NPR: Massachusetts (cf. Texas)

With the second anniversary of the ACA and the Supreme Court challenge coming up, the media are focused on every angle of national health reform. We know that real life stories are often the best way to communicate reality, and NPR did a great job on Tuesday bringing us two similar people from Texas and Massachusetts. Similar, except that the Massachusetts person has good, affordable health coverage.

The stories, One Nation, Two Health Care Extremes is built off of two reporters, one from each state. In Houston, Carrie Feibel introduces us to what it’s like for someone in a state with 25% of residents uninsured.

CARRIE FEIBEL: More than six million Texans have no health coverage – government or private. That often means an anxious scramble for care at overcrowded charity clinics or the emergency room.

One of those six million works here, at the Faith Christian Academy. It’s a private school located just a few miles south of Houston’s refinery row. You can’t see the petrochemical plants, but you can sometimes smell them. Melinda Maarouf is a teacher’s aide.

… Maarouf is 55, divorced, with one daughter in college. The school can’t afford to bring her on full time right now, so she makes just over $11,000 a year. That’s right around the federal poverty line, and that means hard choices when it comes to her health. Maarouf has hypertension, and she says there have been times when she skipped pills to make them last longer.

MAAROUF: I can always tell when my blood pressure is elevated. I feel uncomfortable. I feel edgy and kind of shaky, and my ears ring.

FEIBEL: Maarouf knows that if she doesn’t control her pressure, she could have a stroke, a heart attack or kidney damage. Recently, she found help at a charity clinic called Ibn Sina. She pays only $25 per visit. But Maarouf says the blood pressure is all she can afford to treat right now.

MAAROUF: I haven’t had a Pap smear – goodness – I can’t even tell you – probably since my daughter was born, and she’s 26. And I haven’t had a well woman exam, and I’m sure it’s time for some routine blood work. But, you know, it’s just not in the budget.

FEIBEL: Maarouf has never had a mammogram, and she’s continued to push off some needed dental work. Medical bills scare her. In 2010, she went to the emergency room with chest pain. Doctors didn’t find anything wrong, but she ended up with $3,000 in bills she couldn’t pay.

…Melinda Maarouf is like millions of other working Texans. As long as she’s not disabled, she can’t get Medicaid, and she’s years away from Medicare. Hospitals in Texas spend over $4 billion a year treating uninsured patients like Maarouf. County taxpayers absorb some of the cost, and some get shifted onto insured Texans who end up paying higher premiums for their own coverage. Melinda Maarouf says she feels stuck and exposed.

MAAROUF: It’s like you’re sort of walking a tightrope or sometimes feel like I’m on the edge of a cliff. As long as everything is status quo and there’s no glitches or bumps in the road, I feel OK. But I sometimes feel like I’m one emergency room visit away from a catastrophe.

Meanwhile, in Boston, WBUR’s Martha Bebinger tells a much different story:

MARTHA BEBINGER: Peter Brook is one of the 439,000 residents who has coverage as a result of the state law.
…Landscaping is one of the many odd jobs Brook takes on to cover his basic needs. Five years ago, before Massachusetts started offering free and subsidized coverage, he could not afford health insurance or the insulin and needles Brook uses daily to treat his diabetes.

BROOK: When I didn’t have health insurance, I’d use a needle for 30 days, like 150 shots or something, and so it gets a little bit dull.

BEBINGER: When Brook had complications related to his diabetes, he didn’t have money for care. The worst was a digestive problem that would bring on crippling stomach pain.

BROOK: I would tend to hole up in the fetal position at home and then, over the course of a week or two, my skinny body would lose 25, 30 pounds and then I’d end up looking like a death camp survivor.

BEBINGER: And then there was the time Brook fractured his pinky and set it by taping the broken section to his ring finger. It’s still crooked.

Today, Brook has free health insurance and a regular doctor at the South Boston Community Health Center. Brook’s only cost is a $3.65 co-pay for prescriptions, which adds up to about $14 a month.

BROOK: I now have good health care so that that is a weight off of my mind. It’s been a year and a half since I’ve been in the hospital and for the first fifty years of my life, I never went six months without having a inpatient hospital stay for one thing or another.

Perhaps rather than thinking about health care reform options as Barack or Mitt, we all should think of the choice as Peter or Melinda.
-Brian Rosman

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