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healthcare benefits to their retirees. People in their mid to late 50s or early 60s are finding themselves having to pay for their own medical insurance, if they can get it. "These people are having to spend a great portion of their income, and many are on fixed incomes, to have health insurance," said Beach. "These are working class to middle class folks. It affects other parts of their life. It could mean that now they can't afford to take a trip to see the grandkids." Many simply cannot afford this expense, and choose to go without. Studies, however, show that people in this age group who go uninsured for periods of time are at increased risk of premature death, and that their health deteriorates more dramatically than peers who have continuous health coverage. Asbury is living proof. The last time he went in for a medical exam about eight months ago, his doctor wanted to run a PSA test to check for any early signs of prostate cancer in his body. Asbury already has an enlarged prostate. The doctor said he would only charge him $35 for the test if he did it right away. "But I didn't have the money," said Asbury. So the test wasn't done. G oing without health insur- ance wasn't something that Asbury thought he'd have to face at age 64. When a first career as a general contractor in the construction trades got cut short through a debilitating car acci- dent, Asbury recovered but had to change to a less-physical profession. He went back to school in the late 70s, studying business man- agement. After graduating from Occidental College in Eagle Rock, Calif. and also earning an MBA from UCLA, he has worked since the early 80s at a variety of comparatively well- paid, white-collar jobs in operations manage- ment, business, and information technology. Except for a couple years in the mid-90s when he was doing independent consulting work, Asbury and his family enjoyed regular health insurance – mainly through his ex-wife's job at University of California, Los Angeles and a job he held that offered Kaiser Permanente coverage – from the mid-80s up to 1998. He had looked into buying insurance dur- ing that gap in the 90s, but the $900 premi- ums each month he found through Blue Cross were too expensive and family cover- age to include his then-wife and two daugh- ters was even more. "There was just no way we could swing it," he said. In 1999, he started working at a startup healthcare company that developed medical assessment software. The company, ironical- ly, didn't offer healthcare benefits. He looked into an individual policy again. He found it was still too expensive at about $4,000 to $5,000 a year. So he went without. In 2000, he and his wife divorced. She ended up returning to work at UCLA and getting benefits for herself and their daugh- ters, but that didn't help Asbury. After the healthcare software company went out of business in 2001, Asbury searched for a job with a solid company that provided health insurance, but to no avail. "It's the kind of thing where they'd be inter- ested if I were 35, but at this point, I'm over 50," he said. "I wasn't able to land anything." So he started consulting. Unfortunately, Asbury found himself without health insurance right at a time when most people are developing the most serious health problems they've faced to date. His internist, Dr. Alan Steinberg, discovered around this time that Asbury's difficulty uri- nating was due to an enlarged prostate. Dr. Steinberg prescribed Proscar once a day, which costs $2.97 a pill at Costco. A regular physical showed Asbury's bone density was 15 percent below normal. Dr. Steinberg pre- scribed Androgel, which costs $500 per month at Costco. Asbury was having digestive problems. That led to a daily dose of Pro- tonix, which costs $3 a pill at Costco. Then there are his seasonal and ongoing allergies, for which he sometimes take Zyrtec. All told, his prescription drug bill alone comes out to more than $8,000 per year. He tries to reduce that by halving his use of Androgel and by splitting his Protonix. He also pays $90 to $100 per office visit, for which Dr. Steinberg gives him a reduced rate. Last year, Asbury had his teeth cleaned and x-rayed, which cost $240. Two of his teeth have fallen out in recent years, he suspects because of his bone density problem, and he's lost a crown on one that he can't afford to replace. As a result, he has to be careful not to eat foods that are too hard. Three years ago, he visited the optometrist and had to buy a new pair of reading glasses that cost $700. "That was a huge outlay for me," he remembers. His annual medical costs cur- rently total about $9,000 to $10,000. In 2002, he shopped around for health insurance again. Still no go. Blue Cross want- ed $1,100 or $1,200 a month for just PPO cov- erage, with a $2,500 deductible and no prescription drug benefit. Four other compa- nies simply said no. It's not like Asbury doesn't make a good living. He estimates that he earns a gross income of about $65,000 per year doing con- tract consulting on IT projects for large com- panies Northrup Grumman and Boeing, where he's currently working. But once you take out taxes, the $9,000 for healthcare, 10 C A L I F O R N I A N U R S E W W W . C A L N U R S E S . O R G A P R I L 2 0 0 6 "It really comes down to: Do they take their medicines or pay the rent this month? Do they eat? So they halve their diabetes pills to make their pills go a lot farther. A year after, you find their sugar's out of control. The next year, they go blind." —alan steinberg, asbury's doctor PUTTING A FACE TO THE UNINSURED This profile is the second of an occasional series to highlight the plight of our nation's uninsured and underinsured. More than 46 million Americans currently have no health insurance, and that number grows more rapidly each year. They are our neigh- bors, our friends, our kids, our parents. This series is intended to match faces to these numbers, and provide the stories to fuel our work toward a single-payer system with a single, quality standard of care for everyone. If you know of uninsured or underinsured people with good stories who'd be willing to be profiled, please con- tact us at calnursenews@calnurses.org.