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

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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 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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