Health care reform gives hope to uninsured

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For David Salvesen, it could mean finally getting into Medicare. For Thomas Evans, it might be health insurance that follows him around and a network he could tap into. For Tamara Rajah and her clients, it would mean finally being able to get health insurance and much-needed care for their lupus.

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Tamara Rajah (left) and her daughter Alison Sheppard suffer from lupus. They favor ending exclusions from insurance plans.  Michael Holahan/Staff
Michael Holahan/Staff
Tamara Rajah (left) and her daughter Alison Sheppard suffer from lupus. They favor ending exclusions from insurance plans.

As the U.S. Senate prepares to vote this week on sweeping health care reform, nearly 75,000 people are uninsured in Richmond, Columbia and Aiken counties, according to an estimate published earlier this year in The Augusta Chronicle . Those patients seek health care security and a way to better and affordable health that right now depends on indigent care, community clinics and volunteer doctors.

Mr. Salvesen, 55, had worked since he was 13, mostly as a pipe fitter, until his emphysema and chronic obstructive pulmonary disease made him so short of breath it affected his work.

"One day I was walking around incoherent," he said. "I didn't know where I was."

Since doctors told him he was unfit to work, however, he has waged an unsuccessful four-year battle to get disability coverage.

"I guess it is a system that is overwhelmed," Mr. Salvesen said. "They are always denying and denying until you're absolutely at your end."

He relies on indigent care through University Hospital and other care at the Miracle Making Ministries clinic on Druid Park Avenue.

"These clinics save this town," Mr. Salvesen said.

Instead of qualifying for it through disability, he likes the idea of being able to buy into Medicare at age 55.

"That would be a good deal for me," he said.

Unfortunately for Mr. Salvesen, Sen. Joe Lieberman, D-Conn., reportedly does not agree, and that part of the health reform will apparently be dropped to get his vote, crucial for the 60 that Senate Democrats need to get the bill past Republican filibusters.

Sen. Ben Nelson, of Nebraska, the last Democratic holdout, declared his support for the legislation Saturday, virtually guaranteeing a vote before Christmas Day.

Next to Mr. Salvesen at the community clinic is Thomas Evans, 46, who returned to Augusta about four months ago after getting laid off from his computer-services job in Atlanta. While looking for work since, he has also gone through hoops trying to qualify for indigent care at University Hospital and then find a doctor who can follow him for high blood pressure, among other things. For him, the useful end result of health care reform could be summed up in three words: "Network," he said. "Easier access."

As a computer technician, he is hoping federal efforts to require electronic medical records in a few years will improve his care, making it easier to move around, and provide a market for his skills.

"Electronic records management," he said. "That's what I do."

He imagines himself "dealing with the mom-and-pop clinics and hospitals," he said. "That when it does become mandatory, they don't have to go to these large companies like McKesson, Cerner, Cardinal Health and pay all of these high fees" to get a system installed.

He thinks health insurance is something that people ought to be able to buy into.

"For those who are disadvantaged it should be relatively free," he said. "Not totally free, but relatively."

That seems problematic to Melinda Rider, the executive director of the Neighborhood Improvement Project, which runs the Belle Terrace Health and Wellness Center and the Belle Terrace Downtown Health Center. She has seen the number of uninsured her clinics serve jump from 30 percent to more than 50 percent, with about 70 percent of those being served by the downtown clinic.

The clinics charge a sliding scale fee, and even that is tough for some patients, which makes Ms. Rider wonder how an individual mandate to purchase insurance would work.

"For those patients who are on the sliding-fee scale, insurance that they have to pay for isn't going to work," she said. "They can't pay for it."

Instead, she thinks officials should just acknowledge that health care is a necessity and do what is required to get patients care.

"There has to be a consensus that we need to provide care, and not we need to provide care as long as it doesn't cost us anything, because that's not going to happen," Ms. Rider said.

"We all know in the long run we are better off. We pay for it now or we wait and pay a whole lot more later, both in terms of direct cost but also in terms of just human suffering."

One aspect of health reform that appears likely to be part of any final bill is an end to denial of coverage for pre-existing conditions.

This pleases, Tamara Rajah, the CEO of Skip to My Lupus Inc. in Augusta, a group that seeks to connect lupus sufferers such as Mrs. Rajah with services and support. Her daughter Alison Sheppard also has lupus and, after searching for two years, was able to qualify for health insurance through her father only to get kicked off at the worst time.

"They dropped me while I was in the hospital," Ms. Sheppard said. "The reason was I went to the hospital too many times."

Being denied insurance is something Mrs. Rajah said she hears "maybe two or three times a week." And the consequences of going without care are severe for lupus patients, whose immune system mistakenly attacks different organ systems and can lead to kidney failure and heart attacks, she said.

"If they don't get ongoing treatment, they normally suffer a premature death," Mrs. Rajah said, "and a terrible one at that."

Even if it passes, much of the health reform bill does not kick in for years, which makes no sense to Terrence Cook. The Augusta allergist is the chairman of the board and president of Richmond County Medical Society Project Access, which coordinates volunteer hours and services from physicians with low-income, uninsured patients in Richmond and Columbia counties.

In the past year, the number of patients it serves has gone from about 235 to about 620, he said, even as the group has taken 10 percent and 15 percent cuts in funding. Instead of creating a whole new bureaucracy, as the bills envision, why not use the existing Medicaid for a temporary expansion to reach patients suffering without care, Dr. Cook said.

"One of the things you could do with that is you could begin to rescue people immediately and begin to solve some problems," Dr. Cook said. It would have to be a federal-only Medicaid expansion (Medicaid funding is normally split between the federal and state governments) and it would be made temporary so that once the economy recovers and more people are working the guidelines would go back to previous levels.

"What we're trying to do is maintain people with chronic illnesses, provide them with their medications, so they stay out of the emergency room and their disease process does not progress to the point where it becomes ever so much more expensive to care for them," Dr. Cook said.

To Mr. Salvesen, a working man who now misses work and all that came with it, health reform is just a matter of fairness and decency.

"Everybody needs health care," he said. "Money shouldn't matter."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

ARE YOU UNINSURED AND IN NEED OF ASSISTANCE?

While the U.S. Senate debates health reform, local organizations are taking care of the uninsured.


- Richmond County Medical Society Project Access, which serves the uninsured in Richmond and Columbia counties through a network of volunteer doctors and hospitals. Coverage is limited to those at or below 150 percent of the federal poverty level -- for instance, an annual income of $20,975 for a family of four. It is for patients ages 18 to 64 who have been a resident of Richmond County for at least six months or a resident of Columbia County for at least a year. Call (706) 733-5177.


- Belle Terrace Health and Wellness Center, 2467 Golden Camp Road, and the Belle Terrace Downtown Health Center, 818 St. Sebastian Way, Professional Office Building II, Suite 404A. Call (706) 790-4440. The centers charge low-income uninsured on a sliding scale.


- Miracle Making Ministries Druid Park Community Health Center, 1127 Druid Park Ave. Call (706) 738-0455.


-- Tom Corwin, staff writer

Key provisions of the Senate's health care legislation

* In place of a government-run insurance option, the estimated 30 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now.


* Insurance companies would be barred immediately from denying coverage to children because of a pre-existing health condition. The prohibition on denial of coverage for adults would not take effect in the Senate bill until 2014, a disappointment for consumer advocates.


* Among the changes Senate Majority Leader Harry Reid incorporated was dropping a proposed tax on cosmetic surgical procedures, including Botox injections. Instead, Senate Democrats are proposing a 10 percent sales tax on tanning salons, to be paid by the person soaking up the rays. The Food and Drug Administration says ultraviolet radiation from tanning can increase the risk of skin cancer.


* The revised bill also calls for a 0.9 percent increase in the Medicare payroll tax on incomes exceeding $200,000 for individuals and $250,000 for couples. Mr. Reid's earlier bill had a smaller increase, 0.5 percent.


* The bill also taxes high-cost insurance plans as part of a plan to put downward pressure on health care use.


- Associated Press

What happened


With a critical health care vote looming this weekend, Senate Democrats reached a deal with the lone party holdout, Nebraska Sen. Ben Nelson. With Mr. Nelson backing the health care legislation, Democrats have the 60 votes they need to quash a series of Republican-led filibusters and pass the bill by Christmas.

What it took


Mr. Nelson agreed to support the bill only after Democratic leaders made changes that included placing limits on federal abortion funding. He reached the agreement in Senate Majority Leader Harry Reid's office Friday night after round-the-clock talks with Mr. Reid and Sen. Barbara Boxer, D-Calif., a leading supporter of abortion rights.


The compromise toughening abortion restrictions tries to maintain a strict separation between taxpayer funds and private premiums that would pay for abortion coverage. It would also allow states to restrict coverage for abortion in new insurance marketplaces.

What's next


The deal with Mr. Nelson paved the way for Mr. Reid to introduce a long list of proposed changes to the legislation Saturday morning and then file a series of procedural motions that would allow the Senate to take a final vote on the bill on Christmas Eve.


That requires three procedural votes staggered between Monday morning and Wednesday afternoon, a tight timeline Democrats must adhere to if they are to pass a bill by their self-imposed deadline.


The Senate bill will have to be reconciled with health care legislation passed by the House in November. That process could drag on for months, although Democrats are hoping to finish work in January.

What it will mean


The $871 billion bill, expected to cut $132 billion from the deficit over the next 10 years, would require nearly everyone to obtain health insurance policies. By 2019, about 94 percent of eligible Americans are expected to have coverage, up from the current 83 percent, according to the nonpartisan Congressional Budget Office, which estimated 31 million more people younger than 65 would become insured, leaving about 23 million without coverage.


- Edited from wire reports

Comments (253) Add comment
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wcr250
50
Points
wcr250 12/20/09 - 04:10 am
0
0
What a croc. of s---. this is

What a croc. of s---. this is not a health care bill , but socialism. People will be forced to pay for every dead beat and liberal in the us. It is the end of freedom as we know it in this country.Of course you would have to have an IQ over 20 to be able to figure this out.

justus4
99
Points
justus4 12/20/09 - 06:25 am
0
0
Oh, oh. The printing
Unpublished

Oh, oh. The printing operation is finding non-minotiry individuals that would benefit from health care reform and look at the first comment yapping 'bout "socialism" or "end of freedom" all ideas that are heard all day, every day. But the article is not gonna be well-recieved by U know who, because this poor guy from the article looks like U knwo who. They have contempt for these kind of stories and the subsequent comments will prove it. Health care will pass. The President will get the credit. Americans will benefit with longer lives and improved quality of life like the guy from the story. Now, go find that guy or perferable a non-minority female who have gone bankrupt and lost everything to medical cost after breast cancer. Stories of real Americans with real medical problems should have been a series in the local printing operation - other cities have done great work on telling such stories. Just state the facts and the American people will do what's right for the future.

johnston.cliff
2
Points
johnston.cliff 12/20/09 - 07:14 am
0
0
If these people can't afford

If these people can't afford these services now, how will they afford the services after this horrible bill passes? Will money be confiscated from others to pay for these people's services? Will insurance companies be driven out of business because they don't get tax subsidy and the only place to get insurance will be the government? Will the entire nation be held hostage by a situation no one can escape from without escaping from this once country. Will socialism make us a part of the European Union? Is this the change all fools hope for?

johnston.cliff
2
Points
johnston.cliff 12/20/09 - 07:53 am
0
0
...once great country...

...once great country...

wildman
1110
Points
wildman 12/20/09 - 07:54 am
0
0
This is the beginning of the

This is the beginning of the down fall for American medicine. If you think it's bad now just hold on because we are about to experience medical treatment that is run by the government. Please tell me one thing the government has run without screwing it up? Lord help us all.

sgachief
0
Points
sgachief 12/20/09 - 08:33 am
0
0
Tom, I think you are one of

Tom, I think you are one of the most ignorant people on the planet. This is NOT a heathcare bill, this is a death sentence to the finest healthcare system in the world.

justthefacts
21696
Points
justthefacts 12/20/09 - 08:46 am
0
0
Obama settled for the sake of

Obama settled for the sake of saying he passed a HC bill. Although, like Congress and the Prez, I have not actually read it, it appears to be nowhere near the original plan. No public option, no Fed funds for Abortion, etc. Like, the failed Copenhagen farce, appearances of success appear most important to Obama.

UncleStrom
2
Points
UncleStrom 12/20/09 - 08:50 am
0
0
jtf, unfortunately the

jtf, unfortunately the abortion provision is still in there. If you want the gory details check out: http://republicanleader.house.gov/blog/?p=725

Runner46
0
Points
Runner46 12/20/09 - 09:37 am
0
0
I believe that health care

I believe that health care reform is a good thing. What I object to is the government's intent to force everyone to buy this insurance. This is supposed to be a democracy, so why force insurance down everyone's throat? There are other ways to make reforms without taking away a person's freedom of choice. Where are those choices under the Democrat Plan?

soldout
1280
Points
soldout 12/20/09 - 09:43 am
0
0
Alternative care is the

Alternative care is the answer; not socialized medicine. It is so far advanced in so many areas.

bushwhacker
39
Points
bushwhacker 12/20/09 - 09:50 am
0
0
It forces COMPANIES to be

It forces COMPANIES to be responsible. Otherwise the minimum wage earners would never be able to afford insurance.

bushwhacker
39
Points
bushwhacker 12/20/09 - 09:52 am
0
0
As for abortion, why didn't

As for abortion, why didn't the last administration tackle it?

travelp
31
Points
travelp 12/20/09 - 10:15 am
0
0
Emphysema and COPD are

Emphysema and COPD are usually related to smoking. May not be the case but I would wager we will pay for the first guys healthcare because he smoked all his life.

gaspringwater
3
Points
gaspringwater 12/20/09 - 10:25 am
0
0
The world's a sad song for

The world's a sad song for those going without health care. But things are looking up and someday in the future we’ll have medical care in our society just as good as the other affluent democracies.

johnston.cliff
2
Points
johnston.cliff 12/20/09 - 10:31 am
0
0
A lot of people like wearing

A lot of people like wearing shackles, wrist and ankle. The Dem senators on the Sunday talk shows assure us that we'll all enjoy wearing these shackles and soon we won't even notice them. They assure us that they know what's best for us and there's nothing we can do about it.

johnston.cliff
2
Points
johnston.cliff 12/20/09 - 10:32 am
0
0
LOL, gasp. Isn't that what

LOL, gasp. Isn't that what everyone is worried about?

Niko Mahs
83
Points
Niko Mahs 12/20/09 - 10:33 am
0
0
We get health care and the

We get health care and the GOP'ers have to pay. They are rich bankers, corporate managers, and hedge fund crooks. Good, that's the way it needs to be.

justthefacts
21696
Points
justthefacts 12/20/09 - 10:43 am
0
0
Insurance companie's stock

Insurance companie's stock reached a 52 week high Friday. Yea, Obama really "took them on" didn't he? They are laughing their butts off. David Axelrod just said on Meet the Press when asked why over 60% of Americans don't like this bill said, essentially, that most Americans are ignorance.

bushwhacker
39
Points
bushwhacker 12/20/09 - 10:45 am
0
0
do you mean ignorant? just

do you mean ignorant? just the facts?

bushwhacker
39
Points
bushwhacker 12/20/09 - 10:49 am
0
0
Don't want you to sound

Don't want you to sound ignorant...

UncleStrom
2
Points
UncleStrom 12/20/09 - 10:54 am
0
0
whacker, it's upsetting when

whacker, it's upsetting when somebody steals your trademark isn't it?

gaspringwater
3
Points
gaspringwater 12/20/09 - 11:21 am
0
0
johnston.cliff - Have you

johnston.cliff - Have you noticed they're getting by in those “socialist” countries? They're not stacking the corpses by the roadside yet.

CobaltGeorge
157778
Points
CobaltGeorge 12/20/09 - 11:22 am
0
0
My old saying: "Those that

My old saying: "Those that don't use common sense or accept documented FACTS are just plain STUPID"

bushwhacker
39
Points
bushwhacker 12/20/09 - 11:41 am
0
0
Yes it is strom, now give it

Yes it is strom, now give it back. lol

RIPAmerica
0
Points
RIPAmerica 12/20/09 - 11:42 am
0
0
ps .... healthcare

ps .... healthcare passed
Posted by bushwhacker on Sat Dec 19, 2009 9:37 PM

UncleStrom
2
Points
UncleStrom 12/20/09 - 11:43 am
0
0
Dang, I stayed up all night

Dang, I stayed up all night and somehow missed the Senate vote. What was the final vote total, brushwhanker?

bushwhacker
39
Points
bushwhacker 12/20/09 - 11:45 am
0
0
will be by xmas eve, then you

will be by xmas eve, then you can whine about less fortunate costing you money.

RIPAmerica
0
Points
RIPAmerica 12/20/09 - 11:51 am
0
0
Attn Fat people: read the

Attn Fat people: read the bill. Search for "lifestyle changes". Fat people shouldn't be supporting this "reform" at all. Attn Smokers: read the bill. Search for "lifestyle changes". Smokers shouldn't be supporting this bill. Attn anyone who plans to grow old: read the bill. Search for "actuarial tables". Anyone who plans to grow old shouldn't be supporting this bill. Attn unborn babies: read the bill. Search for "abortion coverage". Any unborn baby who plans to be born shouldn't support this bill. So who does that leave in support? The brain dead and the power hungry. The Defense Rests.

UncleStrom
2
Points
UncleStrom 12/20/09 - 11:51 am
0
0
Do you remember the next

Do you remember the next steps before it becomes law?

bushwhacker
39
Points
bushwhacker 12/20/09 - 11:52 am
0
0
Oh the happiness of living in

Oh the happiness of living in a red state where being backward is thought to be a gift. Merry christmas gifted ones and my present to you will be on xmas eve. God bless our president and this country.

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