Unemployed and Uninsured: Learning which illness to fight

February 20, 2011 

  • ABOUT THE PROJECT

      This project is the result of a partnership between The Bee and the California HealthCare Foundation Center for Health Reporting. The center is a nonpartisan news organization that works with media partners to investigate health care issues. It is funded by the nonprofit, nonpartisan California HealthCare Foundation and is based at the University of Southern California’s Annenberg School for Communication & Journalism.

      For this series, four reporters spent 10 weeks digging through data and interviewing those caught up in the drama of the newly uninsured and the poor. A Bee data specialist examined statistics from more than a dozen sources, including federal, state and county databases. Reporters from The Bee and the Center interviewed almost 100 people, including doctors, physician’s assistants, nurse practitioners, health care experts, government officials, social workers and advocates — both locally and at the state level. In addition, project reporters talked with more than 25 patients and uninsured residents.

      The Bee staff

      Reporters, Ken Carlson, J.N. Sbranti; Photographers/multimedia, Bart Ah You, Darryl Bush, Debbie Noda; Graphics/page design, Brian Harris; Online, Brian Clark, Joshua Sigman; Project editor Dave Lyghtle

      CHCF staff

      Reporter, Jocelyn Wiener; Multimedia, Lauren Whaley; Project editor, Richard Kipling

When she awakes in a bunk bed every morning, in a room with a Justin Bieber poster and other girly decorations, Juli Leavitt is reminded how her life has changed since the economic downturn.

In 2009, the payroll company that employed her as an operations supervisor lost 40 percent of its business in 60 days. Leavitt and several co-workers were laid off.

She gave up a condo in a gated community and moved into her friend’s Turlock home. There, the 61-year-old, silver-haired Leavitt shares a room with her friend’s 9-year-old daughter.

The stress of unemployment has worn on Leavitt, who had earned $53,000 a year and has suffered from diabetes for 13 years.

After losing her job, her blood sugar shot to a dangerous level, putting her at risk of going into a diabetic coma, and she was hospitalized.

“The stress will push your blood sugar out of whack,” she said. “They had to put me on insulin to get me down.”

Her extended health benefits expired after six months, and she has gone without insurance for more than a year.

As a result, she couldn’t afford her medications for diabetes, high blood pressure and cholesterol, and stopped taking them. Her feet hurt from the poor circulation in her legs. Her hands became so numb she couldn’t hold a pencil, she said.

Leavitt, who had been solidly employed for four decades, sought help from the Stanislaus County health program for poor adults, but her unemployment benefits of $1,836 a month were slightly above the eligibility limit.

Even if she were under the cap, the program would require her to pay about $500 a month for any health care received.

About five months ago, Leavitt discovered the Aspen Family Medical Group in Modesto, a private clinic that caters to Medi-Cal recipients and a growing number of uninsured people.

There, Leavitt pays $45 for each visit with a nurse practitioner. She is charged a discounted $85 rate for lab tests to monitor her diabetes and cholesterol. The tests can cost more than $300.

After not taking her pills for a year, her first lab results were alarming.

“The blood sugar was still in the high range,” she said. “My blood pressure was exceedingly high. My triglycerides and cholesterol were off the charts.”

To treat her health conditions, Leavitt is buying pills at $4 to $8 a bottle from the Wal-Mart pharmacy. She isn’t taking a recommended drug to treat her osteoporosis because it costs $135 a month.

Matt Freitas, a nurse practitioner and co-owner of the Aspen clinic, is trying to find a lower-cost alternative for the drug.

Freitas said the clinic sees many patients such as Leavitt who lost health insurance during the recession. Some have advanced illnesses that are hard to treat; others have walked around with trauma injuries because they can’t pay $1,500 for an MRI, he said.

Aspen tries to eke out a profit by hiring office staff through the county’s welfare-to-work program. The clinic gets discounted rates on lab tests from a company that wants to establish itself in the region, Freitas said.

Visiting the low-cost clinic was humbling for Leavitt, who always has gone to more posh medical offices. But she seems to take it in stride.

“I have worked with a recovery program at my church, so that demographic group was not a shock,” she said. “The clinic got me in right away and Matt makes me feel like there is someone out there who still cares.”

Leavitt, who has a $400 monthly car payment and other bills, is struggling to buy medicine and pay for the lab tests to monitor her diabetes. She hopes to avoid a medical setback that would put her in the hospital.

“I don’t know what I would do. I would probably die before I could get the hospital bill paid off,” she said.

]Her job had been moved

In 2008, Leavitt had worked 3½ years as a supervisor for Modesto-based Advanced Payroll Systems, a company that handled payroll duties for small businesses, when another company bought the business and moved her job to Walnut Creek.

The longtime Modesto-area resident commuted and then briefly lived in the Bay Area, and when the company downsized, she returned to the valley and her friend took her in.

Leavitt helps care for her friend’s three children, age 7 to 11, and volunteers at the 11-year-old’s math class at school. Her friend’s children call her “the general” for making them get their homework and chores done on time.

When she is not applying for jobs, she creates art and helps with the Bureau of Land Management’s wild horse adoption program. She has slowed down since the days she wore black leather to ride with the Soldiers for Jesus motorcycle group.

Still, the downtime of unemployment makes her stir-crazy.

“I’m used to running an office and having a to-do list that would choke most people,” she said. “It is difficult to all of sudden slow down.”

Leavitt continues her job hunt despite the competition for available positions. When she tested for a legal assistant job with the district attorney’s office last year, she was waiting on the Modesto courthouse steps at 2:30 a.m. with résumé in hand. Seventy people were there by 3:30 a.m. and 400 took the test.

She scored 17th out of 400 applicants, but only four people were given the jobs, she said. She has applied to every employer from McDonald’s to Wal-Mart, and has shopped her tax-preparing skills to accounting firms.

Some employers say her 30 years of professional experience makes her overqualified, she said, but “I’m told that is their way of saying I’m too old.”

Leavitt’s current dilemma is: She needs to stay healthy to get back into the work force, but needs a good job to pay for health care.

“I have to greet every day with a bit of a smile,” she said. “If I didn’t, I would have to sit down and cry.”

Bee staff writer Ken Carlson can be reached at 578-2321.

Capital Public Radio will discuss The Bee’s series on “Insight,” its interview program, Wednesday from 10 to 11 a.m. Listen at KUOP 91.3 FM or www.capradio.org/news/insight.

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