America’s Uninsured: Often They Are Workers, Children or Gamblers : Health: Most go without insurance for less than six months, and only 15% spend more than two years uninsured. But 57 million Americans could be without coverage sometime this year.

Bill Snoberger made almost $40,000 last year as foreman of a small machine shop and never expected his wife and three children to land among the almost 37 million Americans without health insurance.

But that’s what happened last December after his employer abruptly switched insurance policies and stopped offering family coverage.

“I didn’t worry about it at the time. It was right before Christmas and afterward I was going to look at getting insurance somewhere else,” said Snoberger, 34.

But his 15-year-old daughter, Sandra, became ill in mid-December and on New Year’s Eve she was diagnosed with leukemia. Because of that “pre-existing condition,” private health insurance was suddenly unavailable at any price.

The plight of the 36.6 million Americans without insurance--10 million of whom are children in the most recent government survey--is a driving force behind President Clinton’s campaign to overhaul America’s health care system. He has promised to send Congress a blueprint including universal health coverage.

Five of six Americans have health insurance, but the uninsured include millions of working men and women, their children, individuals gambling they won’t get sick and others.

“They are a lot of everybody,” said Katherine Swartz, an economist at the Harvard School of Public Health.

Many move back and forth between being insured and not. Most go without insurance for less than six months, and only 15% spend more than two years uninsured, according to Swartz.

But 57 million Americans will be without insurance sometime this year, according to the advocacy group Families USA.

Sandra Snoberger wound up in Children’s National Medical Center in Washington, D.C., where she has run up bills of $150,000 and eventually qualified for Medicaid. The premier hospital has a policy of providing full care even for patients without insurance.

“We never thought anything like this would happen,” said Audrey Snoberger, whose husband commutes 70 miles each way to work from their rented home in Cross Junction, Va.

Like the Snobergers, most of the uninsured live in families headed by someone who works, usually for a small business.

In many instances, their company offers no health benefits, or covers only the workers. Often, the employees are unwilling or unable to pay the premiums.

They’re people like Miguel and Evelynda Perez of Milford, Mass.

He ekes out a living as a $4.75-an-hour warehouse worker. His job offers insurance, but it would cost $18 a week and the couple feels they can’t afford the cut in his $177 take-home pay. Their three young children get Medicaid.

Studies show the uninsured get about 40% less care, on average, than people with insurance.

By law, hospitals must treat anyone who shows up with a medical emergency, so when Evelynda Perez underwent an emergency appendectomy recently, she didn’t have to pay the hospital’s $6,450 bill. But the surgeon and other doctors dunned her for more than $2,000.

Cheryl Skelton, 35, of Peabody, Mass., recently got insurance for herself after taking a $6.15-an-hour computer-assembly job. Her weekly premium is less than $22, but she put off covering her two children, who have chronic health problems, because it would boost the premium to $125.

“There’s no justice for children. . . . I’ve got 18 prescriptions in my pocketbook that I can’t afford to fill,” said the frustrated mother.

Russell Beaudreault of Athol, Mass., disabled by a back injury, is covered by Medicare, but his wife, Judy, and son, Scott, 9, have gone uninsured for several years.

“We go to doctors and we bargain with them. If they want $60, we offer them $30 cash,” said Beaudreault. “Most of the time they take it.”

“I have a constant worry that one of us is going to be hospitalized for one reason or another, and then . . . I’ll be on the street,” Judy Beaudreault said.

The problem is worse among younger workers, the self-employed and those in trades that traditionally offer few benefits, including farm work, non-unionized construction and retail sales.

Some of the uninsured are risk-takers.

Sen. Nancy Kassebaum (R-Kan.) said her son Richard, a 32-year-old film editor in Los Angeles, is uninsured. The company he works under contract for doesn’t offer benefits so “he gambles,” said his mother.

Swartz said, “If you’re 25 and single and really don’t think anything was going to happen to you . . . it’s not irrational to not buy insurance.”

A low-income worker facing a $500 deductible and $50 monthly premiums would have “to pay $1,100 before they get any coverage back,” she noted.

For others, it’s a struggle to find affordable insurance.

“It’s very tough to get individual insurance,” said Mark Nadel, an associate director of the General Accounting Office. “There are very few people in middle age who don’t have some condition that would make an insurer not want to cover them.”

The United States is one of the few industrialized nations that makes no provision to insure all its citizens. The current, job-based system of insurance sprang up after World War II. Four out of five workers get insurance through their jobs.

But almost two-thirds of firms with fewer than 25 workers offer no health insurance, according to the Health Insurance Assn. of America.

Clinton’s plan may require firms to provide benefits, but small businesses contend such a mandate would saddle them with ruinous costs.

“The bottom line doesn’t allow it,” said Arlene Swartzman, a book store owner in Tampa, Fla., who provides no health insurance for her sales clerks, all part-timers.

Audrey Snoberger and her two younger children are still uninsured. She plans to shop soon for a new family policy.

“I am just afraid to be in this boat again,” she said.

Faces of the Uninsured

Who are these 36.6 million people without health insurance?

They are a cross-section of America, mostly from working-class families.

Here is a look at them, drawn from an Employee Benefit Research Institute analysis of the government’s March, 1992, Current Population Survey, the most recent available:

* 9.5 million are children under 18; more than a third are in families living in poverty.

* 12.6 million are workers and heads of families.

* 7.9 million are workers dependent on others.

* 6.3 million are adults not in the work force.

* 300,000 are elderly ineligible for Medicare because their Social Security contributions were insufficient.

* Almost 20 million of the uninsured had family incomes under $20,000 in 1991. Another 12.8 million were in families with incomes of $20,000 to $50,000. The rest, 3.8 million, had family incomes above $50,000.

* Fifty-eight percent were white; 19% Hispanic; 18% black and 5% other.

* Fifty-six percent are men, 44% women.

* Twenty-eight million of the uninsured live in cities, 8 million in rural America.

Source: Associated Press