Although I have a master's degree and a half, I've spent most of my career in underemployment. When I was unable to obtain a decent job during this latest economic depression (I quit a soul-sucking job that paid little), I gave up, substitute taught for a year, and retired.
When you retire early, you take a lower rate of retirement, but in my state, our public employees' retirement also offers health insurance, so we are insured again at the moment--my sons until they reach age 25. I still work at one part-time job as an independent contractor; I write occasional book reviews for pay; and I still get child support until next July, when my son turns 19. I settled for a lower-than-legal amount of child support because it was easier than arguing with my ex-husband, and although he pays it late every month, at least he still pays it.
Both sons are in college now, attending with a combination of Pell grants, modest savings from jobs, a few scholarships (even the salutatorian failed to get any truly cushy full ride scholarships--oh, well), and student loans. They'll both graduate with debt, but their father says that if the market improves, he'll sell one of his four houses to help them out at some point. At the moment, though, he gives them nothing.
To give an example of how meager my income has been, during all of their school years, we were eligible for free and reduced lunches except for two years (interestingly, the income eligibility guidelines are online for many years here: http://www.fns.usda.gov/cnd/governance/notices/iegs/iegs.htm). Most of those years, we were a family of three, although for the last five years, there was always an extra teenager here--one was a refugee from an abusive mom (and from Mormonism); another stayed here because he didn't like his stepfather of the week. I fed them, but the only rent they paid was helping with chores.
One of my sons has asthma, and he has been the trickiest to help without insurance because he needs medication. It costs too much to get a health checkup, but fortunately, they offer sports physicals for $30, so even though he doesn't participate in sports, that's how he'd get a checkup and a prescription. His medication cost between $35 and $85 for a refill. For two years, he went without a checkup because the physician's assistant we'd seen was kind enough to renew the prescription when the pharmacy called him. This last year, we took advantage of the free medication service offered by some drug companies, so he was able to get a three-month supply at a time.
Once a year, I get a fairly large tax refund, based on earned income credit. The tax refund is spent like this: 1) dentists 2) optometrists 3) new shoes, a pair of pants, underwear, socks, and two t-shirts for each son 4) belated Christmas presents 5) debt reduction and 6) living expenses. A decent tax refund might last us into May or June, helping with high winter heating bills (I could average those, but it's always a relief to pay less in the summer, so I pay the higher rate in the winter).
I've visited doctors for myself three times in the last ten years. Once, I requested a tranquilizer so I could attend my sons' band concerts (I have agoraphobia & social anxiety). The visit cost so much that I never did fill the prescription. Once, I was seeing spots before my eyes. The doctor ordered blood tests and found out I was low on potassium and other essential elements/vitamins. He ordered follow-up blood tests, but the first ones were so expensive, even with insurance, that I never went back; instead, I tried to improve my diet and I take an occasional multivitamin and the spots went away. The third visit was a month ago, where the doctor (who was recommended) didn't seem to care, and so learned almost nothing about me. It was a hellish experience for a recluse, but it was covered by insurance. I may never go back, even though I have insurance. Or maybe I'll hear about another doctor who's worth a try.
In Colorado, most towns offer a version of the 9 Health Fair, where you can get inexpensive blood tests and other health screenings. Unfortunately, you have to wait in line for hours to receive these benefits. I tried it once, but my anxiety over standing in line, then entering a room crowded with people got the better of me. I left that year without getting any health screenings, and I've never tried again.
All of our immunizations take place at the county health facility, a 5-minute walk from my house. Immunizations generally cost $10 to $15 and some are free. A few years ago, I stepped on a nail, so I went to the county health office for a tetanus booster. They were closed, attending a special immunization festival of some sort in a town 60 miles away. I didn't want to drive that far, so I went to the local doctor's office. They said that they couldn't squeeze me in for a tetanus shot, so I'd have to go to the emergency room. That visit would cost me $185, so I drove the 60 miles for the $10 tetanus shot.
Last year, as my son was climbing down the wooden ladder from his room, he got a splinter under his fingernail, which went all the way to the base of the nail. I knew I couldn't extract it, so we drove to my mother's house, but she was unable to extract it. The next step was the after-hours clinic, which is supposed to be my town's inexpensive alternative for poor people with minor problems. The nurse took one look at the splinter and said that we'd have to go to the emergency room. My son was becoming faint from the pain, so there wasn't an alternative. I left him there because I had to work, but I sent my daughter to sit with him. Maybe if I'd been there, I would have found out that you can get a 50% discount if you pay half the bill within 15 days. They gave him a local anesthetic, cut out the splinter, and he came home. When I received the bill, it was $866. I paid it off in hundreds, seventy-fives, and fifties, over a period of 10 months. Now we have insurance, but it isn't the best insurance. It's supposed to pay 20% of the costs for emergency care, and there's a $6,000 deductible per person ($12,000 for the whole family), so I'm not really sure how much it would have helped with the cost of the splinter removal.
A 19-year-old friend of my sons works part-time (the only job he's been able to get) and suffered from a health emergency that cost several thousand dollars. He used the option to pay within 15 days, so he reduced the bill by half, but it wiped out his savings, so now he's back at square one trying to build up his savings so he can attend community college part-time.
What's good about health care in this country for the working poor? Not much. There's now a "free" clinic in my neighborhood, but to use it at a discount, I would have to make an appointment with the financial person in that town sixty miles away, drive to see her, and fill out copious forms. I know this because my daughter followed this path, which is too difficult for me.
Someone in my town wrote a letter about how outrageous it is that students get free and reduced lunches, yet they have new shoes. When I read that letter, I had just purchased my sons their new shoes for the year, and I shook my head at her ignorance. It's sort of like Romney's ignorance when he says that we provide free care for poor people when they have a medical emergency.
Both sons needed braces. My ex-husband actually pitched in and paid for the first son's braces, but I paid for the second at the rate of $157 a month, but at least they had a financing program, so it worked out even during the years that we didn't have dental insurance.
I haven't been to a dentist in a decade, and there's one at that free clinic, also a five-minute walk from me, so I've been plotting how I could get over there now that I have dental insurance. With insurance, I shouldn't have to drive the sixty miles to go through the paperwork gauntlet, so that should help. So far, though, I haven't been able to figure it out. Does anyone provide a safety net for mentally ill people who are afraid of dentists? I wouldn't even know how to find out. I don't have friends, so there's no one to ask for help, but hey, I'm smart, so I'll probably figure it out before I die from an infection.
In contrast, my daughter is attending school in the UK for a year, working on her master's degree (she's paying for it with thousands of dollars in loans, but it's still cheaper than attending a master's program here). She's able to use the national health system because she's staying for a year, so she went for a checkup (her first in a long time), and they gave her a physical and excellent advice on asthma management, and when she asked how much it cost, they replied that it was free. Free health care. Yes, you have to pay for it with taxes, but imagine never having to worry about how to pay for a splinter.
After looking at Mitt Romney's 2010 tax return, I understand why he doesn't understand poverty. He doesn't even have to work to make money. He's never experienced the balancing act that comes from not having enough--how you have to use a patchwork of services to make sure your kids can see a dentist, get glasses, eat, get needed medications, visit the doctor, and still get a new pair of shoes every year, let alone the struggle to get them into college. He didn't attend public schools, so he has no idea that many public schools are actually good--in fact, that's a message that no one ever states. No one ever says, hey, this is what's right with public education. The lives of the working poor are more complex than Romney could imagine.