Cost pushes health insurance to wayside on The Murfreesboro Post

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Cost pushes health insurance to wayside

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By: LISA MARCHESONI, Senior Writer

Posted: Sunday, November 15, 2009 6:59 am

Cost pushes health insurance to wayside | Health Care, MTMC, Vanderbilt, Ben Saunders

Uncompensated health care costs for hospitals: Stone Crest Medical Center: $23.4 million, Vanderbilt University Medical Center: $228 million, MTMC doesn’t track the number of uninsured visits.

Ben Saunders would love to be covered by health insurance.

He just can’t afford the monthly premiums.

The 26-year-old tile installer is self-employed but because of the economic downturn in home construction, he’s unable to find steady work.

“It’s more of a cost issue more than anything,” Saunders explained simply. “When it comes down to buying food or paying the rent, health insurance goes by the wayside.”

A University of Tennessee study this year estimated about 10 percent of the state’s residents or about 616,937 residents lacked health insurance.

The state of Tennessee pays the insurance premium of his wife, a state employee, but doesn’t pay for the family plan costing about $600 a month. He and his wife are expecting their first child in April. If she opts for the family plan, the insurance will take about 25 percent of her salary alone. He wishes for a lower premium.

Because of his situation, Saunders believes in a government health plan.

“I’m honestly for it,” Saunders said, adding he believes regulations should be in place. “A universal health plan worked well in other countries like Canada.”

People’s fears about a government health plan appear to him to be unfounded.

Saunders hasn’t called U.S. senators or representatives to support health care but has signed online petitions for groups such as “A Truth for Democracy.”

Background

Saunders moved to Murfreesboro about 10 years ago. His parents paid his insurance while he was a student. When he transitioned into the construction industry, he started as a low-paid apprentice without insurance benefits. When he came into the tile installation business five years ago, he worked with an experienced installer who earned six figures. He installs tile on floors, walls and showers.

Because of the economy, work slowed down to the point of non-existent. Since the tornado, he’s picked up a few jobs remodeling. It seems like when a major bill is due, he’ll land a job just in time to pay the bills.

Saunders has shopped around for insurance. He considered CoverTN, described as the state’s “limited benefit health insurance plan for small businesses and the working uninsured. CoverTN offers two plans that cover the services most needed by most people.”

Saunders found CoverTN is probably the best option for small businesses, “except the deductible is still incredibly outrageous at $2,500. As a small business goes, business owners pay one-third, the employee, one-third and one-third by the government.”

Because he owns his own business, he would pay about $80 per month.

“If times were better, I could afford that,” Saunders said wistfully. “If things pick up, I would consider CoverTN.”

If he paid about $35 more per month, he could afford Blue Cross/Blue Shield insurance with a lower deductible.

“Especially with a child on the way, it worries me now more than before,” Saunders reflected. “Now that I’m married and have a child on the way, I tend to worry a bit more about my health.”

In fact, he and his wife eat healthier foods. He’s weaned himself off cigarettes by smoking a pipe and hopes to stop smoking the pipe soon.

When he works, he exercises on the physically demanding job. He’s pretty active.

“If I get sick, depending on how bad it is, I take Vitamin C and try and get better,” Saunders explained. “If it’s worst, I would go to a walk-in clinic. That would be cheaper.”

Other insurance

Saunders is insured under his wife’s dental plan costing about $15 per month, but it doesn’t cover as much as he needed recently.

“I had a tooth infection and I went in to have a root canal and other work done,” Saunders explained. “I presented my insurance that covered $100 of the almost $500 worth I needed that day. I had to pay $380 out-of-pocket that day.”

His oral surgeon sent out cultures not covered by insurance so he’s been turned over to collections for that bill.

“I feel the insurance company should have covered the lab for that procedure,” Saunders said, adding, “I never heard of an insurance company that denied lab work.”

Health-wise, he doesn’t have any pressing needs other than more work on his teeth.

Besides his health and dental woes, the self-employed Saunders must pay federal mandatory workman’s compensation of $1,600 annually and liability insurance of $600 annually.

“Right now, it’s a pretty hefty portion of income to insurance,” Saunders noted.

He wouldn’t mind paying more if he worked more.

Similar plights

Director Cliff Sharp of Greenhouse Ministries at 309 S. Spring St. helped 17,000 low-income people who needed food, furniture and bicycles – whatever we can do to help. Besides those needs, Greenhouse Ministries offers classes in literacy, computers, budgeting, parenting and prayer.

“Our motto is planting hope,” Sharp said. “What we can do is give them hope so they can improve their situation.”

Many of the patrons don’t get health insurance.

“A lot of people just put things off unless they’re really sick,” Sharp said.

Then, they seek treatment at the Middle Tennessee Medical Center’s emergency room.

They refer some patrons needing medical care to the Primary Care & Hope Clinic on Old Nashville Highway.

MTMC donated $107,000 last month to the Primary Care & Hope Clinic to care for the uninsured.

Gordon B. Ferguson, president and chief executive officer of MTMC said the clinic “plays a vital role in helping to create a more effective and compassionate health safety-net for the citizens of Rutherford County who are most vulnerable. MTMC is pleased that we have the opportunity to assist the Primary Care & Hope Clinic as they provide primary care to the uninsured and underinsured.”

MTMC has worked in collaboration with the Primary Care & Hope Clinic since 2003.

Clinic Chief Executive Officer Lisa Terry said, “The Primary Care & Hope Clinic is honored to have Middle Tennessee Medical Center support our mission to develop and manage primary healthcare for the most vulnerable in our community. Too often, the uninsured fail to obtain preventive and primary care health services because they have no consistent point of health care access. This donation helps us provide efficient and high-quality health care for the underserved.”

Saunders said he would consider getting treatment from the Primary Care & Hope Clinic if he needed it.

But his real hope is the economy improves enough for him to obtain his own health care.

“I hope the economy is better by next year,” Saunders said as he paused for a moment. “I’ve got my fingers crossed.”

Lisa Marchesoni may be reached at 869-0814 or at lmarchesoni@murfreesboropost.com.

Tagged under Ben Saunders, Health Care, MTMC, Vanderbilt

Member Opinions:

By: Alaskadave on 11/15/09
??? What exactly is the point here?

By: Newport1 on 11/15/09
I got out of it that he doesn't want to pay the premiums, considering he has options. I counted three... He wants the government to pay for it. For some reason, I don't really feel sorry for this guy.

By: citizenjim on 11/15/09
This newspaper is starting to sound like the Tennessean and "Newsless" Journal. I think we're still without a hometown paper.

By: thankyouforsmoking on 11/15/09
What people have to realize is that we don't have a "health care" crisis. If this man is hurt or sick, he can go to the nearest emergency room and they have to treat him. Of course that would leave him with a lot of medical bills, and I believe that the high cost of medical care is unfair. If only he was an illegal alien, then he could go to the ER, be treated, and leave it to the hospital to pay, which in turn raises the costs for everyone else.

By: wacdmc on 11/15/09
Exactly...what's the point? He can pay $80 a month in premiums and have a large deductible or he can go uninsured and have the government pay for his care...we wouldn't want to cut into the cost of his smoking habit. Sounds like the priorities are a bit out of line. Also, maybe he should go to Canada next time he has a toothache and see how long it takes for their government controlled system to get him in for his root canal...

By: mm123 on 11/15/09
Has the state changed its medical plan for employees? They used to cover the family. It might cost $200, but that's better than no coverage at all.

By: Tama73 on 11/15/09
it appears as almost every media outlet lately is pushing the leftist agenda. its beginning to scare me! even my local news. Cmon poeple and wake up, this will destroy us.Obama wants to ram this in or faces for his legacy

By: SocEtTuem on 11/16/09
I would like to offer my health care insurance plan: I pay for my insurance, you pay for yours.

By: Farmall on 11/16/09
My portion is over $200 a month for our family plan. And it doesn't cover all by a long shot. But if the Obama plan happens then the quailty of medical care will plummet. Right now we have a medical insurance problem, with the Obama plan we will have a medical care problem.

By: momof3 on 11/16/09
I am very disappointed at some of the attitudes shown here toward this man. I thought we were part of Bible belt country. Where is your Christian compassion? The article is pointing out what is becoming a larger trend - to go without health insurance, not out of reckless choice but out of necessity. I am also in the same situation, not because I want to be but because I have other more pressing obligations that have to be taken care of first. I have a good job but my employer does not offer health insurance and doesn't intend to. My husband has gone through several jobs in the last year, each time getting laid off due to lack of work. He is presently unemployed and looking desperately for work. He is NOT drawing unemployment by the way, just wanted to throw that out there before some close-minded person made a snide remark about something they know nothing about. And yes, he has a college education but that doesn't seem to matter in this economy. We are trying to keep our bills paid and there is not enough to go around each week. We had health insurance we were paying for ourselves but had to let it go to pay the house and car payments, utilities, etc. and buy food, which we deem more important. I am scared to be without health insurance but at this time, we simply cannot afford it. I don't know that O'bama's plan is the answer either so I am not promoting that as an answer. I just wanted to point out that there are decent hardworking people without health insurance that want it, can't afford it, and won't rely on government assistance to get it. Those of you who have good jobs and good benefits, including insurance, should consider yourselves fortunate and be more considerate and compassionate toward those who are struggling in these economic times. One of these days, you could very well find yourselves in our shoes.

By: momx5 on 11/16/09
i have always maintained: if people paid all of their own insurance instead of letting their employer pay a portion or even allowing the payroll deduction method...there would have been a health insurance revolt a long time ago !
When it comes out of your own pocket you realize how expensive it is to support corporations instead of your own health. Our family has done without ins for many years BUT we always pay for our care as charged by wherever we get it. Catastrophic Insurance is a better buy.
I'm just not into paying for golf retreats in the Caribbean for Ins. Execs.

By: canalou on 11/16/09
More than half the homeless children, men and women are at Room in the Inn because of medical bills combined, in many instances, with loss of jobs...do you really think there is no health care crisis in America? Go to Room In The Inn, check it out. They are people now homeless just like some of our own family....

By: Boo on 11/17/09
momof3- I, too, am saddened by some of these comments. I have a daughter and son-in-law in your situation. In the meantime, our government is paying another family member, who is 30 years old and perfectly able to work, big bucks to lay on her lazy a#% and have babies. She is up to five children now, and there will probably be more to come. There are people who want to work, or go back to school, and the government won't help. The government needs to stop wasting money on dead beats and start helping people who want to be productive, with jobs, health care, and education.

By: SocEtTuem on 11/19/09
Why are you saddened by these comments? The fact is, you have absolutely no right to expect anyone to pay your way, which includes paying for your health insurance. You do not have a constitutional right to live 0n the nipple of mother government and expect others to pay for it. Free health insurance/healthcare is not free. Somebody has to pay the bill. While I can't speak for everyone here, I am at the point where I can pay my own, but not yours too. If you find that "sad", that is unfortunate, but I am at the point where I can't afford more taxes, no matter what they are for.

By: Boo on 11/20/09
Soc-I agree for the most part. But there are good people out there that just need a helping hand. My son-in-law lost a good job four years ago. He couldn't find a permanent job so he worked part time every where he could. He finally found a permanent job, but he couldn't get insurance because his heart condition is "pre-existing." My daughter is a secretary at school, she doesn't make much, but she has insurance, but it doesn't cover every thing he needs. Just last week he threw away a new prescription for his heart because the out of pocket money it was going to cost was needed for their light bill. Now I am buying it for him because right now I can. The government is always going to give our money away. That's a given. I am simply asking that they give it to those who are deserving and trying to get back on their feet, instead of the deadbeats who don't want to work? My daughter and son-in-law have never ask the government for anything, but do you think it would do any good if they did ask? There are people out there who are needing not a handout, but a temporary helping hand and they can't get it. That's what makes me sad.