steel plate in Jeremy's leg and sent him home, saying he'd be back walking in about four weeks.

But his leg took almost two months to heal. He had to quit his job.

The bills from his leg surgery were around $4,000. They would have been a lot less if he had been insured. But Jeremy had no health insurance, even though he lived in Massachusetts -- a state which passed a health care reform law in 2006 that provides health insurance for low-income residents.

Jeremy had been enrolled the year before, at no cost (MassHealth pays for part or all of your premiums if you're unemployed). But like many people in their twenties Jeremy had changed addresses, and when the re-enrollment form came in the mail six months later, it went to his old apartment.

When MassHealth didn't get a response to their letter, they canceled Jeremy's insurance.

For two months that winter, Jeremy was confined to his bed. Luckily he had his girlfriend and his father to help take care of him. They went shopping for him, cooked for him.

After two months, his leg healed, and Jeremy started looking for work immediately. He traveled by foot, since he doesn't have a license.

Jeremy spent three weeks applying to dozens of jobs before he was offered a part-time gig working for a landscaper in Concord. The job would start the following day. But Jeremy never made it to work.

The Second Injury

Because when he got home that day, exhausted and broke, Jeremy accidentally poured a large pot of scalding water down his legs. (The sink was full of dishes, and Jeremy, in his haste to finish dinner so he could go to sleep and begin work the next day, didn't notice there was a plate under the colander. The water passed through the colander and shot right off the plate and into his stomach.)

The burns were diagnosed as third-degree. Over the next couple weeks, Jeremy returned to the local hospital three times to have skin removed and the pus drained from the burns. (He described the burns to me as looking "like beachballs" and "like raw meat.")

On his third visit, a doctor at the local hospital told him they weren't equipped to handle burns so severe, and that Jeremy needed to see a plastic surgeon. The plastic surgeon, in turn, told Jeremy he'd have to go to Mass General Hospital in Boston to have skin graft surgery.

Jeremy traveled all the way to Boston three separate times for skin graft surgery. Between the two hospitals and the plastic surgeon's consultation (which alone cost $1,800), Jeremy owed about $9,000 for the burn treatment, on top of the $4,000 he already owed for leg surgery.

Jeremy had re-applied for health insurance as soon as he broke his leg, but there was a processing period for the paperwork that delayed his application for five months, during which time he had to pay the full amount of his hospital bills.

When he saw how much debt was piling up, Jeremy applied for financial aid from MassHealth. The hospital helped him fill out the application, and told him he'd been enrolled in the system.

But nevertheless, the bills came in the mail saying he had to pay the full amount. To this day Jeremy doesn't know why he didn't receive financial aid.

No Safety Net

Jeremy was unable to work for another two months as he recovered from the burns. Eventually -- after his roommate moved out of the apartment, and he couldn't afford rent -- Jeremy had to move out.

He moved in with his dad and his dad's second-wife's family in a rural town 40 miles west of Boston.

He had no where else to go.

Over a year later, Jeremy is still there, and needs to save up at least $15,000 before he can move out. He needs to pay a deposit on an apartment, get a car, get the car insured.

The problem is, he only makes $15 an hour at his job -- and his boss only lets him work two days a week. Jeremy fought to work more days but his boss couldn't afford it.

Jeremy picks up some extra work roofing, but the money still isn't enough.

And his debt from the hospital bills has ruined his credit.

Life On Hold

Jeremy is the first person to admit that much of this is his own fault. He should have given his new address to MassHealth, he should have been better about keeping track of the paperwork.

He should have been more careful skiing.

But to me, Jeremy's story is an example of why socialized health care still isn't enough. Even though the program has been in place for six years, even though it's been updated and revised to make it better, to make it more effective, even though it was designed to make sure the less-fortunate among us -- people like Jeremy -- don't slip through the cracks, it still isn't enough.

It will take Jeremy years to pay off his debt, and years more to repair his credit so that he can finish college and get a job that makes full use of how smart and talented he is.

Until then, his life is on hold.

*Names have been changed.

 

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Growing up in Concord, Mass., I was close friends with a boy my age named Jeremy*. In sixth grade he was the darling of Concord Middle School: he was handsome and charming, a star hockey player and a ...
Growing up in Concord, Mass., I was close friends with a boy my age named Jeremy*. In sixth grade he was the darling of Concord Middle School: he was handsome and charming, a star hockey player and a ...
 
 
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MJinCanada
Safe from zombies until my 2nd cup of coffee
09:54 AM on 06/26/2012
In Canada, the only way Jeremy could have lost his health care would have been to move to another province and not register for a health card. Even then, most of his care would have been free.
Genders
Love, Tolerance, Enlightenment
06:19 PM on 06/25/2012
Medicare for all is the only civilized solution.

Sweden has better health care for all, and it costs, half what our's dues.
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Devin DeWeil
Live, laugh, and LOVE LIFE!!!
12:00 PM on 06/25/2012
Every single choice "Jeremy" made WAS his own fault. This is NOT "slipping through the cracks", this is not caring about dealing with your responsibilities.

"To this day Jeremy has no idea why he didn't receive financial aid", THIS is RIDICULOUS. It doesn't sound like he tried very hard! No follow up calls and waiting 5 MONTHS to check if his application was processed.

The billing department of the hospital could have helped him. Every hospital in the country has a financial assistance/charity program for the poor with no insurance, EVEN in Massachusetts!

This guy even dropped out of high school because making a bit of money now was better than going to college and making more money later!

Then he finally goes to a college and the most important thing is going away to a place where he could go to class and be a ski bum in his free time.. he runs out of money (since he was skiing instead of working) and drops out yet again.

I'm sorry he broke his leg, but if skiing hadn't been so important then it wouldn't have happened. Completely sucks he was burned badly, yet again there was another opportunity to enroll in MassHealth that wasn't followed up on.

I can't deal with this whiny crap coming from people just a few years younger than me!! STOP WHINING AND GET SERIOUS ABOUT MAKING RESPONSIBLE CHOICES!!

Ok Rant over. lol
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withoutaparty
Fodder for the 24hr news cycle: YOU!
02:19 PM on 06/25/2012
People should be exempt from figuring out their future. He clearly neeeded some heeeelp. The system faaaailed him. Baa baa baa...

/sarcasm off.

Seriously, how do we figure out an 'acceptable failure rate' is for services like these? What does 'help' look like if the person receiving said services is entirely without hap? (hapless) Drives me nuts too...though I also get the feeling the paperwork (just like every other governmental system) is going to be hairy.

+1
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11:03 AM on 06/25/2012
Our country is full of stories like this. If this young man doesn't get his finances straightened out right away he will end up middle aged and long ago ostracized by our cruel money grubbing culture. We see the debtors prisons of our grandfathers eras as draconian and archaic yet look at what can happen to young people of our own era who make mistakes and falter even slightly.
Money and profit factors should be removed by federal mandate from all legal and medical parts of our culture. Then education should also be free for anyone who can keep their grades up.
How many millions of talented healthy promising young people will we ostracize before our system crashes? Maybe it has crashed already.
My fix? Total Universal Health Care, including medical, dental and mental healthcare. No private for profit money exchanges in legal prosecution, defense, incarceration and no bail bonds- no more private criminal attorney's. Total free education from kindergarten to graduate level and beyond.
What a fantastic culture we would have if their were no medically undiagnosed- untreated citizens and if all citizens could pursue education to any level their talents could take them and concentrate on building a better world instead of getting trapped in hopeless debtor situations with middlemen money grubbing hustlers grabbing at their assets for the rest of their lives.
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withoutaparty
Fodder for the 24hr news cycle: YOU!
03:20 PM on 06/25/2012
Whose responsibility is it to make sure he gets his *s* together, Gus?

Himself? His significant other? His parents? Extended family? Friends? Supervisor at his job? Local community? State gov't? Federal gov't?

Please notice how far down the line of possible help the Fed arrives...that's because it's the least efficient.
10:57 AM on 06/25/2012
"Jeremy's story is an example of why socialized health care still isn't enough."

I agree with others who have pointed out here that the program in MA can not be equated with "socialized health care" or "universal health care". A better moniker would be "mandated subsidies to insurance companies with relatively small opt-out fees at tax time, but only if you make enough to pay the fees, otherwise you don't have to pay anything and you're not covered." Anything that has opt-out options built into it is NOT universal.
09:53 AM on 06/25/2012
People need to take personal responsibility for sporting accidents. He should not have been allowed on the slope without ski-specific insurance in place. Especially out of his own home state!
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thejazz
I'll burn that bridge when I come to it.
09:22 AM on 06/25/2012
I really don't understand how Americans equate health insurance with health care? If you buy boat insurance, you don't get a boat. do you?

But, those bills seem very very low. I had surgery and I owed that much money with my EXCELLENT health insurance plan. A plan that is called the cadilac plan here in the United States, but is called crappy basic health care with outragious fees in other industrialized countries.
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Allene Stucki
08:57 AM on 06/25/2012
Jeremy will never finish college - he doesn't have the talent, the drive, or the smarts. He's one of life's losers, and there can never be enough safety nets to save him.
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bop54jen
09:26 AM on 06/25/2012
What kind of comment is this? In Indiana, only 58% of employers even offer health insurance. Or, he could have missed the enrollment form from moving and received a cancer diagnosis. Come on now...we are all Americans...
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Hunter Stuart
Temporary Like Achilles
10:12 AM on 06/29/2012
You have absolutely no idea what you're talking about.
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raker
08:25 AM on 06/25/2012
Four thousand dollars for leg surgery and nine thousand for multiple skin grafts seems implausibly low. Those amounts are more like out-of-pocket debts for a patient who has crappy "affordable" health insurance.

Even with a lousy, half-baked health care system like ours, for it to work properly people have to put in a little effort—like giving the Post Office a forwarding address when they move. The man in this story cut down his own safety net. But even with bare-bones insurance he probably still would have been on the hook for thousands of dollars.
08:15 AM on 06/25/2012
Heath Care Costs? Check out the below link.

http://my.brainshark.com/The-President-s-8-Billion-Coincidence-356086344
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bg66astoria
Research Helps
07:37 AM on 06/25/2012
Mr. Stuart,

Romneycare is NOT universal health care! Insurance does NOT equal healthcare. Is that too difficult to understand?

In the best universal health care programs you're paying for the healthcare NOT for a middleman. That's why in the US universal healthcare would be Medicare/Medicaid for all with all services covered - dental vision, mental health & CMS negotiating directly with mfrs for Rx drugs, not the multi-layer Big Pharma, Pharmacy Benefit Managers & Pharmacy chains adding additional layers.
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07:22 AM on 06/25/2012
So what is the moral of the story?
07:09 AM on 06/25/2012
"Even With Universal Health Care, People Can Slip Through the Cracks"

Stop calling the Mass law and Obamacare "universal healthcare." They are not "universal healthcare", they are "universal health insurance."
03:31 AM on 06/25/2012
Superb information.
I need healthcare information and sharing others people.
http://www.herbscity.com/calms-forte-4-kids-2744.html
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allwarisbad
02:47 AM on 06/25/2012
I do not think the author understands Universal Health Care but is stuck on private agencies being responsible for your care. There are no premiums in UHC. Depending on your earning it comes out of your payroll usually ... and is same care for everybody.