By James Combs, Lake Healthy Living Magazine
Cynthia Boggs of Mount Dora had very little money for medical care. But the sharp, stabbing tooth pain she endured for weeks left her no choice but to visit a dentist. Years of neglect resulted in rotting teeth, as well as cracked dental crowns from a procedure 14 years earlier.
“Because I only had four teeth on my right side, I always chewed on the left, and now that side is going bad as well,” says the 55-year-old Boggs, a waitress at Jeremiah’s for 24 years. “Drinking something hot or cold makes my mouth hurt like the dickens.”
The visit to a dentist’s office revealed another health problem: Her blood pressure was dangerously high. That meant undergoing a root canal or any other dental procedure was too risky. Without health insurance, she could not afford to see a doctor and have her blood pressure monitored and controlled.
“The dentist told me I was lucky I didn’t have a heart attack,” she says. “Even with the Affordable Care Act, I cannot afford health insurance. Buying health insurance would take my husband’s entire paycheck.”
Many Lake County residents are in the same sinking boat as Boggs. In fact, 20 percent of the county’s 305,010 residents are without health insurance.
Almost seven years after the Affordable Care Act was signed into law, many low-income groups are unable to afford health care premiums and monthly payments.
Most of them are between the ages of 18 and 64 and fall in a collective group called the “working poor.” They are not old enough to receive Medicare services, but they make too much money or do not meet certain requirements to become eligible for Medicaid.
Without insurance, they suffer through their illness by postponing doctor’s visits or purchasing over-the-counter medications. They are more likely to be hospitalized for conditions that could have been prevented, oftentimes leaving them with an insurmountable amount of medical debt—even for minor problems.
So, what’s the cure and where’s the safety net for those who work low-paying jobs and have no health insurance?
For patients like Boggs, the answer comes in the form of medical clinics and one nonprofit organization that provide free medical, dental, and specialty care services for uninsured residents and the working poor. Thanks to the volunteer efforts of primary care doctors, dentists, and specialists, uninsured and poor people receive medical care they would struggle to attain elsewhere.
One volunteer is Dr. Kevin Taylor, who has operated an internal medicine practice in Mount Dora since 1988.
“By volunteering, doctors are fulfilling an unmet need for medical and dental care not only in our community but every community throughout the United States,” he says. “And I can assure you we get as much joy out of providing free medical services as patients do receiving it. It’s a two-way street.”
Dr. Taylor is medical director of St. Luke Free Medical and Dental Clinic, a program of the Catholic Charities of Central Florida that provides free care to residents of Lake, Marion, North Orange, and North Seminole counties. To qualify, patients must be at or below 200 percent of the federal poverty level, have no medical insurance, and have been denied by Medicaid. They also must be 18 or older.
St. Luke is often the last resort for patients like Boggs who are struggling financially and require urgent health care. Realizing her blood pressure was potentially life-threatening, her dentist referred her to St. Luke so a doctor could examine her and administer immediate treatment.
For her, it was a godsend. Her blood pressure is now stabilized, and she is scheduled to have all her teeth pulled and replaced with dentures.
“Without St. Luke I don’t know where I’d be,” Boggs says. “I thank the Lord each day that we have an organization like that for people who cannot afford medical help. The entire team there is very helpful and go out of their way to take care of you.”
St. Luke Free Medical and Dental Clinic’s volunteer physicians provide 1,200 hours of medical care throughout the year and see patients on Monday and Wednesday from 1-8 p.m. The office, located at 722 S. Grove St. in Eustis, is equipped with three medical rooms and two dental rooms.
“The majority of patients we see work low-paying jobs and have children,” says Erin Burley, clinic manager of the organization. “They’re struggling to make ends meet financially.”
They are also struggling to maintain their health. Many patients go there for treatment of common ailments like colds or flu. However, medical exams and tests often reveal they have more serious conditions such as hypertension and diabetes—conditions they’ve unknowingly lived with for years.
“Without us, these conditions would be life threatening if we didn’t get them under control,” Burley says. “But our goal is to get them under control, and because of that patients don’t end up continually going to already overcrowded emergency rooms. We give diabetes patients a glucometer and test strips. They have to fill out a log every time they test themselves. We also help them apply for reduced pharmaceutical prices.”
Dr. Don Ilkka, a dentist in Leesburg, serves as St. Luke’s dental director. He provides teeth cleaning and extractions and treats conditions such as bleeding and swollen gums. That’s extremely important, especially considering oral bacteria can escape into the bloodstream and cause blood clots or trigger a potentially deadly infection of the inner lining of the heart known as endocarditis.
“Providing dental care is probably the most important aspect of St. Luke,” Dr. Taylor says. “If patients get sick they can always go to the emergency room. However, uninsured patients with dental problems have nowhere to go. And if they do go to the emergency room they are only given antibiotics. We can treat their conditions and provide follow-up care to prevent future dental problems.”
Of course, not every patient comes in with a potentially life-threatening medical problem. Some just want to regain their quality of life. Such is the case of Charlene Bellenger, a Tavares resident who has seven degenerated discs throughout her spine.
Formerly a general accountant, she moved from Maine to Lake County in 2013 to take care of a friend with a broken hip. Since then, she has been without a job and health insurance and is living off her rapidly shrinking savings account.
Her back pain became intolerable in recent months. To compound problems, her doctor in Maine refused to continue filling her prescription. She visited St. Luke, and a volunteer physician prescribed her 800-milligram Ibuprofen tablets.
“On a scale of 1 to 10, my pain level has been reduced to a 3,” says Bellenger, who is in her 50s. “St. Luke ministers without judgment or bias, just like the Bible says to do. It brings tears to my eyes knowing there are people out there who are passionate about helping less fortunate people like myself.”
They Do Care
Treating medical conditions such as colds, flus, and high blood pressure is one thing. But what happens when low-income, uninsured residents have diseases that require care from a specialist? For instance, a patient with a nervous system disorder such as multiple sclerosis needs to be treated by a neurologist, while a patient with disabling foot pain needs to be seen by a podiatrist.
Or, even worse, what if someone is battling cancer, a disease that often requires a team of cancer surgeons, medical oncologists, and radiation oncologists and is infinitely more expensive to treat than hypertension and diabetes?
That’s the predicament Ronald Keffler of Eustis recently found himself in after being diagnosed with skin cancer on his shoulder, arm, back, and leg. He also had a baseball-sized tumor behind his ear.
Most people who receive a cancer diagnosis would wonder how serious it is, whether the cancer is treatable, and how long they have to live.
Keffler’s immediate response: “How much does it cost?”
Indeed, a fair question from an unemployed man with no health insurance. Keffler, 60, hasn’t worked since retiring as a nurse in 2003.
“I didn’t know where to go or who to seek out,” he says.
He was referred to We Care of Lake County, a Mount Dora-based organization that coordinates free specialty medical care for uninsured adults between the ages of 18 and 64.
Within several weeks, Keffler underwent surgery with a plastic surgeon in Tavares to have his ear tumor removed and then visited a dermatologist in Leesburg to have the remaining skin cancer removed. He currently goes back for follow-up care every six months.
“I cannot praise We Care enough,” he says. “They are angels in God’s wings. They go way beyond to make sure patients receive the treatment they need.”
A group of local physicians formed We Care of Lake County 23 years ago to provide a safety net for those without health insurance. Today, the nonprofit organization maintains a network of 67 specialists throughout the county, connecting patients with services in oncology, radiology, nephrology, gynecology, neurology, podiatry, pain management, dermatology, and orthopedics.
Free specialty care is provided to patients who are at or below 200 percent of the federal poverty level, have no medical insurance, and are Lake County residents. Patients must be referred by a free or sliding-scale clinic. Once approved, they make visits to the specialists’ offices during regular office hours.
“Nobody else in the office knows that one of our patients is there receiving services for free,” says Carol Millwater, executive director of We Care of Lake County. “It’s very low key.”
The organization receives funds through grants, donations, fundraisers, and the Lake County Board of County Commissioners. During the 2015-2016 fiscal year, We Care’s specialty physicians provided $3.8 million in medical services.
“Without our organization, the situation would be bad for uninsured patients because their diseases would become chronic and critical and they’d be in the emergency room,” Millwater says. “That means their recovery would be longer and their outcomes not as good. We want people to get well, help them get on with their lives, and have excellent outcomes.”
A good outcome is precisely what a 56-year-old Lady Lake resident battling an aggressive form of breast cancer enjoyed. The woman, who wishes to remain anonymous, is a small business owner who had no savings and has been without health insurance for 10 years.
Following her diagnosis, she was directed to We Care. She endured six weeks of radiation, four months of chemotherapy, and underwent a modified radical mastectomy where 15 lymph nodes were removed.
Today, she is cancer free.
“To have resources like We Care available is truly amazing,” the woman says. “They saved my life literally and figuratively. It’s such a good feeling to know there are people willing to help the needy.”
For Lake County residents without health insurance, a group of kind-hearted physicians is just what the doctor ordered.
Lake County health by the numbers:
*305,010 residents live in Lake County.
*46,253 residents are uninsured.
*35.5 percent are at or below 200 percent of the Florida Poverty Line.
*14.3 percent are at or below 100 percent of the Florida Poverty Line.
*54.5 percent are between ages 18 and 64 (the ages of the group known as the working poor).
*421.5 is the emergency room visit rate in Lake County. That’s higher than the state average of 393.3
*897 residents in 2016 died of cancer, the leading cause of death in Lake County.
*844 residents in 2016 died of heart disease, the second-leading cause of death in Lake County.