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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Unhealthy cycle

Nikole Hannah-jones Newhouse News Service

PORTLAND – The job offer flooded Sebastian Williams with relief. He’d hunted for work since he was dismissed more than a year ago from a truck-driving gig for speeding.

The weight of overdue bills crushed him. He could hardly look his elderly mother in the eyes because he felt like her burden instead of her aid.

Williams had only to pass a physical, and he could have the cement-mixer job and full benefits. No sweat, he thought.

But minutes into the health screening, the doctor called it off. Dangerously high blood pressure and blood sugar meant he wouldn’t pass.

“Please, I can get my blood pressure and sugar down,” Williams pleaded. “Do you know how hard it is to be a diabetic with no insurance? I really need this job.”

A few minutes later, the 41-year-old slid into the seat of his car, put his head in his hands and cried.

Williams, among the 47 million uninsured in this country, is stuck in a frustrating cycle: He’s in poor health in large part because he doesn’t have insurance. He doesn’t have insurance because he doesn’t have a job. He’s been turned down for a job because he’s in poor health.

Two-thirds of Americans younger than 65 get health insurance through employers. Yet as insurance costs for businesses have skyrocketed, fewer employers offer insurance as a benefit. Those that do are looking for ways to cut costs; employer-based health premiums have increased 87 percent since 2000.

Many companies are turning to pre-employment screenings. Insurance companies give discounts for employers who require physicals as a condition of employment, says Alan Lasky, a vice president at Kroll, a national company that coordinates health screenings for businesses. “I think we have more savvy employers. It’s becoming more popular.”

Lasky says companies aren’t screening out sick employees but making sure that health problems won’t cause workers to hurt themselves or others.

Donna Beegle, who runs a nonprofit called PovertyBridge that works to improve the lives of the poor, suspects that’s not entirely true. But she also doesn’t point her finger at businesses. She points her finger at society.

“You hardly ever hear us talking about health keeping people from working and health keeping people in poverty,” she says. “Because we blame people who are in poverty, we are so silent around this issue.”

Though no one knows how many people share Williams’ situation, health-care workers say his story is all too familiar.

“We see a bunch of these people,” says Jill Ginsberg, who runs the North by Northeast Community Health Center in Portland, which gives free medical care to the indigent. “It’s such a Catch-22. Here you have people who are able to work, who want to work, and when they find (job openings) they just get stymied.”

Just before 11 on a Tuesday morning, Williams pulls his white Pontiac Bonneville with its dented bumper into the work force development parking lot in Northeast Portland. He’s a squat man with a receding hairline, his face a mask of determination. He slings a blue backpack over his shoulder and heads inside, where he joins a dozen or so people seated at computers, searching for a chance.

Each day since Williams lost his job, looking for work has been his work.

He’s never been rich, the best dressed or the most educated. But since he was 13, Williams took pride in working. It’s what made him a man.

After graduating from high school, he got a job painting trucks for Freightliner. After getting laid off, he went to truck-driving school.

“I could pay my bills on time, keep my car up, help my family out,” Williams says, scrolling through job Web sites. “You know, I had a little money to go out on the weekend and travel a bit.”

When he lost his job truck driving, he not only lost his income but also the key to his health. Without insurance, Williams stopped going to the doctor even though he has diabetes. Sometimes, he says, he couldn’t even pay for food. A $200 doctor’s visit – out of the question.

Williams is like most of Ginsberg’s patients at the North by Northeast clinic. He’s an African-American man – among the least likely nationwide to be insured – middle-aged, with hypertension. A $5-a-month medication could easily control high blood pressure, Ginsberg says, but without forking over money to see a doctor, you can’t get a prescription.

So, like Williams, they wake each day sicker than the last. And many don’t learn how sick they are until a potential employer pays for a physical. It’s often the first time they’ve seen a doctor in months. Sometimes, years.

About 40 percent of the unemployed don’t work because of chronic illness or disease, according to the U.S. Census. “It’s devastating for people to find out a problem they weren’t aware of and that this could cost them this job or future jobs,” Ginsberg says.

The cement-mixer job seemed like a lifesaver. It fit Williams’ qualifications and paid close to $20 an hour. Often the jobs requiring health screenings are those with salaries that could lift a person from poverty’s rim.

Now Williams considers settling for $8-an-hour jobs as a laborer. It won’t pay his bills. Won’t pay a doctor. But it’s better than nothing.

Williams logs off the computer. His shoulders stoop as he fights a wave of the blues. He’s worried about money and what the stress will do to his fragile health.

“I’m a Cancer,” he says, grabbing a golden chain with a dangling crab from under his fleece. “You see a crab, when he’s cornered, he’s going to keep fighting to the death.”