The Grand County Gamble: Various factors leave many here without health insurance | SkyHiNews.com

The Grand County Gamble: Various factors leave many here without health insurance

Tonya Bina
Sky-Hi Daily News

Byron Hetzler/Sky-Hi Daily News

Single mom and part-time Deno’s server Kathy Schipper acquired a policy for $200 a month through Rocky Mountain Health Plans after her friend Craig “Craigy T” Thomason, a longtime Fraser Valley local, died at St. Anthony’s Hospital on his 31st birthday.

Without health insurance, Thomason had been diagnosed with advanced melanoma and was told by doctors he had two to six months to live. But the cancer, determined to be Stage IV, spread throughout his body much more quickly than expected and led to his sudden death.

Thomason had noticed a dark spot on the skin of his back about two years ago, but didn’t think much of it.

When it became worse, Thomason went to a few doctors, but never took the next step ” a biopsy ” even when the spot started to cause him pain. He didn’t believe it was cancer, friends and family said, and he didn’t have the money to have it treated because he didn’t have insurance.

It was a devastating lesson to Schipper, 38, who has a 3-year-old daughter.

She now thinks insurance should be made a higher priority for many of her peers, and they should find a way to afford it.

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“I know a lot of my friends could if they tried. I watch them go into a bar and spend $100 a night, yet they don’t spend $80 to $100 a month on some type of insurance.

“I’ve been to plenty of fundraisers in this town,” she said, referring to those that help pay others’ medical debts.

A Grand County problem

In Grand County, 58 percent of the population rated affordable health insurance as the No. 1 community health problem with “low-paying jobs without benefits” coming in a close second, according to the 2007 Grand County Community Health Assessment.

From the Colorado 2008 Blue Ribbon Commission for Healthcare Reform, one can extrapolate about 2,400 individuals out of a population of 14,222 in Grand County are without any insurance.

Many blame an inefficient national health care system for the rising costs of health care and insurance, one that is a tangled web of competing private interests, costly government programs, rising premiums and coverage cuts.

It’s the taxpayer and the patient, in the end, who lose out.

Take the Andersons of Granby.

In spite of paying $1,000 a month for it, small-business owner Ken Anderson, who can usually be found behind the counter of his Rocky Mountain General Store, feels fortunate to even have health insurance.

One-thousand dollars is a considerable amount of money when trying to make ends meet on Main Street, but Ken’s wife Sharon’s pre-existing condition, diabetes, made the search for coverage a long and exhausting one.

The couple was rejected time and again by every commercial company they contacted. Cover Colorado, a state-funded program, was the only insurance provider that didn’t turn them down.

To afford it, Sharon works an extra part-time job, and there are a lot of luxuries they do without, Ken said, such as dining out, going to movies and going on vacation.

The true cost of being self-employed

It was Joe Mulder’s lifelong dream to own an auto repair shop.

After moving from Lakewood with his family, Joe worked at Granby’s City Market at nights to save up enough to open the doors to his small business in Hot Sulphur Springs near his hometown of Kremmling a year ago.

He steadily has been growing a list of loyal customers at Joe’s Auto but is realizing the cost of being self-employed.

He has long provided worker’s compensation for his employees, but only within the month have he and his wife Chelsea committed to health insurance for themselves and their two young children.

As they struggled to pay the bills ” car payments, business loans, rent, groceries and the overall cost of living upon moving to Grand County ” they went without health coverage for two years.

When their baby had an ear infection, Chelsea brought him to a physician in Kremmling, a visit that cost $130. Like previous visits, she had set up a payment plan to pay out-of-pocket.

With a newly acquired policy for the four of them at a cost of nearly $400 a month, even now, they debate whether its really the time to take on the financial burden.

“It’s $400 a month I don’t really have,” Joe said. “I’m still not so sure we can afford it. But we went ahead and got it; hopefully it works out.”

“It’s not like we’re doing bad; he’s doing really well,” said Chelsea, who helps supplement the family income by working part-time at the Hot Sulphur Springs Resort front desk. “There’s been only two weeks he was slow all year.”

The Mulders, like an estimated 48 million people in the United States and 792,000 in Colorado, had taken the gamble of cutting out costly insurance premiums to make ends meet.

“Health insurance premiums have risen dramatically in recent years, outpacing overall inflation and growth in wages,” according to the Blue Ribbon study launched two years ago by the Colorado General Assembly. “Total premiums for employer-sponsored insurance (combined employer and employee shares) have more than doubled in Colorado between 1996 and 2005.”

Those who lose the gamble suffer greatly, accounting for roughly 1.9 to 2.2 million (and rising) American families that filed for bankruptcy because of medical debt in one year (2001), according to Market Watch.

Forty-three states rank higher than Colorado in providing health insurance for children; 14.1 percent of children in Colorado are not covered by private or public health insurance and a higher number of Colorado children are not getting routine preventive dental care, according to a 2007 Colorado Health Report by the Colorado Health Foundation.

That same study also shows that Colorado ranks poorly, 32nd, in adults with health insurance.

One in four adults has no regular source of care. Meanwhile, the state scored fairly well, an A minus, when it comes to caring for the aging population over 65 years.

“I worry about my kids, if something were to happen at school or at daycare,” Chelsea Mulder said before they settled on a policy.

But like many families, the Mulders’ decision to forgo health insurance was an obvious choice ” food or health coverage.

Even now, sitting in the armpit of the system, their high debt-to-income ratio shows they don’t make enough to afford adequate insurance, yet they over-qualify for government-funded programs such as the low-income health insurance programs Medicaid, Colorado’s Child Health Plan Plus and Grand County’s Advocacy for Children’s Health and Education Services.

While going without coverage, Chelsea would tote her 4-year-old and 23-month-old to visiting medical vans ” at a cost of $10 per visit ” to ensure her children’s health. And she’d make appointments at Planned Parenthood in Granby, which sees female patients and bills them on a sliding scale.

The couple surrendered to coverage for the unexpected.

“My husband and I worry ” what if I get pregnant again?” Chelsea said.

Service and seasonal

Seasonal workers at Winter Park Resort do not qualify for the resort’s benefit package until their third season. For the first and second seasons, they are offered access to insurance, but the resort does not contribute.

How many freshman employees take part in such coverage is unknown.

For 9- to 12-month employees, the resort takes on 75 percent of the cost of insurance. In line with the industry standard, the cost of insurance is on the rise at the resort.

“We’re seeing increases every year,” said Winter Park Resort Benefit and Compensation Manager Kelly Renoux, “about 7 percent to 10 percent a year.”

Service and seasonal construction workers, who often fall between the cracks when it comes to health care coverage, make up the largest percentage of Grand County’s workforce, according to the Colorado 2006 Quarterly Census of Employment and Wages.

The industry paying the highest average wage, business management, with an average income of $70,928, supplies only 0.1 percent of jobs in Grand County.

Accommodation and food services employees are a big part of Grand County’s workforce, yet that industry pays the second lowest average wage at $16,900 a year.

Construction workers comprise of the second largest percentage in Grand County, at 15.8 percent, with an annual average income of $35,880.

Yet a rising cost of living, with the price of homes increasing 58 percent during the past five years, according to the 2007 Grand County Housing Needs Assessment study, the financial burden placed on these individuals and their households is compounded.

Service, seasonal and construction workers represent the bulk of the underinsured or uninsured in Grand County, said Amy Butler, chief financial officer of the Kremmling Memorial Hospital District. Many small businesses cannot afford to supply health insurance to employees, especially those workers who are seasonal and migrant.

Workers between the ages of 25 and 40 years old are those who generally risk going without coverage.

“I’ve seen more with Medicaid and uninsured than I ever have,” Butler said.

“Insurance is rising higher and higher and people just can’t afford it.”

This affects the cost of health care for everyone, as hospitals and health care providers try to make up the difference for those who don’t or can’t pay.

In the resort area of Grand County where jobs are mostly seasonal and the cost of living is the highest, many locals just say “no” to the high cost of insurance.

“A good 90 percent of our employees definitely don’t have insurance. It’s a scary thing,” said Edie Kiernan, manager of Deno’s Mountain Bistro in downtown Winter Park. The high season for service-industry workers is late December to April, then July and August. The months in between are times when incomes are stretched thin, Kiernan said.

The manager sees employees pretending they’re not hurt or sick so that they can work during busy shifts rather than see a doctor. But putting off care often leads to a worse injury or sickness.

“I think a lot of them go on a wing and a prayer here, especially those who do like snowboarding and skiing, hoping they don’t hurt themselves,” Kiernan said.

Long-time locals

But it’s not just the seasonal or migratory workforce that struggles with rising premiums and selective health care; it can be any year-round Grand County household.

The Linke family, Gay and Monte with children Ellis, 11, and Tel, 7, are waiting for something to give that will make health coverage more affordable and more fair.

Gay is a teacher at Granby Elementary School and Monte manages Williams Peak Ranch. The couple juggles health insurance choices, never knowing if what they’ve chosen will mean debt on the front-end in the form of premiums, or on the back-end in the form of high deductibles and high medical bills.

Only Gay takes part in the insurance package provided by the school district because adding her family would cut too much into the household income.

So they’ve gambled with a major medical policy for the three remaining family members, with a deductible of $3,400 per year, a figure they’ve never reached even with an emergency visit for a broken arm and a surgery last year.

Her son’s past sinus infection was flagged in the policy as a pre-existing condition, so even if the family would reach its deductible, a reoccurrence would not be covered.

The family pays out-of-pocket, banking on the notion that overall, the family is healthy and its members typically are not sick or accident-prone.

But debt is mounting from those rare instances when health care is needed, and forget about having dental policies, Gay said.

“We’re two college graduates; we have good jobs, we have insurance. We’re just underinsured,” she said. “I feel like at least I should be able to take my children in twice a year for dental check-ups.”

” To reach Tonya Bina, e-mail tbina@grandcountynews.com or 970-887-3334 ext. 19603.

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