LISA MARCHESONI, Senior Writer
Posted: Sunday, November 15, 2009 6:59 am

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.