March 30, 2007

The Young and the Uninsured

t was an unfamiliar pain, sharp and persistent, as if a rag were being twisted inside his abdomen. Tighter and tighter, crunching in on his organs, enough to wake Andrew Ondrejcak one morning in 2004 before his alarm went off. Indigestion? No, probably it was a return of the stomach ulcers that had plagued him as an undergrad a few years back. Ulcers felt somewhat different, it's true, more an isolated stabbing compared with the lateral serrations currently tormenting him. But it had been a while; you forget the specifics of pain. Whatever it was, Ondrejcak, who was 24, worried he might have to see a doctor, something he made a point to avoid. Like 47 million other Americans, including most everyone he knew, Ondrejcak did not have health insurance.

Telling himself the pain was nothing, he walked to Sweet Melissa, a bakery on Court Street, where he made $6 an hour plus tips. He had come to New York from Mississippi, hoping to become a designer—maybe in theater, maybe fashion—but for the time being, he paid his rent (barely) by serving pastries. "Health insurance wasn't even an option," Ondrejcak told me recently. "I was flying through my savings, trying to get a career started. I was doing a lot of assisting designers who were doing great work, but I wasn't making anything. The last thing I'm going to do is spend $300 or whatever on insurance, you know?" He paused before adding, "I'm a healthy person, I rarely get sick. I run, I do yoga. I take all the vitamins. Honestly, I never thought about it."

At Sweet Melissa, the pain only worsened. But what to do? How to even find a doctor? Only one-third of the uninsured have a regular physician, and he was not among them. He searched the Yellow Pages for doctors in Brooklyn with the prefix gastro near their names; most wouldn't take him. Eventually, he found a public clinic—a friend had been there—that recommended a specialist in Bay Ridge. "It's probably ulcers," the doctor said, after Ondrejcak said he suspected ulcers. He was given a prescription for Nexium ($73) along with a depressing bill of $200 for the visit. "Basically all the money I'd made that week. I left keeling over in pain but took the bus home because I was so broke," he told me. He swallowed the Nexium with a swig of Maalox and went to bed, hoping the pill would rewire whatever was wrong.

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