When 53-year-old Jackie Drews became ill some 25 years ago, she never envisioned that her medical saga would last very long, or sink her as far into debt as it did. Repeatedly misdiagnosed for four years, her medical bills mounted until she lost her car, her house and what remained of her health.
After her appendix burst several years ago and she was given last rites twice, Drews, a self-described “landless Indian,” was left with more than $300,000 in medical bills. Today, she takes $150 in prescription medicine every day, and says she is alive only because someone mentioned to her that she could receive help from the Indian Health Service.
Drews’ story was just one of many told at this week’s annual meeting of Montana People’s Action, which launched a new health care chapter to focus on the needs of the state’s low- and moderate-income population, and their lack of adequate information on health services available to them. Such an effort is long overdue. In Montana, one out of five citizens has no form of health insurance. The problem is particularly acute among Montana’s Native American community, where many people are falling into insurmountable debt just trying to keep up with medical costs for themselves and their families.
“The largest number of [Native American] people in debt are the ones getting health care for their kids,” says Indian People’s Action representative Janet Robideau. “We’ll let ourselves go until we’re dead and buried, but we’ll always get our kids medical care.” And while MPA and other low–income advocates scored a big victory in the 1999 legislative session with expanded funding for the Children’s Health Insurance Plan (CHIP) to an estimated 10,000 children of low-income families, thus far only 2,500 children have been enrolled because many people know nothing about it.
The problem, it seems, is a classic bureaucratic Catch-22. According to Mary Noel of the Montana Department of Public Health and Human Services, administrative costs for CHIP are capped at 10 percent of the program’s budget, and virtually no money was allocated for community outreach to boost enrollment.
However, since funding for CHIP is based on the number of children enrolled, the only way to get more money for outreach is to enroll more children. But by the time enough children are enrolled to pay for outreach, it won’t be necessary.
“It doesn’t make any sense to me at all. It’s totally backward,” says Noel. And as Robideau points out, many Indian people are intimidated by the long application process. Even the state’s newly improved “universal application” due out in January, which will allow low-income families to use one form for both Medicaid and CHIP, is eight pages long.
Both St. Patrick Hospital and Community Medical Center were asked to send representatives to discuss the programs they offer to low-income families. Neither attended.