Without a safety net

It started in the grocery store.

"I had heaviness in my chest. I started sweating profusely, and I was sick to my stomach," recalled "Diane," a 56-year-old Montgomery woman who asked that her real name not be used.

"I got home and was feeling a little better, but then it happened again and I knew I was in trouble."

Diane was taken to Provena Mercy Medical Center. Two days later, she was airlifted to Northwestern Memorial Hospital in Chicago. It was May 2007. She was 53. Her heart had failed.

Diane spent 12 days at Northwestern, several of them on the heart donor list, and doctors ordered cardiac rehab for her. The good news was she had health insurance. The bad news: The insurance wouldn't cover the rehab.

Then it got worse.

Although her husband was laid off in 2007, his former employer had kept the couple's insurance going. But the company was small, and that generosity couldn't last. When two other employees had medical problems (cancer and a car crash, respectively), the woman couldn't afford to keep the insurance going for past employees.

Diane's husband can go to Veterans Affairs hospitals, but she's had to go through her recovery completely uninsured.

"My heart doctor, he wanted me to have all these tests done, and I said, 'I'm sorry. I just can't afford this,' " she said.

Unemployed to uninsured

For nearly two years, Diane was part of a growing national group: the uninsured. If you put 20 average Americans in a room, three would have no insurance at all, according to U.S. Census Bureau figures.

There were 46.3 million uninsured Americans last year — 15.4 percent of the population. Among white Americans, about one in 10 had no insurance last year. In the black population, it was about one in five. And in the Hispanic community, a staggering 30 percent — nearly one in three — had no insurance.

The lion's share of coverage comes through employers, but unemployment is rising. Many lose their ability to see a doctor when they lose their jobs.

Between 2007 and 2008, the number of people who got insurance through an employer dropped by 900,000, going down to 176.3 million.

During that same year, more than 1.8 million people joined the ranks of the unemployed, according to the Bureau of Labor Statistics.

Locally, the federally qualified health center Aunt Martha's Healthcare Network has seen the fallout firsthand.

"In terms of options for the uninsured, we are the government's preferred option," communications director Tom Owens said.

Between July 1, 2008, and June 30, 2009, the three Aunt Martha's free clinics in Aurora saw a 17 percent jump in number of patients and a 21 percent jump in number of patient visits from the year before. That means the clinics saw 3,000 more people and 10,000 more appointments in that time, stretching the agency's resources.

In the last fiscal year, the group saw more than 20,000 patients and nearly 55,000 patient visits.

Respondents to a recent Beacon-News survey about health care were torn over improving health care if it means raising their taxes. The majority of the people who have adequate health insurance would not pay more taxes to ensure better health care for all (39 of 70), and the majority of people without adequate insurance would pay more taxes (14 of 22).

Cut-rate service

For Tabitha Ellberg of Aurora, it's all about family.

The 27-year-old mother of three is insured through her employer, but it's been three years since her children and husband were covered — except for Medicaid, which she said results in cut-rate service.

"The waiting room was absolutely overfilled," she recalls of a recent trip to the dentist for her daughter. "It was packed. It was dirty. There were kids running around and crying. The dentist came in. She didn't explain anything she was doing to my daughter."

The second office Ellberg tried was what she called an outdated facility.

Working in health care, currently as a medical assistant to a dermatologist, Ellberg has seen both sides of care. She is proud her employer offers the same level of service to Medicaid patients and insured ones, but past employers have made her privy to the worst-kept secret in health care.

"They're going to do the lowest care possible because it's Medicaid," she said.

Mysteries

Diane takes six prescriptions a day — all drugs she was prescribed two years ago. She can't afford the needed tests to determine if the drugs are still helping or just making things worse. She pays out-of-pocket but has a "kind doctor" who only charges a sliver of the normal cost of visits.

She is tired all the time and can't lift anything heavier than 15 pounds. Stairs are difficult. Sometimes she wakes up with her heart pounding. It won't stop.

But the worst part is the mystery.

"I just don't know the status of my heart right now," she said.

Ellberg has her own mystery. Her husband has been showing some strange symptoms — numbness, tingling and feelings of pressure in his head and chest. They can't afford the tests they need to tell if it's as simple as a pinched nerve or something more serious.

But there's another pressing riddle.

"I'm trying to figure out how we're going to get October's mortgage payment in, you know?" Ellberg said.

Money an issue

Ellberg's three daughters and her husband could get approved for insurance through Ellberg's work, but the family couldn't afford it.

"In order for me to add my husband and my children to my health insurance, I would end up paying them," she said, referring to her employer. "I wouldn't get a paycheck."

As for Diane, not surprisingly, insurance companies were not jumping at the chance to take on a 56-year-old woman with a bad heart.

"I am like the Typhoid Mary. No one will touch me because of the heart condition," she said.

Diane began fighting to get on disability as soon as she left the hospital. She didn't want to, but had no other options.

It takes about 29 months from diagnosis to get on disability. Diane had to appear before a judge this summer with her attorney to ask for the assistance she doesn't want.

"The process takes forever and a day," she said.

Diane was forced to fight for disability because she had no other options. She is a proud woman who has worked all her life, and she is embarrassed to say she is on disability. That's why she asked that her real name not be used for this story.