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Sandy Johnson at her home in Ogdensburg. Photo: Julie Grant
Sandy Johnson at her home in Ogdensburg. Photo: Julie Grant

Lack of money for medical care blamed for high death rates

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St. Lawrence County has high rates of diabetes, high blood pressure and many types of cancers. People here aren't as healthy as most New Yorkers, or even most Americans. Local health care advocates say one big reason for that is poverty. Many St. Lawrence County residents don't have health insurance and can't afford to go to the doctor, so they miss out on a lot of routine preventive care: a mammogram, stress and cholesterol tests.

Julie Grant spoke with one North Country woman who needs help with her medical costs, but she's not counting on the new federal health insurance law.

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Julie Grant
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Sandy Johnson never thought she’d be without health insurance at the age of 60. The petite blond lives in Ogdensburg, and pays rent to share her sister’s house with its dark wood moldings, lace tablecloth and framed photos of playful grandchildren. 

Johnson had gotten health insurance through her employer for 25 years.  She contributed $60 a month. Then she retired.

“I have no insurance now, because I just can’t afford it," said Johnson, who says that paying for health insurance herself would cost $550 per month. “I get roughly 700 dollars a month from my retirement.  And if you take $550 out of that then you don’t have much to play with for a month.”

Johnson is too young to qualify for Medicare, and she makes too much money for Medicaid.  Johnson works two part-time jobs and makes $350 a month.  Added to her retirement income, that’s just over $1000 dollars a month, which is over the Medicaid limit.

Johnson started to realize how big a problem that was going to be on her first visit to the doctor after she retired.  She needed three prescriptions updated.  First, she paid $70 for the visit.  Then she learned that just one of her medications, one for her thyroid, would cost $200 per month.

“And then I was like, ‘Oh My God.  What am I going to do?  It’s just so hard,” said Johnson. She needs her meds, and she says she put a screeching halt to taking care of herself in other ways.  She stopped going to the dentist and the eye doctor.  Still, she struggled to pay for her medications. “That’s what discourages you.  You’re like, ‘I worked 25 years of my life, and I got a slap in the kisser.’  There just isn’t anything else out there.  I have tried everything under the sun,” said Johnson.

Johnson did find some help.  Her doctor’s office recommended a program called The Health Initiative, based in Potsdam.  Last October, they were able to get the pharmaceutical company to take care of the cost of Johnson’s thyroid medication for one year, and she’s been getting it for free.

Ruth Fishbeck is director of the Health Initiative.  It’s a not-for-profit organization that was started in 1999 when two hospitals collaborated to assess the health needs of St. Lawrence County.  Fishbeck says they find programs and funding for many people, but nearly every week, they get calls from others they can’t help.

“There are people I just have to say there’s nothing.  There’s nothing for you.  So that’s still a very hard thing for us to turn someone down,” said Fishbeck. According to her, St. Lawrence County is ranked among the worst of New York’s 62 Counties by most health measures.  There are so many people in the county who can’t afford to pay for a doctor’s visit, lab work and prescriptions, so they don’t go to doctor, even when they know they’re sick.

Fishbeck calls this a crisis and said, “Well, people are dying. We rank in health outcomes, we rank 58th or 59th out of 62, and that means premature death and sickness. So we have a significantly higher number of people experiencing premature death, before the age of 75. Unacceptably high rates of premature death.  And a lot of it is simply the lack of money to get adequate health care.”

Fishbeck says many people think the biggest issue in rural communities is the lack of doctors.  And that is a problem. However, she says that an even bigger concern is this lack of money to go to the doctor.  If someone has cancer, for example, Fishbeck says they might need to drive to Syracuse, or Burlington, Vermont for treatment.  On top of all the medical costs, that’s gas money they might not have.

 Medicaid only helps the very poorest: those with almost no income at all.  That’s why at just over $1000 income a month, someone like Sandy Johnson doesn’t qualify for government assistance. 

“So many people are under the impression that there are programs, that the government wouldn’t let somebody with cancer not get treatment because they don’t have money. But that happens every day because there is no program.  I can’t even repeat that enough," said Fishbeck. She wants the Supreme Court to uphold the national health care law, and she  says it could help a lot of people afford health insurance. 

Even though Sandy Johnson doesn’t know how she’ll pay for her thyroid medication after October, she still isn’t convinced that the health insurance reform law is a good idea. She said, “If it happens, I’ll be amazed.  There’s got to be a glitch.  There’s got to be something to screw up the little guy. The rich will keep getting richer and the poor will keep getting poorer…because we’ll keep paying everything out of our pockets.”

But Fishbeck thinks the federal health insurance law will help. She says more people will be able to afford insurance, so they won’t have to pay out of pocket.

New York has already received $27 million from the federal government to set up what are called health care exchanges as part of the law. The exchanges are meant to provide a competitive insurance market for people who don’t get health insurance through their employers.  The department of health is setting up the exchanges in New York.  A spokesman there says they are “putting the final touches” on the exchanges, and are not ready to talk about them at this point.

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