Pensacola Independent News

COVER STORY | Vol. 6, No. 31, August 3, 2006
(Left Behind Part 1: Healthcare)
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Left Behind Part 1: Heathcare

Who's providing healthcare for the poor and uninsured?

Rosalynda Blackburn shuffles slowly to the exam room at the Escambia Community Clinics. Two back operations on her spine and degenerative discs have gnarled up the feisty woman like an old oak tree.

The 55-year-old twice suffered ruptured discs in 1984 and 1986 working on draw twisters, which made nylon for clothing and other products at the former Monsanto plant. The job required her to lift up to 30 pounds of nylon from near the floor to above her head.

An orthopedic physician told her back then she'd be stuck in a wheelchair by now. Not easy news to hear for a woman who raised three boys by herself and often worked two or more jobs to support her family.

"I tell 'em now, they gotta catch me first," she says. "I don't even walk fast anymore but they gotta catch me to get in it. As long as God allows me to walk, I'm going to do that."

Pain from her back injuries that affects the use of her arms and legs made her stop working at a nursing home in 1996. She also suffers from high-blood pressure and clinical depression.

But because her injuries made her unable to hold down a job, she lost health insurance coverage. Social Security refused to give her benefits claiming she had "no documentation" of her debilitating health problems.

For five years, she suffered back pain and depression without visiting any doctors and surviving from help from family, friends and her church.

Finally, she heard about Escambia Community Clinics in 2001, which provides healthcare to the poor and uninsured. She learned she might qualify for free healthcare. Her blood pressure was so high when she finally arrived that doctors told her she was close to suffering a deadly stroke, she recalls.

"This place has been a life saver to me," she says, tearing up at the memory. "I didn't see doctors for years and years. I didn't have money to go to a doctor. I thought I could handle it myself. I couldn't."

Today, Blackburn regularly visits the clinic in Pensacola on the corner of Palafox and Maxwell streets, which is packed with about 50 people on a recent Monday morning.

She receives—free of charge—medication for blood pressure and other ailments from Escambia Community Clinics and medication for her depression from Lakeview Center, a mental healthcare clinic. Still, her sons chip in every month and buy about $300 worth of medications she can't get and needs, she says.

Blackburn remains without health insurance but the clinic and an attorney are now trying to help her qualify for federal assistance again.

You might think, Blackburn is a unique case. Well, she's not, according to the Comprehensive Assessment for Tracking Health 2005 study. The 600-page assessment, which was released July 27, reports that health problems in Escambia and Santa Rosa counties are continuing to get worse and worse in many areas since 1995, especially among minorities and the poor.

Meanwhile, it's estimated 1 in every 5 residents are uninsured, or about 61,400. That's up 14 percent, since 2003. And by 2015, 1 in every 4 residents, or about 90,600, are expected to lack health coverage.

"Without health insurance, you have people who don't want to handle you," Blackburn says. "I have no income whatsoever. I had no one to turn to. Without this clinic, I wouldn't have lived another six months back in 2001."

Jim Mills, the Partnership for a Healthy Community president, admits the problem is complex and troubling.

"The picture is not entirely bleak," he says. "We have four community hospitals where the quality of care is outstanding. But the assessment doesn't answer some tough questions. Why are some health problems so severe? What's the solution? These are questions that as a community we have to answer in the days and months ahead."

Assessment 2005's troubling results for Escambia and Santa Rosa counties, which show health problems worse than similar counties and the state average, include:

• Smoking-related cancers and lung cancer in both counties;
• Cardiovascular and heart disease in both counties;
• Patients suffering from depressive disorders and elderly abuse in both counties;
• Repeat births to teen-agers in Escambia County;
• Proliferation of diabetes in Escambia County; and
• Health-risk behaviors in Escambia County.

In addition, the comprehensive study, which is conducted every five years and focuses on 430 specific health indicators, reveals that "poor health outcomes tend to be more prevalent in areas where there are large numbers of minority and/or lower income residents."

Don Turner, Escambia Community Clinic administrator, says the clinic will treat about 34,000 visits this year and provide about $3 million in charity care, or healthcare that is provided free of charge or isn't paid for at its location, which is open seven days a week. Sacred Heart Health System and Baptist Health Care, which help fund the clinic, provide an estimated $20 million each year in charity care.

"It's always busy," he says. "We have more people seeking treatment than we have time, money or resources. We do the best we can to meet the need at a fraction of the cost."

It costs Escambia Community Clinic on average about $86 to treat each patient it sees, which is estimated to be about four times less than the roughly $350 it costs to provide care to similar patients in emergency rooms at local hospitals.

Visits by the uninsured to the more expensive ERs drives up healthcare costs, costing those locally, who do have health insurance, about $31.6 million a year in expenses that are passed on.

Healthcare leaders say, as a result of the worsening health problems revealed by the Assessment 2005 study, they plan to call on residents, doctors, business leaders and local government officials to begin looking at solutions.

Some solutions they mention, include grassroots partnerships among local agencies to provide care and education. A ½-cent sales tax to provide about $14 million a year in healthcare to the poor is also being considered, and may go before voters in March 2007 for approval.

Although Turner says the root causes of the high rates of diabetes, for instance, need to be examined, he's convinced a big reason for the health problems being seen among the poor is the simple lack of access to care.

"I hope this will be a call to action for our leadership in the community," he says.

David Sjoberg, a Baptist Health Care executive and the Partnership for a Healthy Community treasurer, agrees with Turner about providing more care to the poor and uninsured.

"When we do this assessment again in five years, we'll see all these health problems again and they'll be worse, unless we really address the issues," he says. "It's pretty evident something needs to be done."

Mills adds: "I don't believe Washington or Tallahassee is going to come up with solutions for the problems we have in Escambia and Santa Rosa. Our hospitals are overwhelmed. Our community clinics are overwhelmed. We'd all like to see these indicators going in different directions than they are going."

So would Susan Croft, who doesn't make enough money at her job as a cleaning lady to afford insurance. She says she'd pay in blood or plasma donations, if there was such a thing. She suffers from insomnia from severe headaches she receives, she says, as she awaits medication at the Escambia Community Clinics. Croft admits she splits her pills in half to make her prescriptions last longer.

"If we didn't have some place like this, there would be nowhere to go," she says. "I need care. I am uninsured and one of the working poor. I have no choice."

Todd Cissell says he, too, has no choice currently. The 38-year-old construction worker recently got out of jail and is unemployed. But he admits as a construction worker, he rarely had health benefits.

"This is the first time, I have ever been to a clinic in my life," says Cissell, who came in for relief from migraines he's suffering. "I've always worked and am kind of embarrassed by the whole situation. But I'm down on my luck and medicine is so high you can't hardly afford it."

Mike Ziehl and his wife, Edna, didn't believe either that they would ever lack health insurance or go without healthcare. But they did.

A former store president for a national pizza chain, he was in a car accident, resulting in two shoulder surgeries and elbow surgery. He then developed staph infections in his spine that "felt like a belt of spikes around me." His medical bills quickly climbed into the tens of thousands of dollars and his health problems cost him his job, he says.

Without health insurance, he sat in his recliner for nine months and was in pain 23 hours a day, hoping he would get better, he says. Before his accident, he used to walk four miles a day with his wife around Cordova Mall.

Ziehl says a local hospital refused to give him the treatment he needed. So, finally tired of suffering, he walked into the Escambia Community Clinic and it placed him in Baptist Hospital for treatment. The 57-year-old Ziehl also suffers from diabetes and high cholesterol.

"The only reason I'm alive is because the clinic and Baptist Hospital helped me out," he says. "This can happen to anyone. You lose your job and you lose your benefits and all of a sudden you're not covered. I was scared to death. I can't believe I'm still here."

Healthcare crisis of the poor and uninsured
• More than 61,400 of the 313,000 residents of Escambia County have no health insurance coverage and are not eligible for any publicly-funded program.
• In 2006, 1 out of every 5 residents of the county will be uninsured.
• The percentage of Escambia County residents without health coverage is nearly 20 percent and exceeds the national average of 16 percent.
• The number of uninsured and medically poor in Escambia County is expected to grow to more than 90,600 by the year 2015, or more than 1 out of every 4 residents.
• Over the same period of time, the total number of residents with health coverage is expected to decline (from about 162,000 to 151,000).
• Nearly 4 out of 5 residents with no health insurance are employed.
• In 1999, according to the Florida Chamber of Commerce, 91 percent of Florida employers provided health coverage benefits to employees. In 2003, that figure declined to 73 percent.
• During the same period, costs for health insurance rose 58.6 percent.
• The majority of employers, who do not offer coverage, cite high cost or limited access to group health insurance as the reason.
• Escambia County is the 15th most populous county in the state of Florida, but ranks 28th among 67 counties in per capita income and 66th among the 67 Florida counties in spending for health and human services.
• More than 17 percent of Escambia County's population lives in households with total incomes less than $15,000 per year.
• Uninsured and medically poor residents forego medical treatment that they cannot afford and ultimately seek care in emergency rooms.
• For this population, chronic conditions such as diabetes and heart disease are not managed appropriately and prescription medications are not taken as needed, causing conditions to worsen and become increasingly expensive to treat.
• Emergency rooms at hospitals in Escambia County consistently operate above capacity and experienced more than 170,000 visits during 2005.
• In 2004 and 2005 the effects of the hurricanes which struck the area exacerbated the problem.

Source: AccessEscambia

Click here for compiled healthcare statistics for the area

duwayne@inweekly.net

InWeekly

Left Behind Part 1: Heathcare