Blood Work

If you´re a medically uninsured North Broward resident, stay healthy -- or else

His heart didn´t sound good. There was a murmur. And the carotid artery, which supplies blood to the brain, didn´t seem to be functioning well. The doctor ordered further tests.

So John Frey, who had been suffering from dizziness and headaches and now feared he might have a heart attack or stroke, went to the North Broward Medical Center one morning last week for an echocardiogram, an ultrasound, and an electrocardiogram.

Once there, a pleasant hospital attendant named Annette Perez briefed him on what he needed to do.

John Frey came to South Florida to get better. Bad move.
C. STILES
John Frey came to South Florida to get better. Bad move.

¨The three tests cost $1,639,¨ Perez told him at the registration desk. ¨You´re going to have to pay that today.¨

That was a problem. The 55-year-old Frey had lost everything -- his family, his business, his country club membership, almost his mind -- during a vodka- and cocaine-fueled downward spiral that began in his 40s. Four years sober, he´d come to Florida from Delaware last year for its first-rate Alcoholics Anonymous program and religiously attended two meetings a day.

Although his new state was a dream in terms of recovery, it was a nightmare when it came to health care. Suffering from depression, diabetes, and high blood pressure, he had no insurance and no money to pay his own way. He´d gone without insulin, wracked up almost $6,000 in hospital bills, and now he was being told he had to come up with money he didn´t have to see if he needed heart surgery.

¨If I can´t pay, what happens to me?¨ he asked Perez.

¨You can go to the emergency room,¨ she answered.

¨So I need to have a heart attack or a stroke before I can get help?¨

Perez didn´t have an answer for that, but he was right: In lieu of the money, he needed a medical emergency to get the care he needed.

¨We are not refusing you service,¨ Perez said.

¨You are definitely refusing me service if I don´t pay up front,¨ Frey returned.

Again, he was right.

Frey´s descent into health-care hell is indicative not only of the huge problems with medical care in America but also what happens to countless indigent people in Broward County.

In this case, it could be more than just wrong it might be illegal.

In charge of helping people like Frey is the North Broward Hospital District, which runs four hospitals and receives more than $200 million a year in property taxes to treat the poor. To borrow the words of its own employee handbook, the district is ¨the county´s safety net, ensuring that those who need care receive it, regardless of their ability to pay.¨

In Frey´s case, though, he kept getting hospital bills he couldn´t pay. And when he finally learned about what the district calls the Star program, which provides discounted and free medical services to indigent patients, he was run through the bureaucratic ringer.

He says he´s been turned away from the district office at the Seventh Avenue Clinic twice for not having the proper paperwork, which includes a notarized letter from his landlord, tax returns, utility bills, and a host of other documents.

¨I couldn´t get a letter, and I don´t have any tax returns,¨ explains Frey, who lived in a boarding house at the time. ¨I didn´t know what I needed to do, and nobody told me. Then, when I found out what to do, they turned me away because I didn´t have all the papers they wanted.¨

When Legal Aid Services attorney Sharon Bourassa, who has represented numerous district patients in the past, heard about Frey´s travails, she said she had seen dozens of similar cases, deeming it ¨unconscionable.¨ She says the district should have helped Frey get into the program the first time he stepped inside a clinic and said he couldn´t afford to pay.

By not doing so, she says, the district didn´t follow the law.

¨If a patient can´t show they are indigent, then under the law, the district must verify it,¨ Bourassa says. ¨You can´t ask patients to do something that is impossible for them to do. They should be inquiring up-front about his income and not asking him to go back and bring proof in on finances. These are emergency situations. The man shouldn´t be turned away or have to pay costs.¨

District spokeswoman Sara Howley agrees that it is incumbent upon NBHD to verify patients´ indigent status, but she says there are limits.

¨There´s no question we have wanted to help this gentleman, but he needs to provide us some information so we can help him,¨ Howley says. ¨We had a caseworker who tried to get him qualified. We had 52,000 people enrolled in the program last year, so we are helping people.¨

Maybe so, but Frey´s odyssey through the system seems to point to huge holes in that safety net that health-care advocates have been complaining about for years.

A big fellow with a bald dome and friendly demeanor, Frey had health care in Delaware and assumed it would transfer to Florida when he moved to Pompano Beach. He was wrong. With only $600 a month coming from a small trust fund from his mother´s estate to pay rent and keep him off the streets, he was able to get food stamps so he wouldn´t go hungry but had no luck when it came to health care. And it nearly cost him his life.

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