All Things Considered

As Focus Shifts To Jobs, The Uninsured Seek Solutions

By Debbie Elliott

February 9, 2010 1:22 PM

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The national debate over health care appears to be taking a back seat to jobs creation — but the problem persists for people who have jobs but no health insurance.

As part of our series "Are You Covered," we check back in with Fernando Arriola, a contractor in New Orleans who can't get health coverage. He's adopted an unconventional approach to medical care and is now working to set up a clinic for the uninsured.

Going Abroad For Cheaper Care

Winter (what there is of it in New Orleans) is the slow season for Arriola's construction firm. So late last year, he took care of a nagging medical problem.

Construction workers convert Sunday school rooms into exam rooms at the New Orleans Faith Health Alliance, a fledgling health clinic for uninsured workers at First Grace United Methodist Church in New Orleans' Mid-City neighborhood.(Debbie Elliott)

"I had a minor surgery," he says. "[It] wasn't anything big — just had a growth removed. So I went to Guatemala. It cost me a grand total of $80, including the doctor visit. I was able to save some money. I couldn't even pay for the doctor visit over here."

Arriola is a naturalized citizen who has called New Orleans home for 40 years. But his regular doctor these days is in his native Guatemala. So when he goes to visit family, he gets care and stocks up on his blood pressure medicine.

Patient Lee Hardy, who has been uninsured since Hurricane Katrina, speaks with nurse practitioner Mary Mackie at the New Orleans Faith Health Alliance.(Debbie Elliott)

First Denied, Then Disappointed

The 58-year-old self-employed businessman gave up his health coverage after Hurricane Katrina to save money when times were tough. When he tried to reinstate the policy, he was denied. Arriola had hoped Congress would allow people like him to buy into the Medicare system a little early.

"See, I'm willing to pay for what I am getting," Arriola says. "That's not the point. It's just that I cannot even get it."

He's frustrated that politicians can't seem to agree on a fix.

"It's a mess," he says. "I don't know that they can do anything."

Hope For The Uninsured

For his part, Arriola has been trying to do something locally by serving on the board of directors of a fledgling health clinic for uninsured workers: the New Orleans Faith Health Alliance.

At First Grace United Methodist Church in the Mid-City neighborhood, a construction crew is transforming Sunday school classrooms into exam rooms. The full clinic won't be ready until late spring, so for now a small, windowless choir room serves as a makeshift exam room.

Nurse practitioner Gwen George is taking Lee Hardy's blood pressure. It's a little high. He tells her he was diagnosed with high blood pressure five years ago, before Hurricane Katrina.

Hardy is a morning show producer for a local AM radio station that does not provide health insurance. He had hoped Congress would create a public health plan.

"People think that it's for other people out there that don't want to work and people who are just lazy bums," Hardy says. "I stand before you as living proof that that's not the case. I mean, I work hard."

But he hasn't had coverage since the storm. "The job ... that I did have health insurance with was gone. So you can mark it down to Aug. 29, 2005," he says.

And it's been that long since he's seen a doctor, even though his previous job was as a marketing director for a home health care agency.

George says Hardy is typical of the clinic's patients. Most have chronic health problems, like high blood pressure or diabetes, and have gone for years without care. Katrina devastated the city's health care system, including Charity Hospital. Even today, she says, there are few treatment options unless you wait for hours at a free clinic.

"And when you have a job, you really can't wait 10, 12 hours to be seen because you'll no longer have your job," she says. "And so they're really forced to have no care at all, or a place like this where they can get care."

Since November, the New Orleans Faith Health Alliance has been seeing patients three half-days a week, addressing a mere fraction of the need in this city, where so many work in industries that don't offer coverage — like construction and hospitality.

'The Reality Of New Orleans'

Clinic director Luanne Francis says there are about 80,000 uninsured workers in the New Orleans metro area.

"We are specifically focused on serving these people," Francis says, "because we believe these people are falling through the cracks and go a long period of time without seeing a provider."

But it's not a free ride. Patients must join, or become members by paying a fee based on their income. And they pay for each visit.

When Lee Hardy emerges from the exam room after an hourlong consultation, he calls the clinic "a blessing." He says he'll be recommending it to friends and colleagues.

"A lot of people I know are employed and not insured," says Hardy. "That's the reality of the New Orleans that we live in, particularly post-Katrina."

The New Orleans Faith Health Alliance has signed up 15 members so far. And the newest is Arriola, who says the clinic will help him with routine matters such as his blood pressure. But he's still concerned about major medical issues.

His plan for now? "Pray that nothing happens," Arriola says.

At least not until he's 65 and qualifies for Medicare.

This story was produced through a collaboration between NPR and Kaiser Health News (KHN), an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente. Copyright 2010 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

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MICHELE NORRIS, host:

The shift in focus from health care to job creation is little comfort to the many Americans who have jobs but no health insurance. As part of our series Are You Covered, NPRs Debbie Elliott checks back in with a New Orleans contractor who wants insurance, but insurers dont want him.

DEBBIE ELLIOTT: Winter, what there is of it in New Orleans, is the slow season for Fernando Arriolas construction firm. So, late last year, he took care of a nagging medical problem.

Mr. FERNANDO ARRIOLA (Contractor): I had a minor surgery, you know, it wasnt anything big - just had a growth removed. So I went to Guatemala. And it cost me a grand total of $80, including the doctor visit. I was able to save some money. I couldnt even pay for the doctor visit over here.

ELLIOTT: Arriola is a naturalized citizen who has called New Orleans home for 40 years. But his regular doctor these days is in his native Guatemala. So when he goes to visit family, he gets care and stocks up on his blood pressure medicine. The 58-year-old self-employed businessman gave up his health coverage after Hurricane Katrina to save money when times were tough. When he tried to reinstate the policy, he was denied. Arriola had hoped Congress would allow people like him to pay for early Medicare coverage.

Mr. ARRIOLA: See, Im willing to pay for what Im getting, you know, thats not the point. Its just that I cannot even get it.

ELLIOTT: Hes frustrated that politicians cant seem to agree on a fix.

Mr. ARRIOLA: Its a mess. It is a mess. I dont know that they can do anything.

ELLIOTT: For his part, Arriola has been trying to do something locally for people like him by serving on the board of directors of a fledgling health clinic for uninsured workers.

(Soundbite of construction)

ELLIOTT: At the First Grace United Methodist Church in the Mid-City neighborhood, a construction crew is transforming Sunday school classrooms into exam rooms. Its the new home of the New Orleans Faith Health Alliance.

(Soundbite of exam room)

ELLIOTT: The full clinic wont be ready until late spring. So for now a small, windowless choir room serves as a makeshift exam room.

Ms. GWEN GEORGE (Nurse Practitioner): 144 over 86.

ELLIOTT: Nurse practitioner Gwen George is with a new patient.

Ms. GEORGE: Thats a little bit high, but its not real high.

Mr. LEE HARDY (Producer, Radio Station): Elevated.

Ms. GEORGE: Right. Do you have - have you ever had any blood pressure problems?

Mr. HARDY: I was diagnosed elevated, yeah.

Ms. GEORGE: With high blood pressure? How long was that?

Mr. HARDY: Pre-Katrina.

Ms. GEORGE: Okay. About five years, then.

Mr. HARDY: Yeah.

Ms. GEORGE: Okay.

ELLIOTT: Her patient is Lee Hardy, a morning show producer for a local AM radio station. Hardy had hoped Congress would create a public health plan.

Mr. HARDY: People who think that its for other people out there that dont want to work and people who are just lazy bums and so on and so forth. But that is not the case. I mean, I stand before you as living proof that it's not the case. I mean, I work hard.

ELLIOTT: How long have you been without health insurance?

Mr. HARDY: Well, let's see. Katrina came in 2005, and the job that I had, that I did have health insurance with was gone. So, you can mark it right back to August 29th, 2005.

ELLIOTT: And its been that long since hes seen a doctor, even though his previous job was as a marketing director for a home health care agency. Nurse Gwen George says Hardy is typical of the patients she sees at this clinic. Most have chronic health problems like high blood pressure or diabetes and have gone for years without care. Katrina devastated the citys health care system, including Charity Hospital. Even today, she says, there are few treatment options.

Ms. GEORGE: Unless they go to the university, which is going to be free care, but its hours and hours to wait. And when you have a job, you really cant wait 10, 12 hours to be seen because youll no longer have your job.

ELLIOTT: Since November, the New Orleans Faith Health Alliance has been seeing patients three half-days a week, addressing a mere fraction of the need in this city, where so many work in industries that dont offer health coverage - like construction and hospitality. Clinic director Luanne Francis says there are about 80,000 uninsured workers in the New Orleans metro area.

Ms. LUANNE FRANCIS (Clinic Director, New Orleans Faith Health Alliance): We are specifically focused on serving these people because we think these people are the ones that are falling through the cracks and who go, you know, for a long period of time without seeing a provider.

ELLIOTT: But its not a free ride. Patients must join or become members by paying a fee based on their income and pay for each visit.

Mr. HARDY: Thank you all.

Ms. GEORGE: Okay, thank you, Lee. See you later.

Mr. HARDY: Bye, bye.

ELLIOTT: Lee Hardy emerges from the exam room after an hourlong consultation.

Mr. HARDY: This place is a blessing. And Im going to recommend it to a lot of people and I certainly do know a lot of folks who would probably qualify for the services.

(Soundbite of laughter)

Mr. HARDY: Because a lot of people that I know are employed and not insured. And thats the reality of the New Orleans that we live in.

ELLIOTT: The clinic has signed up 15 members so far. And the newest is contractor Fernando Arriola who says the clinic will help him with routine matters like his blood pressure. But hes still concerned about major medical issues. His plan for now?

Mr. ARRIOLA: Pray that nothing happens.

ELLIOTT: At least not until hes 65 and qualifies for Medicare.

Debbie Elliott, NPR News, New Orleans.

NORRIS: Are You Covered is about the health care experience of ordinary Americans. Its produced in collaboration with Kaiser Health News, a nonprofit news service. Transcript provided by NPR, Copyright National Public Radio.

Source: NPR

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