Increasingly, not just the poor are uninsured

By Timothy Pratt

Monday, April 27, 2009 | 2 a.m.

The free-falling economy is sending many more people to the state’s clinics that treat the uninsured.

Last month, 2,498 patients without health insurance went to the clinics of Nevada Health Centers, a federally funded program that charges on a sliding scale. That’s 52 percent more than in March 2008, when the clinics saw 1,642. If you look at the past six months compared with the previous six months, the increase is less, but still striking: 21.5 percent.

Patricia Durbin, executive director of the Great Basin Primary Care Association, a nonprofit organization that promotes health care for people in need, said she didn’t find those numbers surprising, given double-digit and growing unemployment rates.

At the same time, she said, “some of the demographics are (surprising).”

“It’s no longer just a poor person’s problem,” Durbin said. “The lack of health insurance and affordable health care is affecting more of the middle class.”

At the Eastern Family Medical and Dental Center in Las Vegas on Friday, Archie Wolfe had spent half his day traveling from Pahrump with his wife, Theresa. She has arthritis and back problems. But taking a shuttle that cost Wolfe half a day’s pay was still the best option.

Wolfe, 54, is without health insurance for the first time in his life, four months and counting.

He made the 63-mile trek to the clinic on Eastern Avenue because it was the closest of 29 Nevada Health Centers statewide.

Wolfe said he had worked as a chef for 15 years, most recently at the Millennium Hotel in Anchorage, Alaska, before moving with his wife to Las Vegas last year. He never had to think about finding a doctor who charges on a sliding scale. The couple moved to Las Vegas because they thought the climate would be better for Theresa, and that there would be work for Archie.

But then the local economy shattered. For six months, the couple got help from Clark County Social Service. Wolfe applied for jobs at Wynn, Encore, MGM. “They all said, ‘We’ll call you back.’ ” They didn’t.

A friend told him in January that Irene’s, a casino in Pahrump, was hiring. The couple moved.

But there’s no insurance with the $8-an-hour job.

Others at the clinic Friday also work for hourly wages, but they are earning less than they were six months ago — too little to afford private insurance plans and too much for government assistance.

Sylvia Mijarez considered herself lucky, holding onto her job as a supervisor at Summit Medical after her husband lost his job as an electrician. Mijarez was at the clinic on Eastern for her 4-year-old daughter Lajiyah’s checkup. But she can’t afford to put her husband on her insurance plan.

Andrea Thurman, regional operations director for Nevada Health Centers, says the issue of the uninsured in the valley’s clinics becomes more acute every day.

“It’s a challenge to accommodate the need,” she said.

At the Eastern clinic, up to 45 percent of the patients lack insurance, she said.

Carl Heard, chief medical officer for the program, noted that the federal stimulus dollars now trickling into Nevada include $1 million for Nevada Health Centers.

“It’s a big help,” he said. “But it’s not the solution ... We’re doing everything we can to bring in any resources we can to meet the needs of the population.”

Durbin thinks the state could use at least 20 more clinics from the federally funded program. Facing the likelihood of unmet need, she is worried about the effects on people’s health.

“Uninsured folks are putting primary health care, preventive care and chronic disease management further down the list,” she said. “They’re choosing between groceries and tests.”

“That’s going to show up later in the emergency room when problems become acute,” she said.

“There will be a lot more people without adequate care. People are going to die.”