Athens County resident Etta Carpenter received a letter in 2010 letting her know that because she wasn't yet 55, she would be taken off her husband's insurance plan on Jan. 1, 2011.
She went to an emergency room with acute bronchitis on Jan. 11 of last year and she's still paying the bills, totaling more than $3,000.
Now both her knees are swollen, aching and require draining, but sometimes she simply tolerates the pain rather than paying $100 to have each knee drained.
ASHLEY RITTENHOUSE The Marietta Times
Marietta resident Rose Murray reviews paperwork with Adele Long, a nurse practitioner who volunteers with the Washington County Free Clinic. The clinic provides free primary care for Washington County residents between ages 19 and 64 who do not have health insurance and whose personal income is less than 200 percent of federal poverty guidelines. It is located in Marietta College’s Physician Assistant Training Program building on Third Street in Marietta.
"Sometimes it's hard to make ends meet and take care of yourself too," said Carpenter, 51. "It's just a shame. I know I'm not the only person in this boat."
According to the Centers for Disease Control and Prevention, 48.2 million Americans under the age of 65 are uninsured. In Ohio, 1,364,064 residents ages 18 to 64 are uninsured, according to the Ohio Colleges of Medicine Government Resource Center. Both figures are from 2010, the most recent data available.
A recent Washington County Needs Assessment survey completed by 750 county residents indicates 107 adult respondents are without insurance.
Costs for uninsured:
Marietta Memorial Hospital:
Nursery - $776 per day.
Normal delivery - $1,844.
Basic emergency room care - $150.
Basic operation - $945 for the first 15 minutes; $37 for each additional minute.
Ultrasound - $76.
Stress test - $575.
Knee MRI - $3,063.
Urine pregnancy test - $57.
Ohio State University Medical Center:
Nursery - $1,257 per day.
Vaginal low-risk delivery - $5,965.
Basic emergency room care - $258.
Basic operation - $3,029 for the first 30 minutes; $1,515 for each additional 15 minutes.
Anesthesia for operation - $385 for the first 30 minutes; $193 for each additional 15 minutes.
Brain MRI - $4,704.
Lipid panel - $235.
Note: prices are subject to change and extra fees are charged for most services and procedures, as additional services or medications are required.
Sources: www.medicalcenter.osu.edu and www.mmhospital.org.
For those who do not have health insurance to help cover their medical expenses, even common and basic medical procedures and services - such as a visit to the emergency room - can be a hardship.
"If you're going to come to the emergency room and you just had basic emergency care, the charge we have is $150," said Jennifer Offenberger, director of marketing and public relations for the Memorial Health System. "That doesn't include medicine, any kind of other procedures you needed while you were there or any special accommodations."
Officials with the health system declined to provide prices for other common services and procedures, saying too many factors come into play when costs are determined.
The state of Ohio, however, requires by law that hospitals provide a price list containing fees for room and board, emergency department, operating room, delivery, physical therapy and other procedures.
According to a list on Marietta Memorial Hospital's website, www.mmhospital.org, the fee for a normal delivery of a baby is $1,844, although anesthesia, drugs, supplies required for a particular delivery room procedure and fees for physician services or anesthesia administration are not included.
At the Ohio State University Medical Center, a normal, vaginal low-risk birth costs $5,965, with extra fees excluded from that cost, as well. The information is available at www.medicalcenter.osu.edu.
Fees for other common services are also provided on the hospitals' websites.
The fee for an ultrasound at Marietta Memorial Hospital, according to the website, is $76, although additional charges are possible depending on the services performed. The fee for an MRI of the knee is $3,063, while a stress test is $575 plus possible additional fees.
"If you're a self-pay patient without insurance, you automatically have a 40 percent discount on the charges of the hospital," Offenberger noted. "If you pay the day of service you get 15 percent off and if you pay within 30 days you get 10 percent off, so you can get upwards of 55 percent off if you're self pay and you pay the day of services."
Offenberger added that about eight percent of the system's patient population is self-pay, meaning they do not have insurance.
Samantha Parks, 36, of Williamstown, said she tries not to let it bother her that neither she or her husband have health insurance because the way she sees it, there's nothing she can do to change that.
"As far as me, I'm pretty healthy, but my husband has issues," said Parks, a full-time employee at Over the Moon Pizzeria on Front Street in Marietta. "We don't have insurance here but we couldn't afford it anyway."
Parks noted that she has four children, all on medical cards. She said she doesn't have dental insurance, either.
"I have a tooth that needs pulled," she said. "It's a situation where which child needs this, which bill needs paid, then you decide what to do."
Dental fees can weigh heavily on those who do not have dental insurance, with services costing hundreds of dollars.
According to Megan Lake, a business coordinator at Licklider Family Dentistry in Marietta, a routine cleaning and exam without insurance is $106, without X-rays.
She said it's about $200 to get one wisdom tooth removed and a crown or cap costs about $850.
"For patients who don't have dental insurance and are paying out of pocket we give a 10 percent discount," Lake noted. "We also offer our patients who do not have insurance CareCredit. It can only be used for medical, dental and optical purposes. It's a zero interest credit card. Plans are from six months to 24 months."
Lowell resident Anna Hendershot, 29, has not had health insurance since about eight years ago, when she was on her parents' insurance plan.
Although the company her husband works for does offer health insurance, it would be too costly for both of them to be covered, she said.
"I've been lucky to be healthy so far. You worry about anything can happen any day," she said. "You just have to plan a little more without the backup of insurance to help you."
Hendershot noted that when she does get sick, she usually visits the MedExpress Urgent Care center in Vienna. She said she makes it clear before she is seen by a doctor that she does not have health insurance, and she is assisted with, for example, free samples of medication.
Jason Koma, a spokesman for the Ohio State Medical Association, said the organization urges people - especially those without health insurance - to be honest with their doctor about their situation.
He said the organization also encourages physicians across the state to establish a financial policy for those without health insurance. Such a policy may include payment terms or a fee schedule.
"The biggest message we as a physicians association want to get across is the last thing a physician wants is to have a patient who delays or prevents getting medical care he or she needs," Koma said. "Ultimately that may make the particular condition get worse and leave that particular patient to have to seek care from the emergency department for something that would've been preventable in an earlier stage."
As a not-for-profit organization, the Camden-Clark Medical Center in Parkersburg does not turn anyone away for inability to pay and a charity care program is available for those who qualify, according to Greg Smith, a spokesman for the medical center.
"Eight to 10 percent of our patients are self-pay...which the uninsured would fall in," he said. "Under the charity program each is reviewed on a case-by-case basis and it's based on federal poverty guidelines and it's based on a sliding scale."
Smith noted that those who do not have health insurance, as well as those who have health insurance, Medicare and Medicaid can all potentially qualify for the charity care program.
He said over the past 10 months, the center has provided $18,524,000 in charity care and accrued $14,419,000 in bad debt, for a total of $32,943,000.
"We have financial counselors that take care of people like that," Smith said.