Brewster: Uninsured and Underinsured

Hear Uninsured and Underinsured

Two Cape Cods Series

60-year-old Betsy Smith has a doctorate degree and owns her own home in Brewster, along the shore of Seymour's Pond, which is a very good thing because she spends 65% of her yearly income on health insurance.

Betsy Smith: "I went all around trying to find a way to qualify for a group insurance policy because it is so much cheaper to be employed through a group? I now have this individual policy that I am paying for by myself without any favorable rates because I cannot negotiate my rates. Blue Cross and Blue Shield doesn't want to negotiate with me."

Smith teaches English classes as an adjunct at Cape Cod Community College, and she pays $539 a month for the most basic health insurance plan she could find. But with fuel prices, taxes and the general cost of living on the Cape on the rise, Smith wonders how long she'll be able to keep teaching.

Betsy Smith: "I love teaching. As long as I am able, I am happy to teach my two classes, but more and more of my salary goes towards paying for my health insurance. It used to be travel money, but now it is going to health insurance. It's just very discouraging to think about the compromises that you need to make in order to be mindful of your health."

Brewster resident Bonnie Bonincontri doesn't have any health insurance at all. The single mom cobbles together part-time jobs to make her living on Cape Cod, including teaching classes and working in an office. But no matter how many hours she puts in, she cannot afford coverage. Without insurance, her entire lifestyle and everything she owns is at risk. But she tries not to think about that.

Bonnie Bonincontri: "I'm sort of am living with blinders on, I guess, and am taking my health for granted. But I understand that. I have talked to people who have had tremendous illnesses and they had insurance, and even the insurance didn't cover everything, and then they're hit with these just un-payable medical bills. I guess if that were to happen, I could lose my house, I guess."

Bonincontri is right. Without health insurance, she may be just one illness or injury away from not being able to afford her home anymore. Chris Austin is the director of the Interfaith Council for the Homeless in Orleans. The most common reason, she says, that families come to the council looking for help staying in their homes is the breadwinners lacked insurance coverage when an unexpected health problem came their way.

Chris Austin: "They'll try everything. They'll go to parents and ask for a loan. They'll go to friends and ask for a loan. Really and truly, illness is one of the things that really puts people behind because they don't have health insurance. They will use their money to get to the doctor then, or get the prescription that that child or that wife or that husband or that partner needs. And then that working partner is out of work. And that is all it takes because they are all living so close to the edge. And once that rent or mortgage starts to slip, they are in really serious trouble, at risk of becoming homeless, and that's what gets them here."

Barnstable County officials estimate that between 40,000 and 45,000 Cape residents do not have health insurance. Len Stewart is the county's director of Human Services. He says health insurance is typically tied to employment in the U.S., which leaves Cape Cod in a difficult situation because the region has a large number of seasonal and part-time jobs that typically don't offer coverage. And unfortunately, when money gets tight, Stuart says one of the first things a worker will give up is his or her or health insurance.

Len Stewart: "Often health insurance is one of those things they give up because the other financial items in their household are so much more acute. You have to put food on the table if you've got kids, you have to pay your mortgage or your rent or you're out. So health insurance becomes almost a luxury that while they know they need it, they try to postpone in it the hopes that nothing bad will happen."

State lawmakers are still hammering out the details of the universal health care plan passed this spring. The legislation is designed to cover between 90 and 95% of the state's estimated half-million uninsured residents. Some Cape Coders have floated a plan called Cape Care, which would provide all Barnstable County families with coverage paid for by fees collected from residents. But local families have heard politicians promise universal health coverage before.

Two Cape Cods Series