National Nurses United

© 2007 JON ORLANDO/JONORLANDOPHOTO.COM the program also has a lifetime cap of $1 million, so that would only delay the inevitable for another year at the rate Thomas' bills stack up. The last option was not really an option yet, but something Wilkes could fight for, and that was for Congress to pass a universal, single-payer health insurance plan for all U.S. residents. Wilkes has been active with hemophilia support groups, but never fancied himself an activist. When Physicians for a National Health Plan heard about his story and asked him in January to speak at a press conference reintroducing HR 676, a federal bill that would establish a U.S. single-payer, Wilkes readily agreed. "Single-payer is essentially the antithesis of everything I see is wrong with the current system," said Wilkes. "Now with the uninsured, we have ER overcrowding, a focus on acute instead of preventive care, a lack of focus on wellness, and an absurd, ridiculous MARCH 2007 amount of money that's going to administration, overhead, and processing all the claims that get kicked back." For the moment, Wilkes has signed Thomas up for CoverColorado, but the program won't enroll him until his $1 million cap with United Healthcare is reached and he gets kicked off that plan. Trouble is, despite a lot of proactive phone calls by Wilkes, United Healthcare can't get its paperwork together to tell him whether or not Thomas has hit the cap. Wilkes estimates that his son has, but everything is still in limbo until he gets official word. And that gap is very financially scary. For the Wilkes family, even a coverage gap of a few weeks can mean hundreds of thousands of dollars in medical bills. Meanwhile, Wilkes has tried to closely coordinate with Thomas' hemophilia treatment center and the providers there so that billing for services falls in a coverage period. W W W. C A L N U R S E S . O R G At the end of the day for Wilkes, the question isn't just whether people have or don't have insurance. It's also about who is providing the insurance: a private company whose goal is to make money and thereby incentivized to avoid caring for people like his son Thomas, or a public agency whose goal is to make sure everybody gets the healthcare they need. "We've got insurance. We've bought insurance and we've been getting insurance. Telling us we need to buy insurance doesn't change anything," said Wilkes. "The solution must reduce costs by eliminating overhead and profits by private insurance companies. We must develop a single-payer model." I Lucia Hwang is editor of Registered Nurse. Jon Orlando is a Colorado-based photographer working on a long-term project documenting the healthcare crisis among middle and upper-middle class families, and is interested in expanding his project nationwide. REGISTERED NURSE 19

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