Byline: Faith Ford
Feb. 20--PANAMA CITY -- Karreen 'Dee' Adams has diabetes, high blood pressure, arthritis and no health insurance. The 57-year-old Panama City woman, semi-retired after 18 years working as a teacher's aide in New Jersey, said she cannot afford the luxury of medical coverage. Adams said she is living off her deceased husband's pension, and after moving out of a subsidized housing complex, Adams has to hold her purse strings tight.
She is one of a growing number of local residents living without health insurance.
In Florida, 19.2 percent of residents under 65 do not have coverage, according to the 2004 Florida Health Insurance Study conducted for the Florida Agency for Health Care Administration. In Bay County, the numbers are slightly lower, with 18.3 percent of those under 65 without insurance, the study shows.
The uninsured are not unique to Bay County or Florida, said Dan Morgan, chief financial officer for Bay Medical Center, the county's largest hospital.
'As the cost of health care goes up, you're seeing more and more employers either cutting back on providing health care or cutting back on the amount that they pay,' Morgan said.
Facing higher premiums, some workers are choosing between health insurance and necessities such as food and shelter.
Unemployed people like Adams, who do not qualify for Medicare of Medicaid, also make up a large portion of the uninsured. Almost half of Florida's unemployed population is not insured, the study shows.
Cardiologist Curtis Williams has witnessed what happens when patients, especially those with serious health problems, do not have medical insurance. Williams is the founder and medical director at the St. Andrew Community Medical Center, a free, faith-based Panama City clinic that serves patients who are at or below 150 percent of the federal poverty level and ineligible for Medicare or Medicaid.
'It is tragic. It is absolutely tragic,' Williams said. 'I've seen people who have diabetes and need insulin who have not checked their blood sugar level or taken any insulin in five years because they can't afford to go to the doctor.'
Ric Steen, 53, and Patricia Grizzle, 57, both have no health insurance and a long list of health problems. Adams, Steen and Grizzle -- all Panama City residents --are patients at the faith-based clinic.
A former mail handler, Steen said he went into security work when he could no longer handle the heavy lifting required by his former job. Eventually, Steen said, he reached a point where he felt he was a danger to himself and others because of his health problems.
Along with having no health coverage, he has no income. Before he went to the clinic, Steen said he was getting some care from a doctor who his daughter worked for.
Steen remembers the first time Williams treated him.
'He said, 'Son, you're a mess,'' Steen recalled, listing off his health problems including diabetes, high cholesterol, high blood pressure and chronic lung disease. He also has had a stroke.
'I shudder to think what kind of shape I'd be in now without their help,' Steen said.
Grizzle said she suffers from fibromyalgia, high blood pressure, chronic lung disease and other health problems related to an injury. She has not had health insurance since she and her husband divorced about 10 years ago.
'If it wasn't for the clinic, I would probably be dead right now,' she said.
Like Steen, she has no income. Before the clinic, Grizzle said she relied on the emergency department at Bay Medical Center.
Adams was making occasional trips to Gulf Coast Medical Center's emergency department before she was taken in at the free clinic. Not a fan of hospitals, she said she went only when she needed a prescription written or her children forced her because she was in such bad shape. She racked up more than $700 in charges.
'I'll owe them forever,' she said, adding that she tries to send $5 each month toward her bill.
Gulf Coast Medical Center CEO Todd Gallati said an increasing number of uninsured patients are landing in the private hospital's emergency department.
In 2005, 7,839 patients, or 18.8 percent of the hospital's emergency room traffic, were uninsured. By comparison, in 2004, 7,164 patients, or 17.6 percent of emergency department patients, did not have insurance.
Congress passed the Emergency Medical Treatment and Labor Act in 1986 requiring that hospitals treat all emergency department patients with or without payment.
Gallati suggested increasing the availability of preventative care might alleviate the burden on hospitals. Studies show patients with insurance are healthier, Gallati said, because they make regular doctor visits rather than waiting until medical issues reach crisis level.
To better serve the uninsured and keep chronic health problems in check, Gallati said more clinics like the Federally Qualified Health Center (FQHC) would be a good start.
Made possible through federal legislation passed in 1989, FQHCs provide primary care to all patients regardless of their ability to pay. Patients who can afford to pay are charged on a sliding scale based on income.
'If we had one, say, in every community -- Lynn Haven, the Beach, Panama City -- the overall health of folks in Bay County would dramatically improve,' Gallati said.
The Community Health Center-Bay County has been awarded federal grant money to become an FQHC. Since opening in 2003, the clinic for the uninsured has had limited hours. With the FQHC designation, the clinic is expected to be open seven days a week.
In 2005, Gulf Coast Medical Center provided $4.7 million in uncompensated care.
Bay Medical Center, a nonprofit hospital that receives some breaks for treating the indigent, provided $18.1 million in uncompensated care in 2005. That's up from $16.6 million in 2004, but Morgan said the jump is in line with an increase in overall patient admissions.
Clinics like the Community Health Center-Bay County and the St. Andrew Community Medical Center are part of a solution, Morgan said.
'Logic would say, if you get to these people earlier and particularly those with chronic diseases and other things,' Morgan said 'hopefully you can prevent the severity or frequency that they become inpatients.'
Still, he said: 'I don't see it solving the problem.'
Since its opening in 2004, the St. Andrew Community Medical Center has been overwhelmed. Office manager Mandi Simmons said she had to do away with a waiting list last year after realizing some patients had been waiting as long as a year for an appointment. The medical clinic -- run by volunteers -- is open only one night a week.
Simmons said there are 663 patients in the computer system, although that figure includes patients for the medical clinic and a dental clinic run by the same church group.
Steen is quick to shower praises on the medical center and its volunteer staff. He counts himself lucky to have signed on early before word spread.
'It's a classic thumb in the dike. It's a lot of help,' Steen said. 'But there is a whole lot more need than they can provide for. I know they have turned away more than they've helped.'
Copyright (c) 2006, The News Herald, Panama City, Fla.
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