Ingrid Smith never expected it to happen to her.
"We always worked," she said of herself and her husband. "We always paid our bills. We have two little girls."
But in December, her husband lost his job — and with it, the family's health insurance.
And in January, Ingrid was diagnosed with a mass in her lower back.
Now, "I'm one of those with no insurance," she said, wiping away tears.
For Ingrid and more than 600 others in Lancaster County, the situation would be even more dire without PALCO — Project Access Lancaster County, a groundbreaking initiative that partners with doctors and hospitals to offer health care to people who have no access to insurance.
Because of PALCO, the story that Ingrid told Thursday, and the story that four other patients at SouthEast Lancaster Health Services told, was a story of hope rather than a story of despair.
At SouthEast Lancaster's third annual "Cover the Uninsured Week" patient luncheon, though, clinic leaders warned that despite the good PALCO has done in its first full year of operation, it's only a Band-Aid, not a cure for the problem of 47 million Americans who have no medical insurance.
"The bottom line is, there's a huge problem in our country," nurse practitioner Linda Gort-Walton said, "… and all we're doing is putting little fingers in the dike to keep people's lives and livelihoods from running out."
Hope from hopelessnessFor SouthEast Lancaster patients who shared their stories Thursday, there were two common threads.
All of them have jobs, or had them. All of them needed PALCO.
Adrienne Boullianne, of Lancaster, is a self-employed hair stylist who couldn't afford to buy health insurance for herself. Although she tried to maintain a healthy lifestyle, she said, medical problems began to crop up.
"I recently learned that I have a severe shoulder injury affected by five disorders, including a torn rotator cuff," she said.
"As a hair stylist, I would not be able to function much longer if I could not get necessary treatment, including physical therapy."
Ron Pope needed medical help both for his wife and himself, and finally found it at SouthEast Lancaster's Bright Side Opportunities Center office. "If it had not been for PALCO and my doctor and my wife's doctor," he said, "I probably would be living on the streets."
Now, though, he runs his own business.
Ed Summers worked for 47 years, but his medical insurer dropped him. He had no way of paying for treatment for a series of mini-strokes. Finally he read about SouthEast Lancaster's services, and the clinic connected him with PALCO.
"Truly, America needs more such choices," he said.
Ingrid Smith was getting treatment for a dislocated hip — a job-related injury that was covered by workers' compensation — when the mass in her back was discovered.
She applied for Medicaid, but because her husband was collecting unemployment benefits, the family was earning too much to qualify. Her orthopedic surgeon referred her to PALCO.
As she told her story Thursday, she was waiting for results of a biopsy of the mass.
"I just don't know what to do," she said. "My husband found a part-time job, and here we are. We've always been good citizens. … We have to buy food with credit cards. Where do we go?
"I have to tell my story."
Partial answersAshley Heagy, 21, found herself without insurance after her mother's coverage dropped her. She couldn't enroll in the health plan at her job until the new year's open enrollment period. And she needs regular medication for a thyroid condition.
When you're making $7.50 an hour, Heagy said, paying $70 a month or more for prescriptions isn't an option.
Heagy found help at PALCO for several months, until she was able to get insurance from her employer. She only had to pay $5 a month for generic drugs.
But PALCO ran into a financial crunch in its prescription plan and had to end it.
"In six months, we spent $100,000," said Lisa Riffanacht, PALCO's director, "with only about 300 people [enrolled]. We'd like to have about 2,000 people in the program by the end of the year.
"We just couldn't sustain it."
Instead, PALCO is directing clients to other prescription assistance plans.
PALCO also is struggling to figure out how to respond to situations like Barry's.
Barry, a SouthEast Lancaster patient who couldn't attend the lunch because of his job, supports his wife and family on a restaurant dishwasher's salary of about $1,200 a month. Nurse practitioner Audrey Patterson said Barry could get health insurance for himself and his family at work — for $1,000 a month. Just for Barry, the premium is $300.
"It's really not a choice," Patterson said.
When Barry became ill, SouthEast Lancaster was able to get help for him through PALCO. He has been diagnosed with emphysema.
Since then, PALCO has decided that anyone who can get insurance through a job isn't eligible for help, but Riffanacht said the organization hopes the federal government will develop guidelines on when insurance prices are so high as to constitute lack of access.
"There's got to be an easier way," Riffanacht said, "and we're still looking for it."
PALCO has provided treatment for about 620 people who otherwise would have no access to care, Riffanacht said.
The program is a network of all four county hospitals and 650 doctors who volunteer their services at no charge. The hospitals offer all kinds of tests and lab work free.
"But there are gaps," Riffanacht said. "We are a bridge. The idea is for people to eventually get insurance."
That's the rub.
Some 47 million Americans are uninsured. SouthEast Lancaster estimates that 11.3 percent of all county residents, or nearly 53,000, have no insurance.
SouthEast Lancaster cares for more than 14,000 patients at its South Duke Street and Bright Side clinics. Demand for its services has jumped more than 40 percent in the last five years, said Executive Director Jim Kelly.
Social worker Helen Jones said PALCO has made an enormous difference — "before, sometimes there was no solution" — but she pointed out that PALCO only works for people who live in Lancaster County.
"We need universal health care," Linda Gort-Walton said.
Ingrid Smith doesn't know what the future holds.
But, she said, "I thank God for PALCO."
Helen Colwell Adams is a Sunday News staff writer. E-mail her at hcolwell@lnpnews.com, or phone 291-4962.
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