The insurance Catch-22

TARYN PERKINS, of North Philadelphia, is among the legion of Americans who need insurance and can't get it.

Ironically, she lost insurance because her medical problems made it harder for her to work, and losing the job means that she has lost the ability to treat her problems. In Perkins' case, it's arthritis, hypertension and other issues.

The arthritis "really hurts" and acts up on cold days, when it rains, on climbing stairs, even when standing for a long time, said Perkins, 48, who lives with her four children. Perkins' health-care struggle also makes it more difficult to be the mom she wants to be, she said.

"If I had insurance, I could get help - medically - so that I could get a job and be a productive member of society, but if I can't get myself together healthwise, I can't," she said.

The arthritis developed in 2004 and 2005, said Perkins. It grew so painful that she had to leave her last job, as a food preparer for the school district, where she didn't qualify for health insurance because she was working part time.

"I was supposed to come back in a year [for another cortisone shot], but by then I had lost my insurance," she said.

Perkins cannot always afford to buy the four medications she needs regularly to treat hypertension, depression and arthritis, she said.

"Walmart has four-dollar prescriptions, but it's so far, I can't always get there," said Perkins, who doesn't own a car. "Sometimes I have to pay somebody to take me there, and I can't always do that."

Instead, she said, "I fill them when I can, or skip a few days to make them last."

"I can't see a proper doctor or get X-rays because I don't have insurance," Perkins said. Her children - ages 16, 12, 10 and 8 - have insurance through CHIP, a state-funded program for uninsured children and teens.

"I'm a good mom and good person," she said. "If I can't maintain my body and take care of things, then I can't take care of my babies. They need me to cook, to clean, to go places."