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Monday, Jan. 07, 2008
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Health clinic comes to aid of uninsured

For Melissa Stamus, three jobs couldn’t pay for six teeth.

Stamus, 39, of Stormstown, juggled shifts at two clothing stores and a home-care service. But none of her part-time work included health benefits.

When she needed fillings and a root canal, she went to Centre Volunteers in Medicine, a State College clinic that provides free medical and dental care for uninsured county residents.

Without the clinic, she said, her problems would have gone untreated.

“All my teeth would be falling out of my mouth,” Stamus said. “I wouldn’t have been able to afford to get that done.” Clinic workers see people like her every day.

Largely, they say, their patients work but either lack health benefits or can’t afford company plans. Many are self-employed. The common denominator: Private insurance costs too much.

“A lot of our patients are living hand to mouth, paycheck to paycheck,” said Jennifer Michaels, a clinic social worker.

Last year, the clinic registered 7,328 physician, dentist and social-worker appointments. Since opening in 2003, it has grown busier each year, and now answers up to 150 calls a day.

The clinic estimates about 11,000 county residents live without medical insurance and more than 30,000 don’t have dental insurance — almost 30 percent of the county’s population.

“We figure there are still thousands of people in Centre County who don’t know about us, and we’d like to figure out how to reach them,” said Cyndy Biek, development director for CVIM. “Because that’s what we’re here for.”

She and others at the clinic can guess where some potential patients work. They wait tables, drive buses and cabs, operate cash registers — any of a multitude of low-wage service jobs without health benefits.

“They make our cappuccinos for us,” Biek said.

All of these workers are part of a national trend.

Last year, about 8.6 million more Americans were uninsured than in 2000, raising the total to 47 million, mainly because of a steady decline in employer-provided health coverage, a recent Economic Policy Institute report concluded. Nationally from 2000 to 2006, the number of uninsured workers rose by 5 million.

About 85 percent of CVIM’s patients work, and many struggle to pay rent and keep their heads above water even with more than one income.

“If something happens — their car breaks down or another unexpected expense — it can throw everything off,” said Kristi Mattzela, social work supervisor for the clinic.

First to go often is health insurance, especially dental, Mattzela said. At present, the clinic’s wait list for dentist appointments has almost 1,100 names. Others, though, don’t wait.

“We’ve had patients pull their own teeth out with pliers because they couldn’t afford dental care,” Michaels said. “They’re desperate.”

So are the uninsured with health problems that make private plans unaffordable. Clinic workers have heard of people using the hospital emergency room for primary care and of diabetics sharing insulin. Diabetes is the most-frequently treated condition at the clinic, and it’s not uncommon for patients to need $700 of medicine each month.

“Maybe they could afford to pay (out of pocket) for a doctor’s appointment, but there’s no way they could afford their medications,” Biek said.

Low-income plans exist, such as AdultBasic from the state and various private ones. But, clinic workers said, they usually don’t cover prescriptions and procedures enough for people with chronic conditions.

A better option for working individuals is the state’s Medical Assistance for Workers with Disabilities, which provides more comprehensive care. Clinic physicians often refer patients to MAWD.

“You could work an hour stuffing envelopes for a church,” Mattzela said. “As long as you’re paid, you qualify.”

Dr. Rogers McLane, a retired physician who volunteers at the clinic, blames the nation’s “hodgepodge system” of health insurance for leaving working people uninsured. The problem for many, he said, is continuity of coverage. He sees a lot of former patients who get work with benefits return to the clinic.

“It’s seasonal work,” McLane said. “You have people who get benefits for six months, then they don’t have them.”

Some patients, though cash-strapped, recognize the gift they’ve received and try to give a little back.

“We have a patient, every time she comes here, she writes a check for $10,” Biek said. “She says, ‘If I had insurance, I’d pay that.’ ”

Chris Rosenblum can be reached at 231-4620.

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