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When Faith Coleman found out she had kidney cancer, she was terrified. For her, the news carried an added weight.
She had no health insurance.
“It was horrific,” Coleman said. “My youngest child was 9 years old and I thought, ‘I’m going to die and leave this girl behind.’ I was scared to death.”
Because she was uninsured, no hospital would admit her without upfront payment. In the end, Coleman mortgaged her house to pay for a surgery that put her into remission. She walked into the hospital carrying a $35,000 cashier’s check.
That was in 2003.
Last fall, she learned she had cancer again, this time in her stomach.
“Of course, I still didn’t have insurance, because now I’m the cancer pariah,” Coleman said. “Insurance companies won’t even look at me.”
This time, Coleman qualified for Medicaid, because she’s a nurse practitioner. The program paid for a surgery that removed three-quarters of her stomach and for chemotherapy. Once again, Coleman went into remission.
On Tuesday, she learned that she has cancer again. This time, it’s in her liver and spleen. She’s still uninsured.
It can happen to anyone
When Coleman was first diagnosed with cancer, she’d just begun her career as a nurse practitioner. Starting out, an insurance plan was too big a cost to shoulder, so she opted out, she said.
Now, she can’t get a policy — or at least not a realistic one. Her latest offer would have cost $360 a month, and carried a $15,000 deductible. It wouldn’t cover any cancer treatments for 10 years.
“Of course I didn’t take it,” Coleman said. “There wouldn’t be a point. A month later, I started coughing up blood.”
Undergoing cancer treatments uninsured is what led her to co-found the Flagler Free Clinic with Dr. John Canakaris, a Bunnell-based physician. The clinic brings no-cost health care to those without insurance.
After she triumphed over her first round of cancer, she wondered what uninsured people without homes they could mortgage to cover hospital costs did when they got sick.
“I thought, ‘I guess they just die,’” Coleman said.
The Flagler Free Clinic provides refuge for people in those situations. It opened in 2005 with eight patients and eight volunteers.
Today, it has well over 100 volunteers and hosts four clinics monthly: The first and third Saturday of the month starting at 8 a.m., and the first and third Thursday of the month starting at 5 p.m.
Thursday clinics take 10 patients — more if enough volunteer doctors are available — and Saturday clinics take 60. Lines form as early as 4 a.m. on Saturdays, the uninsured of the county flocking to the sole place they can get help.
More are turned away than are helped. The clinic sees as many people as it can, but, as a privately funded institution, its resources are sparce.
But for most who come to the clinic, this is their only hope, so they wait. They wait even if they know their place in line is too high to grant them time with a doctor. They wait until they’re told to leave, and even then, some of them stay.
Thursday, a man holding a card labeled “17” for his place in line approached reception and pled. He lives five miles east of here, he said. He’s been waiting all day. He can’t come back. He has a urinary issue; he can’t sleep at night. He’s holding a bicycle helmet in his hands.
Georgia McFarland-Seabolt, volunteer coordinator for the Thursday clinics, sighs. She’s been volunteering at the clinic for about three years now, but turning patients away hasn’t gotten any easier. She says he can wait and see if a physician becomes available while the clinic is open, but she can’t promise anything.
Moments later, another doctor showed up to volunteer. The clinic never knows exactly how many physicians it’ll have available Thursday nights, because most of them come straight from work, and can get tied up at their own practices.
“Good, another doctor,” McFarland-Seabolt said. “We might be okay after all.”
A rising problem
The people sitting in the waiting room of the Flagler Free Clinic are part of a growing population.
Patient turnout since the 2008 recession has easily tripled, Coleman said. Unemployment remains high — it was 11.9% in September — and an estimated 23.3% of Flagler residents are without health insurance, according to Small Area Health Insurance Estimates derived from 2010 Census data.
Florida’s rate of uninsured is the second-highest in the country, with an estimated 25.3% of its residents lacking health insurance, according to the SAHIE report. Only Texas had a higher estimated uninsured rate at 26.3%.
And the top two reasons the people go without insurance are the cost of a plan and a lost job or change in employment, according to the Centers for Disease Control and Prevention. These two reasons account for about 80% of uninsured people.
That’s why, for Robert and Theresa Dent and the thousands of other uninsured Flagler County residents, the Flagler Free Clinic is invaluable.
“The clinic is a blessing,” Robert Dent said. “If they weren’t here, a lot of us wouldn’t be, either.”
Robert Dent has had five heart attacks since 2007. He hasn’t had health insurance for any of them. The first, he had while he and his wife lived in Pennsylvania.
Although Robert Dent couldn’t pay, his surgeon decided to operate anyway. Shortly after, the Dents moved to Florida and discovered the free clinic, which treats both of them. Robert Dent can no longer undergo surgery, so the Flagler Free Clinic found a specialist to work with him for alternative treatments — for free.
“Faith, she’s an angel in herself,” Robert Dent said. “She comes in and works where most people would give up.”
After navigating the health care system sans insurance, Coleman couldn’t see herself not working to help others like herself.
“In a way, I’m grateful for the nine years I haven’t had health insurance,” she said. “I can relate to our patients because I’m just like them. I know what it feels like to not know you’ll be able to pay for the care you need, and I know what it feels like to ask someone to do something at a reduced rate. I know how humbling that is.”
Coleman said often, it’s hard for an uninsured person to get decent health care even when they’re paying for a visit to a physician. If doctors know a patient doesn’t have insurance, they might not do anything beyond a basic checkup, just because they know the patient wouldn’t be able to pay for anything else.
As for her own cancer, Coleman qualifies for patient assistance program through the manufacturer of the drug she’ll be using for chemotherapy, which qualifies her for free medication. Town Center Imaging supplied the original PET scan that detected the cancer.
“To me, the sad part is because I don’t have insurance, there are some options out there, like liver chemotherapy ablation, that I’m probably not going to be able to do,” Coleman said. “I shudder to think what that would cost.”
But she tries not to dwell on her own circumstances too much. Her situation led to the free clinic, which is more important than feeling sorry about things she can’t change, she said.
“I never, in my wildest dreams, thought we would get this far,” she said, her voice hitched with emotion. “It just tells you how much need there is.”