More Working Without Health Insurance

BOSTON -- About 500,000 people in Massachusetts do not have health insurance and about 70 percent of those uninsured work.

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NewsCenter 5's Anthony Everett reported that the working uninsured are employed part-time, full-time, or are self-employed, and are either not offered or cannot afford the most basic health insurance coverage.

Wayne and Linda Tyler operate Ed's Place, a deli in Natick, Mass.

"I'm not here for the money. This is all fun," said Linda.

But as they serve up a healthy breakfast for their loyal customers, they are going without health insurance.

"On top of everything else, on top of rent, utilities, what else is killing us?" asked Linda.

"Our first four years here, we were paying for the business. And (insurance) wasn't in the cards then, and still isn't," said Wayne.

The Tylers couldn't find a private health insurance plan for less than $1,300 a month. So they went without.

But in November 2004, Linda was rushed to the hospital with breathing problems. Doctors discovered blocked arteries, but chose medication over surgery. Linda spent one night at Framingham MetroWest Medical Center and a night at New England Medical Center.

Then the bills started rolling in.

"I have a $8,000 bill for New England Medical. I have a $6,000 bill for MetroWest. Close to $20,000," said Linda. "The biggest shock was the ambulance ride, $3,200 between the two."

Linda said she lives next to the hospital.

"I live in the last house before the hospital. It had to take me up the driveway, not even a quarter of a mile. That was $800," she said.

"When you get those bills and worry about what's coming ahead, it's overwhelming. How will you pay for it?" asked Wayne.

For the Tylers, the cost is so high and the risk is so great they're thinking about giving it all up -- giving up their dream so they can work somewhere with health benefits.

"We have to think about 10 or 15 years from now. Our health won't get better as we get older. Do I want to give this all up so we can have futures? Healthy futures?" asked Wayne.

Wayne, who missed six weeks of work for a chest infection, relied on walk-in clinic visits and paid out-of-pocket. He can't afford to be sick again. At 50, Linda would like to have a mammogram. She's never had one.

"How much money can I get for bacon and eggs? We're not a multi-million dollar business here," said Linda.

A recent state-sponsored survey of health insurance found that 68 percent of the uninsured are employed, and 23 percent of those who work are self-employed. The Tylers want to keep their business, but not if it costs them their health.

"We don't drive fancy cars, we are not fancy people. It's just not there," said Linda.

There are several reforms on the table aimed at helping workers like the Tylers. Generally, the reforms work by pooling the uninsured together and using the bargaining power of a larger group to negotiate lower care costs. Gov. Mitt Romney has a plan called "Commonwealth Care." And nationally, a group of Fortune 500 companies is trying a similar approach for its uninsured workers.

If the cost of insurance was lower, the Tylers would buy in, but in the meantime, they're not sure how they will pay the bills from Linda's hospitalizations.