Bankruptcy
Young People Try To Navigate Adulthood Without Insurance
Friday, May 28, 2004
Katie Campbell
Press Journal
VERO BEACH -- First Mary Rebholz, 25, and Ken Kaplan, 23, found each other. Then the young couple found employment.
Now they've found an affordable apartment. From afar, the Vero Beach couple seems to have succeeded in establishing themselves in the adult world.
But one missing item could change all that.
Health insurance.
Without it, one illness or injury could take a lifetime to recovery from financially.
Rebholz and Kaplan are two of the millions of young people who face the precarious health insurance void as part of growing up in the one industrialized nation without national health-care coverage. Eighteen- to 24-year-olds account for just 15 percent of the U.S. population but make up 30 percent of the country's growing numbers of uninsured, the 2000 U.S. Census reported.
"I think about it all the time. I really do," Rebholz said, who has severe scoliosis and a history of other medical conditions that could resurface at any time. Rebholz has not had insurance for more than two years and isn't likely to be insured anytime soon because coverage isn't offered through her job as an office assistant for a small Vero Beach chiropractic practice.
"I just keep thinking, 'What if? What if we start a family early? What if something happens?' If something disastrous happens, your life is ruined," she said. A regular pregnancy and delivery costs at least $10,000, said Sarah Gosney, executive director of the Healthy Start Coalition in Martin County. Any complications can raise the bill dramatically. There's no limit on the dollar figure of the other "what-ifs" that worry Rebholz.
In December something did happen. Rebholz started feeling ill and decided she needed to see a family practitioner. "A 5-minute consultation cost me $172. I was totally taken by surprise," she said. In those 5 minutes, the doctor recommended some blood tests to look at her cholesterol and calcium levels. The tests would have cost $1,800.
"That's the down payment of a house," Rebholz exclaimed. "I can't afford that." She went without the tests and just hoped the illness wasn't anything terribly serious. So far the young couple has avoided medical catastrophe.
"The reality is that most folks don't have the ability to weather a siege of medical bills," said Howard Dvorkin, president of Consolidated Credit Counseling Services Inc. in Fort Lauderdale. "Medical debt can happen overnight. You can generate thousands upon thousands of dollars."
Filing for bankruptcy is often the only way out from under a deluge of medical debt, he said. Some have argued, he said, that medical expenses are the leading cause of the rise in the number of bankruptcy filings, which is at an all-time high with more than 1.6 million filing last year.
Bankruptcy has consequences, Dvorkin said. It means a 10-year smudge on a personal credit record visible to potential employers, home-mortgage loan officers, and automobile and life insurance agencies.
The impacts reach even further
"When one person files for bankruptcy over medical debt, everyone pays," said Todd Zywicki, the Federal Trade Commission's Office of Policy Planning director and associate law professor at George Mason University in Arlington, Va.
"The hospital usually gets nothing back, so at least some of those costs get passed on to other people." Costs are recouped through raising prices for medical services, which translates to higher insurance premiums.
But Dvorkin said that doesn't explain why medical costs and insurance premiums are so high.
"It's because doctors are so afraid of getting sued," he said. "Doctors are prescribing extra tests, to make doubly sure they're prescribing the latest and greatest treatments so they don't get sued."
However the costs are rising, for Rebholz it means market-rate insurance plans are climbing out of reach.
The average family health plan is about $9,000 a year, said Pat Chaney, executive director of the National Coalition for Health Care. That's expected to ascend to $14,000 by 2006.
"It's too expensive. They don't make enough money," Chaney said. "Young people, by the force of economy and by their own sense of invincibility, they end up going without insurance."
Kaplan didn't worry much about being without coverage for 11 months after he graduated last May until his benefits kicked in from the job he started in December, working in medical billing and marketing for a local medical firm. "I look at it as if I think I'm well, I am well. You just have to keep a good attitude," said the healthy young optimist.
That's easy to say for someone who hasn't been to a medical doctor since he was 6 years old. Kaplan and Rebholz see only one way to safety: Get married. Then Rebholz could purchase coverage through her new husband's insurance. But the wedding isn't scheduled until next January.
Until then, Rebholz will continue to go without coverage and the "what-ifs" will continue to linger in her thoughts.
