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    Critically uninsured

    Pinellas health care leaders want the county's help to ease the cost of treating the uninsured.

    By LISA GREENE, Times Staff Writer
    © St. Petersburg Times
    published February 3, 2003

    [Times photos: Carrie Pratt]
    Ruth Corbier, a Morton Plant Mease Hospital patient, waits for a CT scan Friday at the Clearwater hospital's Lykes Cancer Center.
    Ruth Corbier arrived at the Morton Plant Hospital emergency room two years too late.

    She didn't get there until Tuesday afternoon, even though the numbness in her legs and the lump under her ear had been bothering her for two years.

    As she waited for a diagnosis, hospital officials were meeting a few blocks away, reeling off statistics about the health-care crisis and the need for Pinellas County to spend millions more to help the poor.

    People without health insurance are less likely to get preventive care, officials told county commissioners. They are more likely to be diagnosed late. They are more likely to die.

    They could have been talking about Corbier, who couldn't afford the doctor's visits that might have diagnosed her cancer earlier.

    Brian Cook, the director Morton Plant's emergency room, sees patients like Corbier every day, and it makes him angry.

    Two years ago, Cook said, Corbier's cancer probably could have been easily treated.

    But now?

    Tuesday, Cook admitted Corbier to Morton Plant. Soon after, doctors found the tumors in her lungs and the one by her kidney, pressing on her spine.

    By Friday, hospice counselors were scheduled to visit.

    "Now we'll spend tens of thousands of dollars, when it's too late," Cook said. "And it just makes me crazy."

    * * *

    Pinellas County will spend $13.6-million this year on health care for the uninsured poor, mostly on a medical program that helps about 2,800 people each month.

    But that care only helps a fraction of those who need it, said Frank Murphy, the CEO and president of Baycare Health System, which includes the Pinellas hospitals Morton Plant and St. Anthony's.

    A study commissioned by Baycare and Bayfront Medical Center identified 92,000 uninsured Pinellas residents, 48,000 of whom are poor. Pinellas' health plan cares for just 6 percent of those uninsured poor.

    Murphy and others point to Hillsborough County, where a half-cent sales tax helps provide health care. Hillsborough spends $86.5-million, providing care for 41 percent of its uninsured poor.

    "The county has to take a leadership role," Murphy said. "We need your help."

    The hospitals' motive is not entirely altruistic. It loses millions each year caring for the uninsured. Bayfront finished last year $3-million in the red, said Bayfront CEO and president Sue Brody. The hospital spent $10-million caring for the poor.

    Hospital leaders want the county to spend $10-million more on the uninsured next year. They also ask for more direct help: for Pinellas to pick up the $640,000 tab for Bayflite trips never reimbursed, plus spend more on emergency care for the mentally ill.

    Pinellas Commissioner Susan Latvala wants the county to do more, and to focus on providing better care, especially preventive care, for people without insurance. Ultimately, she said, that should lower costs. She's less interested in reimbursing hospitals for emergency care.

    "We're looking for ingenious solutions," Latvala said. "We can't be the checkbook to balance everybody else's budget."

    The debate has been simmering for months. Tuesday, commissioners said they want to help, but made no commitments. The issue couldn't come at a worse time for the county. Proposed state budget cuts this year could cost the county millions.

    * * *

    Corbier first noticed the lump under her ear two years ago. But it didn't hurt, and she had no money.

    When her legs started going numb, she tried to find a doctor. Corbier has worked as a waitress and a bartender, a housekeeper and a security guard. But she didn't have insurance.

    She called the local "211" phone line and various agencies, but she kept getting told the same thing. At 54, she was too young for Medicare. With no young children, she wasn't eligible for Medicaid.

    "I heard, 'I can't help you,' a whole lot," she said.

    She called a free medical clinic several times, but it always seemed to be booked.

    Finally, a friend told her to visit the county's social services department. Workers there set up a doctor's appointment. Last week, Corbier went straight from the doctor's office to the hospital.

    Thursday night, Corbier pushed away her dinner tray and talked about beating cervical cancer nine years ago.

    "I'm luckier than a lot of people," she said.

    She leaned back in her hospital bed and her lips curved in the start of a smile.

    "I've beat cancer once already. I really don't feel like I'm going to beat it this time, but I'm going to give it one hell of a try."

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