Job losses and rising health care costs have left an increasing number of Peninsula residents without health insurance, straining San Mateo County’s health services and budget.
In 2009, 14.3 percent of the county’s 634,000 residents age 64 or younger were uninsured for at least part of the year, up from 10.8 percent in 2007, according to a recent report from the UCLA Center for Health Policy Research.
Almost 100,000 of the county’s 730,000 residents are enrolled in a public health insurance or coverage program, according to Dr. Susan Ehrlich, the executive director and CEO of the San Mateo Medical Center. However, the medical center, which is required to treat the uninsured, isn’t getting extra funding to help handle the growing load.
“We had no new money,” Ehrlich said. “We in fact had less money because of the effect of inflation on the budget. We just had to accommodate the patients. Part of the way that’s reflected is in the waiting list.”
The medical center now has about 1,800 people on a waiting list for a primary-care appointment, most of whom are enrolled in the county’s coverage program Access and Care for Everyone, which handles 22,000 low-income adults who don’t qualify for other government programs such as Medi-Cal, Ehrlich said. On average, they wait four to five months to see a doctor, unless they have an urgent need.
Still, due to increased efficiency, that’s down significantly from six months ago, when there were 5,000 people on the list, Ehrlich said.
Officials had to find $11 million in savings to balance this year’s $253 million budget. To cover the shortfall, the county has ramped up efforts to charge patients who can afford to pay, deleted vacant positions and increased training for some of its nursing staff to cut back on contracted specialized nurses.
Also, the county increasingly looks to nonprofits and private hospitals and medical groups. The Palo Alto Medical Foundation, for example, agreed to take on 300 patients.
The increase in the number of uninsured in San Mateo County reflects a nationwide trend driven by the poor economy. A U.S. Census report released this month showed the number of uninsured Americans grew from 46.3 million in 2008 to 50.7 million in 2009, or up to 16.7 percent of the population.
Nonprofits deliver for uninsured
San Mateo resident Alicia Haro can’t afford the health insurance offered by the retail chain where she works.
“They give you insurance if you want, but you have to pay and I don’t have enough money,” said Haro, 35. “I need money for my children. That’s why I’m looking for something like Samaritan House.”
Haro is one of a growing number who have sought health care help from nonprofits.
Samaritan House, which runs two clinics with volunteer doctors, has seen its patient count climb to around 9,000 a year, up from 7,000 a few years ago, Operations Director Sharon Petersen said. Its waiting list is about two weeks.
In May, Petersen stopped taking new dental appointments because there was already a three-year wait.
Many of the clients have lost their jobs, and “having to make a choice between food and shelter and medical care, most of them drop their COBRA because they can’t afford it,” Petersen said.
The Legal Aid Society of San Mateo County’s Health Consumer Center has had about 280 clients in the past six months, double the amount the program is designed to handle.
The center helps people who have been denied coverage, are facing a lawsuit for unpaid medical bills or can’t get care under their coverage, directing attorney Tricia Vinson said.
Vinson said many people’s incomes are too high to qualify for government plans, but they can’t afford health insurance.
“In some ways, it is affecting the working poor and the working middle-income people as much as it’s affecting the lower-income people,” Vinson said.
Recession causes health problems
San Mateo County is providing services for a larger number of uninsured residents compared to before the recession.
Unemployment rate in August: 4 percent (third-lowest statewide)
Uninsured all or part of year (ages 0-64): 10.8 percent (third-lowest statewide)
Had employment-based coverage all year (ages 0-64): 69.6 percent (third-highest statewide)
Unemployment rate in August: 9.1 percent (third-lowest statewide)
Uninsured all or part of year (ages 0-64): 14.3 percent (lowest statewide)
Had employment-based coverage all year (ages 0-64): 66 percent (second-highest statewide)
Sources: UCLA Center for Health Policy Research, California Employment Development Department