I have worked in Marion County as a Registered Nurse for 37 years.  After I retired, I decided to seek meaningful volunteer roles where I could use my experience.   I volunteer one day a week at a clinic in Silverton that provides free care for the uninsured. We treat major health problems like High Blood Pressure, Heart Disease, Mental Illness & Diabetes.  We provide preventative care as well such a well child exams, women’s health exams and immunizations.

Most uninsured people reluctantly turn to the Hospital Emergency Rooms or Free Clinics if they are lucky enough to have one in their community. They often wait to seek attention until they are pretty ill.. I saw a young adult with bi-polar disorder desperately seeking help for his out of control symptoms because he could not afford to buy his prescriptions.  He had lost his minimum wage job because he did not have appropriate medical care.

I see Diabetics with “sky high” blood sugar levels because they cannot afford to see their Provider or get their medications any more without insurance.  These types of patients can end up with a very expensive hospitalization when without meds, where the office visits & medications are comparatively inexpensive.

How much better it would be if these folks had a health care coverage for primary care, had a care provider of their own, a Health Home, if you will, where they felt comfortable getting routine preventative care and treatment.  If all children and adults were covered by a basic primary health care plan, they would not need expensive care in emergency departments, and everyone’s health care cost would be reduced.

Good health for Oregonians must be prioritized by providing health care services that promote preventative and primary care.

Karen’s Message to Legislators:

“Especially in the current economic crisis, we must invest in our state and its citizens to ensure a healthier, stronger population, work force, and future.”

The night before my 25th birthday, I was riding across the Morrison bridge in Portland when the front wheel of my bike dropped into one of the bridge joints. I don’t remember anything after that. It wasn’t until the next morning that I regained consciousness. I have no recollection of the hospital, the ambulance ride, the MRI or the x-rays. My $10,000 bill isn’t explained clearly enough to fully understand what care I was given. I just know I have to pay for it. I never went back to the hospital for follow up care because I didn't want to run up anymore bills.

I returned to work pretty quickly but was nauseous and dizzy for weeks. Even though I had been working full time for over six months, it wasn’t until after my accident that I found out about an available benefit package through my employer. I was without health insurance for six years and had no idea it was even an option. It would certainly have been nice to know about those benefits beforehand.

I have since applied for financial assistance for my medical bills through the hospital. Even though the hospital staff knew that I was uninsured, no one told me there was help available to pay my bill. Apparently, it is not their policy to let uninsured or low income patients know that there is help for them . I found out through a friend.

The number of uninsured in my generation is growing. I’ve seen many of my friends establish significant debt after one accident or sickness. Whatever I can do. I'd like to have an effect if possible. I just see it repeated over and over again. For being such a progressive state, it's amazing we can get away with it.

Ash’s Message to Legislators:

“I think it should be hospital policy to be given more information about what you're being charged for, any assistance out there to pay for it and resources for where to go to get more care if you need it.”

Robin Jackson of Portland is self employed and enjoys an international reputation in his field. He also volunteers a significant amount of his time working with at risk youth. Like many self employed people, Robin has to fend for himself in the individual insurance market.

Two years ago, after struggling unsuccessfully for several years to get into the Family Health Insurance Assistance Program (FHIAP), Robin managed to buy a high deductible plan. Two weeks later, Robin fell and broke his collarbone. His break was severe enough to require surgery and the insertion of a metal plate and screws. His insurance provided some coverage but Robin is still paying off a $7,000 bill with his limited income. When he tried applying for a better plan with his insurer, he was denied because his broken collar bone was classified as a preexisting condition.

After struggling for months, Robin was eventually approved for assistance through FHIAP, but he never had a chance to use his new plan. The federal government cut FHIAP dollars and Robin was forced into the Oregon Health Plan for six months. However, he has still been unsuccessful getting the treatment he needs. Though his collar bone constantly throbs and interferes with his ability to work, OHP won’t cover the recommended removal of the metal plate and screws in his shoulder.

When his OHP coverage ends in a few months, Robin will likely join the ranks of the uninsured. He is worried he won’t be able to find individual coverage with a preexisting condition, much less coverage he will be able to afford.

Robin’s Message to Legislators:

“I want a publicly run health care option. I think the program should be easy for people to use, no one should be denied for pre-existing conditions and the care delivered should be of high quality.”

I am disabled, and both my husband, Mike and I are diabetic. When my husband Mike lost his job of 30 years in 2004, we lost our health insurance because we couldn't afford to pay the $748 monthly COBRA premium. We spent a year without any health care coverage or doctor visits. We stopped taking our prescriptions when our supplies ran out. Eventually when I needed to restart some medicines, I couldn't afford the $130 office visit fee to have the doctor see me to write my new prescriptions.

I now have Social Security Disability Benefits and Medicare and Mike is covered through his work plan.  but we don't feel secure. Due to the economy, the company Mike is working for is currently decreasing their hours. Even if Mike is able to keep his job, we fear that if his hours are decreased too much, he will still loose his benefits. Mike will not qualify for Medicare for another 7 years. In order for him to maintain proper control of his diabetes, he must have consistent care. As the system currently stands, I fear for Mike's health if he loses his job.

I strongly support the measure in HB 2009 that calls for sliding scale premium assistance for Oregonions up to 300% FPL.  People cannot continue to sustain the loss of health care along with salaries.  They need to be healthy enough to work and support their families. I encourage you all to act quickly to meet the current need of the ever expanding numbers of uninsured Oregonians.

Kathy’s Message to Legislators:

“We’ve got to get some sort of health care for everyone.   We have a desperate need in this state, and it’s not just the people who qualify for the Oregon Health Plan. It’s the people in the middle, who make too much for OHP, but can’t afford to buy health insurance.   At some point, everyone will need this.”

Due to a congenital facial deformity, I have been experiencing severe chronic pain in my jaw, ears, neck, and shoulders for the past three years. I am the mother of three little girls and my routine debilitating migraines and pain medications have made it difficult for me to be the kind of parent I would like to be. The medications have provided little relief, the pain becoming so severe at one point that I could no longer chew food and my weight plummeted to a dangerous 116 pounds.

Surgery to correct the deformity became my only option. Even though my doctor, oral surgeon, orthodontist, and sleep study doctor all insisted that I proceed with surgery immediately, my insurance through Providence Health would not cover the recommended procedure. I sent four appeal letters to Providence, including detailed arguments from my doctors. Each appeal was denied. Though the company recognized the medically necessary nature of the recommended treatment, they refused to cover it because my condition did not fit within their definition of degenerative disease. James and I decided to go ahead with the surgeries this past fall and winter and not to worry about the cost until afterwards. James needs his wife back and the girls need there mom back. I need me back.

James is working overtime at the Tualitin fire department and my friends and I are gathering donations through craft and garage sales, but we’re still struggling with the $35,000 bill from the surgeon. We haven't received the bills for the operating room fees, anesthesia, hospital equipment and stay and are unsure how we’ll cover all the costs. We are both frustrated and anxious. It is so hard, to be that person that needs help! I feel pretty hopeless at the moment. We have fought every angle with Providence health insurance, but they have backed us in a corner.

Chrissy’s Message to Legislators:

"Insurance companies should not be standing in the way of decisions made between doctors and patients. We have played by the rules. Why are we being penalized?"

"I have a good job that provides my family and I with great health insurance, however the insurance company does not want to pay for the surgery that she needs. I make too much money to qualify for any type of financial aid.  I work overtime every month, just to make ends meet.  I am tired and exhausted...."

-James Whyte, husband of Chrissy Whyte, Oregon City

I met "Mark" a 20 year old young man at our safety net children's clinic at the beginning of September. Mark had an established diagnosis of Crohn's Disease, for which he had been treated by a Portland gastroenterologist from 2006 to January 2008. Unfortunately his father lost his health insurance in January and could not afford to refill Mark's medications, which ran out in April. Because he was over 18, Mark was not eligible for OHP. By August, Mark had severe abdominal pains, rectal bleeding and was rapidly loosing weight. His gastro doctor required $300 a visit, which the family did not have. I obtained lab studies on Mark and explained to his parents that his care was beyond my scope of practice as a pediatrician. I started him on Prednisone as an emergency tactic and assured the family we could find another specialist to help him.

In order to access care through our Coalition of Community Clinics, his parents began the laborious set of financial disclosure forms and applications. Meanwhile Mark continued to bleed, lose weight, and suffer excruciating pain. Three weeks later the financial screening process was still pending and Mark was running out of time. None of the other available safety net clinics had a gastro specialist.

To his good fortune Mark's mother obtained insurance through a new job, and the normal 90 day waiting period for coverage was waived. The day after coverage began, Mark was seen by a gastroenterologist and admitted to Providence Hospital, where he required immediate transfusion with two units of blood. He was hospitalized for two weeks, but is now much improved, on medication, and with good follow up - because he has insurance!

Don’s Message to Legislators:

“Despite my patient’s serious medical condition he was denied access to care due to the failure of our system. It is a tragedy and an embarrassment”

“It is quite possible in the U.S. to die on the hospital's steps, despite the good intentions of providers within our dysfunctional system.”

- Don LaGrone, M.D., Portland

We are a self employed family of five with an eight year old who has a condition called sitis inversus. With this comes immotile cilia syndrome and Kartageners disease. All of her internal organs are switched and the cilia in her body do not work. As a result she rotates through different antibiotics every twenty-one days. These medicines can add up to $500 a month and sometimes we cannot provide all the medicine she needs. We have made several trips to the emergency room, unsure of how we were going to pay the costs. We have been left financially strapped by the thousands of dollars we owe in unpaid medical bills.

Until recently, we have made too much for state insurance, while private companies refused to cover Elizabeth due to her "pre-existing condition". We had a group policy through our business but it cost us $750.00 a month and we were unable to continue paying for it. Elizabeth was unable to go to Doernbecher last year for her yearly checkup as we had no insurance. Due to our lack of insurance, our other two daughters have not been able to get well checks or dental care on a regular basis.

Our situation changed this winter, when my business began to lose ground in the slumping economy. We were literally losing a customer a week. A strange benefit to my dramatic decrease in salary was the qualification of my entire family for full medical coverage. I am grateful my family has health care now but I  find it disturbing that we have to almost strive for poverty in order to obtain it. I have been looking for other work, but am worried about losing our health care coverage again.

Ron Renfro's Message to Legislators:

"Had we been able to afford decent insurance at affordable rates, or if the state extended benefits to my children regardless of my income we would not be in the predicament we are in right now."

Delani Stephens of Portland has suffered dizzy spells ever since a car accident three years ago. Without insurance or a primary care provider, her brain injury went unchecked. A year later, Delani suffered a dizzy spell while riding a scooter and ran head on into a truck. She spent 5 days in intensive care with a torn ACL, 7 broken ribs, 2 broken arms and a serious back injury. She is still paying off the $100,000 bill. Delani is positive that if she had been under the consistent care of a doctor, she would have had help managing her health and avoided the dizzy spell that almost cost her her life.

Delani is only able to work part-time now and her employer does not offer health insurance. She remains on a waiting list for the Oregon Health Plan. Without a primary care provider, Delani’s health has continued to spiral downward. Months of immobility after her accident led to a diagnosis of adult onset diabetes. She has been able to get free test strips and medications through the pharmaceutical companies, but she receives no professional maintenance for her chronic health condition. Her gums are infected and have been bleeding but she can’t afford to see a dentist.

Delani gets frustrated when she hears that she should be working with a “team of specialists” to manage her diabetes. She does her best to educate herself on diet and exercise, but can only afford to see a doctor when she needs a prescription refilled. Having guaranteed secure access to a regular doctor at an affordable price would provide Delani with the chronic disease management she needs to live a healthy and productive life.

Delani’s Message to Legislators:

“With better health care, everyone is happier. There are less problems. There is less crime. People are able to keep working. Everyone deserves access to quality health care.”

Michele describes her 29 year old daughter Tessa’s childhood as pretty normal. She received B’s and C’s in school, swam on the swim team and graduated from high school. However, shortly after high school Tessa was diagnosed with major depression, anxiety and paranoia. Twice in the next few years, Tessa tried to commit suicide and was committed to the hospital for mental illness. She stabilized for awhile and Michele kept her daughter on the family insurance. "We felt that as long as we could, we were obligated to take care of her without being a burden on the government."

No longer eligible for her parent’s insurance, Tessa went on social security disability at age 25. But, when her depression returned, she wasn’t able to get an appointment anywhere. Tessa’s health worsened. She became belligerent and mean, someone Michele did not know. They called crisis care, took her into walk in clinics and the police were called multiple times. Tessa was hospitalized for short periods, but never enough to ensure her compliance with treatment upon release. Once, she spent three days in an emergency room with a guard and no treatment because there was not a psych bed anywhere in Oregon. In May of 2008, Tessa had progressed enough to finally be committed.

After five months of treatment, she is doing much better now, looking for work and a new place to live. This could all have been prevented if she could have found help a year and a half ago. She could work when she is well and not be on Social Security if her family knew she would have insurance when she was sick. Michele is "grateful for how well she is doing, but I live in fear that if our health care system does not change, next time, if there is a next time, she might not be able to find help soon enough."

Michele’s Message to Legislators:

"If there was community mental health available, my lovely daughter would not have had to go through her private hell. Tessa could lead a fulfilling and responsible life, something that the current system denies. Taxpayers could save tens if not hundreds of thousands if she could be assured that when she was sick she could get help."