Live Sicker, Die Younger

A year and a half ago, Sheila and Bob Wessenberg lived in a 2200-square-foot luxury townhouse outside Dallas, on an income of over $100,000. Today, they are facing bankruptcy and a terminal illness without healthcare. "I might die as a result of my poverty," says Sheila in disbelief. She has gone seven months without chemotherapy or follow-up exams because she has no insurance and no money to pay for healthcare. In a country that prides itself on medical excellence, we also have one of the most dysfunctional healthcare delivery systems in the world. While politicians tiptoe around the problem, thousands of Americans live sicker and die younger because they don't have access to even basic care.

The Wessenbergs and their two children are among an estimated six million people who lost their insurance last year as a result of the economic downturn. They are also living proof that the slide from middle class comfort to absolute desperation can happen at warp speed, especially when health issues are involved.

Just over a year ago, Bob, a Lotus programmer, had a relatively secure job and his family had excellent health benefits. When Sheila was diagnosed with Stage 2, Grade B breast cancer, she was able to get the lumpectomy and mastectomy she needed. Then Bob lost his job in December, 2001, and the dominoes began to fall. The Wessenbergs did the best they could to pay for COBRA insurance, but when the premiums jumped to $837 a month it became prohibitive. Like most people, the Wessenbergs chose to pay for food and their mortgage rather than health coverage.

When the Wessenbergs dropped their insurance, Sheila stopped seeking treatment for her breast cancer. She was eight months into chemotherapy, and since she suffers a particularly aggressive form of cancer, her doctor had recommended continuing treatments indefinitely. Since losing her insurance, she has not even had follow-up blood work to see if her cancer has spread. Considering that uninsured women with breast cancer are twice as likely to die from the disease as women with coverage, she is free falling without a parachute.

I met Sheila while writing a book that examines the personal toll of being uninsured. "Denied: The Crisis of America's Uninsured," which was released last month, recounts 41 individual stories to reflect the 41 million uninsured Americans. I wish I could say that Sheila's story is unique, but in researching this book I found there is an overabundance of tragedy -- every bit of it unjustifiable. The stories I came across are harrowing. They include Nancy Gorman who was refused radiation for her brain tumor for ten months until she lost her vision and could be reclassified as 'urgent.' And there's Wendy Bennett, who was sitting in her truck at a stop sign, got hit by another vehicle, injured her arm, and was forced to file for bankruptcy within two years as a result. Then there's Kevin Holyroyd, whose strep throat went untreated until it spread to his heart, causing a massive heart attack. These stories piece together the puzzle of how people become uninsured -- be it job loss, divorce, tight finances or chronic illness -- and how that translates into deferred care, financial ruin and unfathomable suffering.

According to the Institute of Medicine, some 18,000 people die prematurely every year as a result of being uninsured. If that isn't an epidemic, then what is? That's like having six September 11ths every year. It makes a mockery of our preoccupation with bio-terrorism and small pox vaccines. While we direct inordinate resources toward a potential threat, we are allowing real people to die real deaths every day on the home front. As if this weren't dire enough, now even the future of our existing subsidized programs is in jeopardy. Nearly every state has announced plans to trim Medicaid, potentially leaving millions more without any coverage in the coming year. In California, the cuts go painfully deep, with a projected 10 percent reduction likely next year. That means services will be reduced, while the eligibility bar will be raised.