First the cut, then the pain for uninsured

When 22-year-old James Munroe sliced his fingers to the bone in an accident Wednesday the decision whether to visit a doctor was simple.

“I said, ‘I’m not going anywhere. I don’t have insurance. I don’t have a job.’ ”

Munroe’s southeast Spokane neighbor, Elizabeth Cobbs, saw the situation differently. As a registered nurse, she recognized the man needed medical attention despite his financial circumstances.

“I told him I would pay for it, and he could pay me back,” Cobbs said. “Really, what’s the choice?”

However, what she had hoped would be a $200 office visit to a local urgent care center to stitch up two fingers ended with a bill of nearly $700.

Cobbs said she was just trying to be a good neighbor, but by doing so she ran straight into the reality of health care for many people in the region.

While the cost of health care is soaring, young people are more likely than others to lack insurance.

And for people like Munroe, the Affordable Care Act hasn’t had much of an impact. Even though the 2010 law includes a provision that extends dependent coverage for adult children to the age of 26, that only applies if the parents are insured.

Munroe’s parents also lack health insurance.

About 28 percent of adults in Spokane County do not have health coverage, according to the Spokane Regional Health District.

Young adults like Munroe account for the highest rate of the uninsured among any age group, according to the U.S. Department of Labor. About 30 percent of young adults are uninsured, a rate three times higher than the rate among children.

“The health care system is broken and in need of repair,” Cobbs said. “Everyone should have a right to affordable health care. It’s appalling that we are the richest nation in the world and yet we can’t provide health care for our poorest and most vulnerable.”

What she did for Munroe is a gesture she hopes any person would make for another person in need, although if she had to do it again, she would “take him to the Sacred Heart emergency room,” she said. The cost would be much higher, but it would most likely be written off by the hospital as charity care.

Cobbs also said she recognized that Munroe’s injuries were not life-threatening, and calling 911 or asking for emergency services just clogs up a system already inundated with individuals seeking free care.

“Going to the emergency room is not the answer,” Cobbs said. “They need the beds for trauma.”

When they arrived at the U.S. Healthworks clinic on 29th Avenue, Cobbs said there was no discussion about options to pay.

Cobbs paid the bill; Munroe says he will work to pay her back.

“She was kind enough to do this for me,” he said, adding he may have to forgo trade school in the fall to earn the money to repay her. For now he works odd jobs, including mowing Cobbs’ lawn.

The clinic charged Munroe $692 – $333 for the care provided by the doctor and medical assistant; a $179 first-time patient fee; $74 for a tetanus shot; and $106 for two finger splints for his hand, which can be purchased online for $6 each.

Cobbs said she plans to ask U.S. Healthworks to consider lowering the cost, but her calls were not returned Thursday. Calls from the newspaper to an office manager at the clinic also were not returned.

“There is a moral imperative here,” Cobbs said. “Why are you charging $53 apiece for a $6 item? At the end of the day it’s profit.”