75,000 here lack health insurance

The Courier-Journal







Michele Wemes, resting her chin on her fist, waited patiently in a Family Health Centers lobby for a blood-pressure checkup.



The 39-year-old lost her health insurance two years ago when she divorced, and knee problems forced her to leave her greenhouse job in March.



A few chairs ahead, Angeline Robinson thumbed through a magazine, waiting for a doctor to see her. At 25, she works at Twinbrook Nursing Home, pursues a pharmacy technician career at Jefferson Community College and is about five weeks pregnant.



Biding their time in a Family Health Centers lobby for discounted health care has become routine for both women -- and for dozens of others.



That's because more than 75,000 Jefferson County residents -- and more than 530,000 Kentuckians -- have no health insurance, according to new figures from the U.S. Census Bureau.



For the first time, the bureau pulled together estimates on the numbers of people with -- and without -- health insurance, and broke them down by county.



Kentucky ranks 27th, with 13 percent of its residents lacking health insurance. More than 95,000 of them are younger than 18.



Indiana's ranking is higher -- No. 14 -- with 11.5 percent, or almost 695,000 uninsured residents.



Both have smaller percentages of uninsured residents than the national average -- 14 percent. That's almost 40 million people.



The bureau's estimates have a margin of error that varies by state -- Kentucky's number of uninsured could be as much as 27,000 higher or lower. Indiana's number could be about 31,500 people.



The Census Bureau compiled the data from five sources, including Medicaid and food stamp records and federal tax returns.



Demand on the rise

Until now, precise numbers have been "elusive, to say the least," said Bill Wagner, executive director of Family Health Centers in Louisville.



But the demand is real, and growing, he said.



"Every day, we turn patients away," Wagner said. "The growing numbers are putting a strain on our system."



State and local agencies will use the new numbers in planning how to care for the uninsured, who place a burden on the health-care system by driving up costs and overwhelming some facilities, such as emergency rooms.



But Wagner and other health-care officials say the Census estimates understate the problem with uninsured residents, since the most recent data was from 2000.



"We've certainly seen a sizable jump since then," he said.



Judy Owens, director of the University of Kentucky Center for Rural Health in Hazard also thinks the statewide figure of 13 percent seems too small.



"We see our workload increasing, and we see the circumstances that people are in are more complicated," Owens said. "The demand for our services (has) never declined."



According to the center's data, the three Kentucky counties with the greatest proportion of uninsured citizens are Clay, McCreary and Owsley. The Census Bureau generally agrees, but reverses their order, reporting that fully 25 percent of Owsley County has no health insurance.



"There are more uninsured or underinsured people than a lot of the data seems to suggest," Owens said.



But the state's figures line up pretty well with the Census Bureau's numbers, said Mark Birdwhistell, undersecretary for health in the Cabinet for Health and Family Services.



Hospitals suffer

Regardless, health-care officials agree that the problem of uninsured patients is a large drain on clinics and hospitals.



Kentucky doesn't track the cost of uninsured patients to taxpayers. But a June study published by Families USA, a Washington, D.C., nonprofit organization that lobbies for health-care consumers, estimates that it cost Kentucky $679 million this year to cover unpaid medical costs for the uninsured.



In Indiana, the cost this year to the state is estimated at $934 million, the study said.



It also said the cost will drive up health-insurance premiums by more than $1,000 for a Kentucky family with employer-sponsored coverage, and more than $900 for an Indiana family.



Last year, Family Health Centers served 43,000 people, charging them on a sliding scale based on their income and family size. Nearly 60 percent had no insurance.



Family Health Centers needs almost $8 million each year to operate, funding that comes from grants or appropriations from all levels of government, Wagner said. More than $2 million comes from an appropriation from Louisville Metro Government.



Without that funding, the centers can't help people like Wemes with her blood pressure. Even so, it doesn't cover all her needs. Wemes can't get help for her knee, for instance, because the clinic isn't equipped to handle her orthopedic needs.



"It stinks," she said. "Unless I go somewhere and have outrageous out-of-pocket expenses, I can't really afford to have it looked at."



Robinson, who can't afford the health insurance offered through her Twinbrook job, said her pregnancy complicates matters.



"I'll be stuck with hospital and doctor's bills that I can't afford," she said -- and she'll have to pay those bills with money that she doesn't have.



Tracking the uninsured

To better help people like Wemes and Robinson in the area, getCare, a Louisville organization that connects uninsured patients with doctors, is working on a database to better track people without insurance.



Logging claims from the uninsured -- which currently doesn't happen -- would give organizations such as getCare a firmer grasp on patients without insurance and how much health care they use, executive director Wendy Ward said.



"For the uninsured, there's no single database," Ward said. "We've had no real way of knowing how many people there are."



The indigent poor -- those living at or below the poverty line -- "are the sickest," Ward said. They are also "the most difficult group to figure out how to get them health-care coverage, and yet they're the ones who need it the most."



Charles Brown knows what that's like. His last steady job ended in October. In April, he worked a few weeks with a home improvement company before a six-week case of pneumonia knocked him out of his job.



"It's hard for me to get the medicine I need," said Brown, 49, a borderline diabetic, who has had hip-replacement surgery. "Not having insurance, I get the minimum amount of medical attention that I really need."



Pamela Greenwell lost her health insurance when she quit her job as a food server about a year ago because of an illness, but she could barely afford the insurance when she had a steady income.



She went months without her blood-pressure medicine. Now, she's in a program that gets her some prescriptions for free, but her lack of health insurance frustrates her each time she changes medicine.



"She has to look at the list to see what's free, to treat me that way," Greenwell said of her doctor. "She has to give me something I can afford."



"It's either that or I take nothin'."