PAYCHECK TO PAYCHECK

BILLS OR PILLS?

The struggle to make ends meet in Centre County

Chris Rosenblum

FERGUSON TOWNSHIP — It's a routine scene: A doctor counsels a patient in an office during a checkup. Jackie Christiansen takes none of it for granted. "I don't know where I would be without this," she said.

CDT photo/Christopher Weddle

Jackie Christiansen talks with Dr. Rogers McLane at the Centre Volunteers in Medicine clinic. Christiansen has no health insurance to help pay for medicine to treat a rare chronic condition that causes her to pass out suddenly or fall into paralytic, hallucinatory states.

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• Health clinic comes to aid of uninsured

Christiansen, 53, has narcolepsy-cataplexy, a rare chronic condition triggered by strong emotions that causes her to pass out suddenly or fall into paralytic, hallucinatory states. She also has no health insurance.

As she did recently, Christiansen goes to Centre Volunteers in Medicine, a State College clinic that provides free care to uninsured county residents. Without CVIM, Christiansen would have to shell out about $475 a month for her necessary medications or resort to the amphetamines and other stimulants that kept her going for years at the risk of a heart attack. “They were killing me,” she said. “I was a walking time bomb.”

Her prescriptions, if she paid for them, would consume more than half of her monthly $848 unemployment benefits, her sole income. In May, she was fired as manager of the Port Matilda American Legion, in part, she thinks, because her condition was misunderstood.

But even at the post, where she earned $10 an hour, she didn’t get benefits — a trend among employers this decade. According to a recent report by the Economic Policy Institute, there were 5 million more uninsured workers nationally last year than in 2000.

Clinic officials say most of their patients work, either without benefits or unable to afford employer-provided coverage or private plans. Often, the officials say, health care taxes budgets stretched thin, forcing people into tough choices.

That’s familiar to Christiansen, who has struggled to make ends meet, working in the past as a truck driver, executive assistant, medical records filer, nursing home aide and part-time bartender.

“If I had to get pills, then I would get my pills and not pay my electric bills,” she said.

These days, she’s divorced and living by herself in a Ferguson Township condo owned by her son. On her front door hangs a cheerful wooden welcome sign — in contrast to her gloomy finances.

Even without rent, Christiansen’s costs for utilities, groceries, basic cable, and gas and insurance for her 1983 Chrysler (she holds a driver’s license despite her condition) swallow almost all her monthly income. After the bills, she has about $280 left, almost what it costs per month for the main narcolepsy medicine she must take to function.

“If I miss one day of pills, I’ll have a seizure,” she said.

She also pays a $200 annual condo association fee. Her meager savings disappeared long ago.

With her income, Christiansen said, she can’t afford even the cheapest private coverage. She’s eligible for Adult- Basic, the state’s budget plan, but Kristi Mattzela, a CVIM social work supervisor, said that doesn’t work for people with pre-existing or chronic conditions because it doesn’t cover medicines.

Help may come for Christiansen from Social Security disability payments, if her application is approved. Depending on an applicant’s prior earnings, benefits typically range from $500 to $1,500 a month in Centre County, Mattzela said.

But Christiansen would trade the assistance for a solid job.

Something she could do from home — filing records, for example — would be ideal, she said. So far, nothing’s turned up. Computer-savvy and able to type, she’s afraid no one would hire her if she reveals her condition. But she’s afraid of keeping quiet, taking a suitable position, such as a receptionist, and failing on the job.

“What if I had to greet people and I’m sitting there when they come in and I’m having one of my seizures?” she said.

Service and retail work are plentiful, but she thinks her back wouldn’t hold up to standing for long periods or keeping up with co-workers half her age. She’s also afraid of passing out and hurting herself — a legitimate concern for a narcoleptic person, one of her physicians said.

“It’s a real impediment, especially if she were working in a public setting,” Dr. Rogers Mc- Lane said.

Even with a job, she still may have a problem.

She could make too much to go to the clinic, which treats patients earning 200 percent or less of federal poverty guidelines. In her case, as a single adult, that limit would be $20,420 annually.

Finding her own insurance could be costly, and she would no longer see the doctors she has come to trust. On the bright side, there are comprehensive programs such as the state’s Medical Assistance for Workers with Disabilities. She also could receive help currently unavailable to her, such as tests to determine if she has sleep apnea, a disorder that interrupts rest.

In the meantime, she continues her job search and makes small changes. She’s walking more to lose weight, and rolls her own cigarettes to save money and cut back. She wants to quit altogether but knows that, like her circumstances, may require perseverance.

“It’s going to be a while,” she said. “Right now, one day at a time is the best I can do.”

Chris Rosenblum can be reached at 231-4620.