Falling Through
Casualties of the Health Insurance Crisis
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Facing a chronic illness with no insurance
A barber with a chronic disease falls deeper into dept.
It is a game he is losing badly.
For several years, Grassia did feel better, and in 2006, having saved a little money and feeling well enough, he fulfilled the prophecy and bought the barber shop for a modest down payment. Scaffidi, the former owner, holds the mortgage, charging very low interest, and Grassia pays him each month.
But in September, the Crohn's returned. Doctors wanted to avoid surgery again if possible. For months he paid for tests, medications, doctors, all out-of-pocket.
Grassia thinks that all along, he has gotten great medical care.
The problem is paying for it.
By April, his savings were exhausted, and doctors determined that he urgently needed surgery. They feared a perforated bowel, which can be fatal. When he told his surgeon, John M. Erbicella, that he had no money, the doctor agreed to cut his bill in half, Grassia said, down to $1,145. Grassia says that's probably still more than the doctor would have gotten from an insurance company.
The surgeon also agreed, Grassia said, to let him pay half up front and $100 a month until the debt was paid.
Grassia said he then went to South Jersey Anesthesia, with offices at the hospital, and made a similar request: perhaps get a discount, and pay half the fee up front, half later.
He says a woman in the office responded, "Well, we can put you under for half the surgery."
When reached by phone last week, a woman in the office said she could not believe such a remark would ever have been made. She did say private-pay patients are generally charged in full because "we don't see the patient back. When it comes to anesthesia, we'll never see them again."
The head of the office could not be reached.
Grassia tries to see things positively, and assumed the woman was trying to be funny, to break any tension. But she insisted he pay in full.
"This was on a Monday," he recalls. "I needed surgery on a Thursday. Where was I going to get the money?"
He went to the bank, got a cash advance on his Visa, and paid the anesthesiologist $1,400, he says.
"I never got behind on my mortgages," Grassia said the other day. "But any type of little savings I had is gone. Gone. I'm just tapped."
Grassia's financial hole doesn't include hospital costs. Luckily, Underwood gave him charity care, as nonprofit hospitals do to justify their tax-free status. Grassia didn't pay a dime for 30 days of care.
He is grateful. But he says he's been paying taxes since he was 15, and doesn't feel bad accepting help.
After the surgery in late April, doctors wanted him to stay home, rest and recover.
But Grassia couldn't afford it.
"I come to work and I'm dying," he recalls. "I'm popping Vicodin after Vicodin just to stand here, just to make money for the day, so I can pay these bills."
