Daniel works as a Bar Manager and Consultant at a locally-owned cocktail lounge in Joplin. Although Daniel enjoys his work, he says that like many locally-owned small businesses, his job cannot afford to offer health insurance to its employees. The last time Daniel had health insurance was nearly 13 years ago through a previous job. Without the opportunity to receive health coverage through his job, he says the premium for a health care plan on the private market would cost around 40% of his monthly income, not including copays and deductibles. Daniel says he prefers to work for a local business rather than somewhere corporate, but that comes with a trade-off which put him in a difficult position when he started having health problems.
After experiencing dramatic and unexplained weight-loss and fatigue, Daniel took on the task of going from doctor to doctor, trying to figure out why his body was unable to get the nutrients it needed. He was misdiagnosed with adult-onset diabetes, or type 2, and was told by a nutritionist that adjusting his diet and exercise routine would cure his symptoms. As an already healthy person, Daniel found that these changes did little to improve his condition, and spent roughly 8 months going from doctor to specialist to doctor, having tests done. Being uninsured, Daniel had to do a lot of shopping around to find doctors who would see him without sending him into debt. Luckily, he was eventually referred to a local doctor through a friend who offered office visits for $70 and had connections to more affordable tests and x-rays.
When Daniel’s primary care physician called him with test results to tell him he was experiencing diabetic ketoacidosis (DKA) – a dangerous condition associated with type 1 diabetes as a result of persistent high blood sugar – he resisted the instructions to get to an ER right away. He knew that an ER visit would be completely unaffordable and that he’d be stuck with a lifetime of debt. “I don’t have insurance, but I’ve got to go because I don’t want to die,” he remembers thinking. With no choice, Daniel went to the ER and endured a 24-hour stay, chest x-rays, multiple IVs and insulin drips and an electrocardiogram (EKG). When the doctors discovered that his pancreas had failed, he was diagnosed as having type 1 diabetes, which unlike type 2, cannot be managed with diet and exercise and requires daily blood sugar monitoring and insulin injections. At the hospital, a social worker helped Daniel apply for financial aid, but he still has not seen what his final bill will be. He anticipates his 1-day stay will cost him around $20,000.
Not only will Daniel be stuck with the financial burden of his life-saving visit to the ER, but his life is forever changed by his diagnosis as a type 1 diabetic. He must now consider the cost of glucose monitors, insulin vials or pens, testing strips, needle tips, and lancets. Although he’s had some luck finding relatively affordable options for diabetics who are uninsured, the uncertainty of what this means for his life going forward is there. “I just turned 37, and I may have other health problems down the road. I have to think: what’s the plan for the future? Do I leave a career that I love to find a job that I don’t just to have health care?” Daniel doesn’t feel that our system is fair, especially for those who have health conditions that require monitoring and treatment. “I don’t make enough to afford health care on my own, but I make too much to get help. I’m just stuck in the middle.”