Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform

Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform

Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform

Just Don't Get Sick: Access to Health Care in the Aftermath of Welfare Reform

Synopsis

Kim A. Hoffman is a senior research associate in the department of public health and preventive medicine and Oregon Health & Science University, Portland, Oregon.

Karen Seccombe is a professor of community health at Portland State University, Portland, Oregon.

Excerpt

Let us introduce [Molly,] a young woman who recently left welfare for work. We interviewed her in her home in a small community at the end of 2002 and then again at the end of 2003 to see how she had been faring since leaving welfare. The focus of our conversation was on health—has Molly been able to get the health care that she and her family need after leaving the security of welfare that had provided for her medical insurance?

Molly touched us by the [ordinariness] of her struggle. Stories like hers are common. She is not a [poster child.] She had no innovative methods of negotiating the welfare system, she did not rise victoriously as a shining example of how welfare reform can work, nor did she triumph and find health care that fit her needs. Instead, her story is a familiar one—struggling to meet her family's needs without the benefit of experience navigating the intricacies of the health care and welfare systems, getting lost through the cracks, and facing massive health care bills as a result.

We met Molly at her one-bedroom apartment in a small town located on the Oregon coast. The relentless rain coming down added a sense of gloom to the largely run-down fishing community that had fallen on hard economic times in recent years. The downtown area consisted of boarded-up buildings, nudged between other [mom-and-pop] businesses that were fighting for their existence. Unemployment is high in her community, as is the rate of poverty: 17 percent live below poverty, compared to nearly 12 percent nationally.

In sharp contrast to the depressed nature of the town was Molly, a young and energetic woman with a fresh face, body piercings, and a friendly smile.

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