My name is Lanett Kane and I work at Peoples Community Health Clinic in Waterloo, Iowa as a family practice registered nurse.
I have worked at PCHC for thirteen years. In the course of my time there I have been a scheduling clerk clinic aide, medical records clerk and lead worker, homeless outreach worker, peri-natal case manager, and accounts receivable clerk. I have been a nurse for a little over a year. At PCHC, I work for less money and have no opportunity in getting help in repaying about $12,000 in student loans compared to similar jobs in the community. But I decided to stay there due to the diversity in our patient population and its mission statement: to serve the underserved.
Working at PCHC has shown me first hand the hardships people endure due to the lack of or shortage of insurance. I have also seen many successes when people with chronic health problems finally have access to health care coverage. Under insurance/no insurance is an epidemic problem and at my job, I have the rare opportunity to not only witness the devastating effects on our patients, but I also realize the devastating impact poor health care has on our society as a whole.
PCHC currently serves 13,048 patients with 53,393 encounters. Of those encounters 39% were Medicaid, 6% were Medicare, 24% were third party payer, and 31 % were self-pay.
There are so many stories I could share, it is hard to narrow it down to a few that epitomize the crisis that we face at PCHC everyday. I would like to begin with a family of five that I have treated. Both parents work and bring home about $2800/month before taxes. They pay $220/month for health insurance for themselves and their three children, but have to pay $500 deductible per person before the insurance will kick in. This insurance coverage does not pay for preventative care or prescriptions.
One of the children has an ongoing medical issue which requires daily medication which costs the family between $20 and $30/month. Within two months this family had three trips to our office: two acute visits at $20, a well child visit with immunizations at $300, and two medicines at $40. Mom’s statement while in the office was, “I don’t even know why we have insurance.”
Once a child turns nineteen they are no longer covered on their parent’s insurance, or they don’t qualify for Title 19, or they don’t make enough money to afford health insurance. And college age adolescents/young adults need to have access to health coverage. We see many health concerns in this age group at PCHC. Many cannot afford the office visit or the medicine to treat STD’s, depression, stomach ulcers, obesity, diabetes, beginning symptoms of hypertension, and common illnesses. One of our patients, who had Diabetes Type I, turned nineteen and no longer had insurance to cover her medicine. She struggled to pay for medicines and rarely was able to check her blood sugars on a glucometer in order to adjust her insulin. She attempted to work but lost several jobs because of her health. Eventually, once her health dramatically declined, she qualified for Medicare/Medicaid. At this point her health insurance (our tax dollars) covered four years of dialysis, 2 heart surgeries, and numerous hospital stays secondary to complications of her diabetes. She died at the age of 36.
It is not unusual at our clinic or the ER to see patients arrive seriously ill because they delayed getting treatment due to lack of medical coverage. I will never forget a 40 year-old man who came to the clinic with a severe life threatening infection to his leg. The infection started as a small skin infection around his ankle. After five days of waiting, the infection spread up his leg, to the tissue below his skin and into his bloodstream. The infection had already begun affecting other major organs. He was having difficult time breathing and his blood pressure was extremely low. He was rushed to the ER and air lifted to University of Iowa Hospital. He eventually recovered from this infection but not before having two leg surgeries, one of those being and amputation of the leg, 10 days in the ICU on life support, and a total of 6 weeks in the hospital. Had this patient been seen at the beginning of his illness, his office visit and appropriate medication would have been a combined cost of about $65.
Recently I treated a 42 year-old female with diabetes Type II and hypertension. She has a four year college degree and is a teacher at a small private school that is unable to offer health coverage to employees. Due to lack of insurance she is unable to afford all of her medications to control her diabetes and hypertension. Her income is too high to qualify for help through pharmaceutical patient assistance program. Her chronic illnesses are taking a toll on her body and she now is requiring heart surgery. A hospital stay for open heart surgery is ~$30,000. How will she pay for that with an income of $18,500/year? She works, teaches our children, pays her taxes, and this is the best we have to offer her!
It’s not just the people we treat at PCHC who struggle with rising health costs. Like other small businesses, PCHC is feeling the affect of trying to offer its employees adequate health care coverage. Currently it costs $208/month for family coverage thru PCHC and $82/month for single coverage. Some of our employees are unable to afford the insurance or have a hard time paying the deductible or the co-pay.
Our society loses when someone loses his leg because of delayed treatment due to no insurance. Our society loses when someone is hospitalized as a direct result of inability to afford medicines. Our society loses when an uninsured person has major surgery and will need to declare bankruptcy due to inability to pay. Our society loses when a person dies at the age of 36 due to inadequate health care coverage. We can’t afford to lose any more.
