For Uninsured, Illness Can Break Spirit as Well as Budget

Most of the 5 million Californians without health insurance are working poor people and their families, but the increasing costs of medical coverage also imperil the middle class. Here are three profiles of everyday Californians who faced financial ruin because they had no health insurance and fell ill or were injured in an accident.

Jim Krause once considered himself a conservative. A self-reliant businessman, he took care of his own affairs. The only thing he asked of government was to keep its nose out of his business.

Now the San Dimas printer is an eloquent advocate of tax-supported health care for all.

Caught without insurance two years ago, Krause went broke paying the medical bills that piled up after he had a stroke and a heart attack and was hospitalized three times.

But the bills broke more than his budget. They shattered his spirit and left him questioning the basic human decency of a country he once thought was the greatest on Earth.

“How can this be happening in America?” Krause asks. “Where is the outrage? Why aren’t people angry?”

Krause had insurance until late 1986, when the company that covered him went under. He shopped around for a new policy, but as a 59-year-old independent businessman, he was unable to find coverage that he could afford. Healthy all his life, Krause said he “didn’t panic” at the thought of going uninsured. He had a minor stroke in 1988, and was willing then to make a greater sacrifice to pay for insurance. But with a recent medical problem, he found nothing that he could possibly afford. Then, in early 1989, he suffered a heart attack.

“I came out of the hospital five days later with a pacemaker in my chest and a $40,000 medical bill in my hand,” Krause said. “There was no way on Earth I could pay that.”

Krause’s wife and children pitched in to help him keep his small business going. Friends and their church lent them $3,000 to stave off the creditors for a while but, finally, Krause declared bankruptcy. He scrapes together about $200 every other month for a visit to the doctor--he has to pay in cash--but he knows he is not getting the kind of care he needs to fight his heart disease.

“I’m not looking for sympathy,” he said. “But people have to understand, this is the worst kind of torture there is. You’re scared to death. You’re afraid of dying, but there is nothing you can do to prevent it, to stop it. If you are poor you are taken care of, and if you are rich you’re OK. But if you’re in between, you’re screwed. That sounds like a cliche, but it’s true. And it’s horrible.

“Without insurance, you’re dead.”

Heidi Wilson, 46, was without insurance several years ago when she fell down a flight of stairs at San Diego State University, breaking her hip and neck.

The medical bills totaled more than $150,000. To pay them, Wilson and her husband sold a home they had built themselves in Escondido, with its 40-acre avocado ranch.

“We had to sell everything to pay off the medical expenses,” said Wilson, a nurse. “We sold our dream.”

Wilson could not get insurance because she has lupus, a disease of the immune system, and no company would cover her. Since then, she has managed to obtain insurance through her husband’s former employer, but the premiums cost the family of four $500 a month.

Even though she is secure for now, Wilson remains angry about the insurance industry. She believes that many middle-class people wrongly perceive the health insurance crisis to be something affecting only the underprivileged.

“It is not just a black problem and a poor problem,” Wilson said. “It is affecting anybody unlucky enough to get a really serious disease.”

When Bill Terrill suffered a heart attack a year ago, he was rushed to the hospital, where physicians performed a quadruple bypass that probably saved his life.

Today, the Manteca resident can’t get a private doctor to see him.

Terrill’s medical costs exceeded the $150,000 lifetime cap set by the health insurance he obtained through the winery where he worked for 28 years. His coverage was canceled, not only for his heart ailment but for all health problems, leaving more than $100,000 in medical bills unpaid.

Unable to negotiate a payment plan with their many creditors, Terrill and his wife, Helen, were forced to file for bankruptcy to save their home. But if Terrill, who now has no insurance, falls ill again, he will have to go to the San Joaquin County hospital, and the government will put a lien on his house to recover whatever it costs to take care of him.

Terrill, 54, has not seen a doctor since last June. He eats carefully and exercises moderately, but he keeps his fingers crossed hoping that he can survive until July, when he will qualify for the federal Medicare program. As a heart attack victim and lifetime sufferer of diabetes, he could not possibly obtain private health insurance to tide him over until then.

“You work all your life and you pay your bills and then all of a sudden the whole world has turned against you,” Helen Terrill said. “It is very degrading. It was almost like after they saved his life, they tried to kill him.”