HEALTH CARE
West Among Nation’s Highest Uninsured Rates
The industries that drive the West often leave their workers on their own when it comes to health insurance.
By David Frey, 11-05-09
Richard Angus had been managing just fine without health insurance. A careful skier and cyclist, the Glenwood Springs, Colo., resident figured he could avoid the costs of health insurance, and the risks of going without it. Then last year, he contracted a blood infection that nearly cost him his life.
Instead, it cost him his livelihood. Three weeks in the hospital left him with $90,000 in medical bills he says he’ll never be able to pay off. His credit rating trashed, he’s seeking bankruptcy protection to stay afloat.
“You’re very happy that you get home. You’re alive!” says Angus, 48. “Then three months, four months down the road, you have to deal with the bills and the people. You almost wonder why they’re keeping me alive when they’re just going to make my life hell.”
Angus isn’t alone. The West has one of the highest rates of uninsured in the country, due largely to the region’s dominant industries. Apart from lots of small, independent businesses, much of the West is driven by the service sector, which often doesn’t provide health insurance. Neither do many construction contractors, energy industry contractors or agriculture operations.
The West had an uninsured rate of 17.4 percent in 2008, according to a U.S. Census report issued in September, compared to a nationwide rate of 15.5 percent. Only the South had a higher rate. The West was the only region of the country to see a statistical change, up .5 points from 2007.
New Mexico has the country’s second-highest uninsured rate, just behind Texas, with 23 percent. That’s nearly one in four residents without health insurance. Arizona and Nevada fall in the top 10, too. All eight intermountain states – Montana, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada and Idaho – rank in the top half of uninsured rates. All the top 25 states are in the South, West, West Coast and Alaska.
“Our rates of uninsurance are currently high and I think it’s principally because of the types of businesses we have,” says David Adamson, executive director of Mountain Family Health Center, in Glenwood Springs, which specializes in serving the uninsured.
Many here worked in the shops, mansions and construction sites of nearby Aspen, or in what was a once-thriving natural gas industry. Those industries often don’t provide insurance, Adamson says.
The congressional district that includes Glenwood and Aspen has the highest uninsured rate in the state behind only urban Denver. The vast district includes some of Colorado’s wealthiest and poorest counties. Aspen’s Pitkin County boasts the state’s highest per capita income. Saguache County has the second lowest.
“We have a high proportion of sole proprietors and small businesses,” says Colorado state demographer Elizabeth Garner. “Small businesses tend to have more of a challenge providing health care coverage, especially with the increased cost of health care coverage. Too, health care coverage tends to follow income. The lower income you are, the more likely you are working in retail, which is less likely to be providing health insurance.”
Angus was working at a trendy Aspen eatery, but it wouldn’t provide health insurance until he had worked there for a year. He also worked as a caretaker for a multi-million-dollar Aspen home, but that job didn’t provide insurance either. He had private insurance until about four years ago, he says, when his monthly bills neared $500.
After his blood infection, Angus says, he earned too much to qualify for indigent care but not enough to pay his massive hospital bills.
“They want $2,000 a month for the rest of my life,” he says. “There’s just no way.”
Demographics also add to the West’s rate of uninsured. Hispanics have the highest uninsured rate, at 32.1 percent, or nearly one in every three. American Indians have an uninsured rate of 31.7 percent. Non-Hispanic whites, by comparison, have the lowest rate, at 10.4 percent.
Rates are even higher among immigrants, who are about 2.5 times less likely to have health insurance than the native-born population. Non-citizens have an uninsured rate of 44.7 percent. That’s about 9.5 million immigrants without insurance.
For Angus, the financial burden he’s been left with has become overwhelming.
“Sometimes you think it’s not worth being alive anymore,” he says. “It’s never-ending.”
You can't even find good sob stories anymore. I'm supposed to feel bad for a 50 year old skier who doesn't carry health insurance?
I'm supposed to feel bad for the immigrants who come here and use our services and pass the costs onto us?
Interesting that the red states are the ones with the most uninsured.
Comment By nancy, 11-05-09Really good story, David - as always.
Comment By Alex, 11-05-09What is sad is that many people (some who can't even afford health care) have been brainwashed into believing that government-run health care would be a bad thing. If you can't afford health care now, a single payer public system would ensure you never end up in Angus' shoes. If you can already afford health care, you'll still have it, but you will get to share the burden of the previously uninsured with the entire tax-paying population, instead of only the rest of the insured. Plus, you'll get to take the insurance companies out of the equation, saving another bundle.
Finally, we could all be proud to be apart of a civilized society which takes care of it's own and offers its citizens the basic opportunity (not a guaranty, but a real opportunity) to be healthy and succeed, instead of a so-called American Dream, which for most people will always be just a dream, no more likely to become reality than winning the lottery.
Our small town in Northwest Montana is full of Richard Anguses- risk takers with no medical insurance who think "that will never happen to me". If people here don’t start spending less on their risk taking pursuits and more on health insurance, physicians will soon take their medical practice elsewhere. Montana is a pretty place to go broke if you’re a physician.
Comment By Andy Leggett, 11-06-09At least one significant reason for the high rate of 'uninsureds', at least here in MT, is the high cost of health insurance. Our family policy costs us more than $5,000 annually and that is with a $10,000 deductible PER INSURED. This week we received notice from Blue Cross that the premiums are being raised 27%. So I'm off to change health insurance companies...oh, wait! This is Montana, we don't have competition in the health insurance market! So, I either pay almost $7,000 in premiums next year or join the ranks of the uninsured. Would that make me an irresponsible 'risk-taker'? Or someone who is sick of being shafted by a health insurance monopoly?
All I want out of health reform is the ability to buy 'catastrophic' insurance at a reasonable rate (you know, the kind of insurance that will pay for care should one of us be hit by a truck or develop cancer; I don't need a policy that will cover gender-transformation surgery, pre-natal care, or stomach-stapling - we're decidedly heterosexual, done having kids, and fit). Almost $7,000 p.a. is NOT reasonable (that's almost 20% of our pre-tax income).
My vote is for opening insurance markets across State lines, removing anti-trust protection (BCBS in Montana is as good as racketeering), restricting medical liability suits (thus reducing liability insurance premiums for medical staff), and giving us all the ability to write our medical costs down against our taxes.
To: "By Tim"
Please describe as clearly as you can who you would "feel sorry for" or "feel bad for" who doesn't "carry" health insurance. What does "carry" health insurance mean?
I'd just want to understand who does meet your standards.
PBS’s Frontline, Sick Around the Work by T.R. Reid was amazing. I wish every member of Congress and the President would watch and take note.
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
oops - Sick Around the World, not Word. So sorry.
Comment By jwscotch, 11-14-09I'm with Tim..."Angus was working at a trendy Aspen eatery, but it wouldn’t provide health insurance until he had worked there for a year." Wow, a whole year...every day...not this guy. Bet the tips were good, also bet his income was greatly under-reported.
Comment By Les Holcomb, 11-14-09Tim and JW,
You guys are just a bunch of old crabs, regardless of your age. You probably have health insurance, cheat on your taxes, resent anyone who seems to have a little more than you do, and not only wish that you had more but wish that you could take away what they had, too. I think I know more about you than I know about Angus. How does that feel?
Hospitals charge people like Angus full charges and try to collect more than they ever would from your private insurance company. And "critical access hospitals" say that regulations allow them to cherry pick. Ours on our little island won't even accept some Medicare retirement plans run by big insurance companies and elderly people are really stuck because the "critical access hospital" bought up all the primary care practices and put the physicians on salary and won't let them treat people who have that Medicare plan. So they get nothing unless they end up in the emergency room and then flown out to a city hospital that does more than they do and takes every comer.
So don't be too hard on Angus. And quit pretending you live in a bubble, you live in this country and like the rest of us, insured or uninsured, we all can become the prey in this predatory health care mess that we have inherited, insured or uninsured. Good ole' boys are only as "good" as their wallets when it comes to healthcare.