Health-Care Debate Saps Energy of Those at Its Heart

Sarah and Will Armstrong are like many middle-class families. They are educated, have three kids and nice house in the suburbs. But at the end of next month, their health insurance will run out.
By Brigid Schulte
Washington Post Staff Writer
Sunday, September 27, 2009

Chuck at 115 Linden Hall Lane worries about losing the monthly $9,000 infusions of a drug that keeps his lungs from collapsing. Martha, who lives at 113 and is expecting her second child, has had trouble finding a midwife. Thelma, residing at 109, fears being forced into a nursing home because insurance won't cover a home health aide. And Sarah, at 114, out thousands of dollars every year to pay for special services for her autistic son that her insurer won't cover, now faces the heart-stopping proposition of losing that coverage altogether.

The people who live around the pretty courtyard and well-kept lawns of Linden Hall Lane in Gaithersburg are like much of America. They have glaucoma and asthma. They've had foot surgeries, aneurysms and heart attacks. They've become disabled or never been sick a day in their lives. Their children have potentially life-threatening breathing problems and run-of-the-mill ear infections, colds and broken arms. Their health issues have been covered by gold-plated insurance plans, capricious for-profit firms, HMOs, Medicare and nothing.

When it comes to their health care, no one is completely happy. Everyone has a complaint. And nobody understands the way the current system works, only that it doesn't work very well.

These are the people President Obama counted on to give his signature health-care reform effort the grass-roots oomph it needs to get through Congress. But no one on this cul-de-sac in Montgomery County has taken his or her private frustrations to a public meeting; no one has lobbied a lawmaker.

The lawyers, architects, doctors, teachers, retirees and federal government employees living in the $300,000, light-filled homes of Linden Hall Lane agree on the moral imperative of providing health-care coverage to all Americans, including the 46 million currently uninsured. But beyond that, the wonky chatter about "bending the curve" of health-care expenses and the noise of "You lie!" outbursts have left them cold. The messy and complex debate in Washington, though only 29.4 miles south of their quiet courtyard, might as well be taking place on a distant planet for all it seems to have to do with the needs of their own lives.

All they know is, something's got to give.

To Patti Lemere, who lives at 119, change, any change, is preferable to the current system. "I don't know what everyone is so afraid of," she said of the loud anti-reform forces. "I don't know what amazing coverage these people have that they're so afraid of losing."

But her next-door neighbor, Doreen Turczyn-Toles at 117, who has a chronic condition, worries that whomever the politicians in Washington are listening to, it isn't her. "The government needs to be careful not to be overly influenced by these specialty groups," she said. "If you're not feeling well, you're not in a position to argue with your insurance company or go to a town hall meeting and say, 'Hey, what about me?' When I was in the process of being diagnosed, I just wanted to hold on to what I had. I worry that the people who need this change most are the least able to make their point."

Careful About Costs

In a way, Lemere, 40, a teacher, and her husband, Michael Pates, 42, a lawyer, are the everyman of the U.S. health-care system. They and their three children are among the 158 million people, more than half of all Americans, who get their health insurance through an employer. And it's not that it's bad. It's just limiting. And often, very, very frustrating.

Before going for any kind of care, from primary-care doctors and pediatricians to specialists, Patti surfs the Blue Cross Blue Shield Web site to find in-network providers, because she's too afraid that choosing anyone else would "be too expensive." And once the family spends enough to hit its deductible, which seems to happen every year by early spring, the fees and co-pays come on fast and strange.

"I just feel like we're always having to pay 50 bucks here, 100 bucks there," she said. "Our son broke his leg. And I had to write a check for $5 for cast material. I know I shouldn't complain about $5. But it's a nickel-and-diming kind of experience. It's always unpredictable, how much we'll have to spend on drugs, on fees, [and] that makes budgeting so difficult."

Patti's mother, Joan Lemere, 74, who lives with them, knows the sick feeling of looking at a $15,000 hospital bill and having no way to pay it. The mother of six was living near Greenville, S.C., 20 years ago, working two jobs. When the Holiday Inn where she worked as a waitress decided it could no longer offer its employees health insurance, Lemere couldn't afford to buy a private policy. So she went without. A few days later, she had a heart attack.

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