One woman finds health care backdoor

A 63-year-old who goes bare-legged as late in the season as possible, Magulick was outfitted for the latest offensive in her guerrilla campaign to get health care. She carried over her shoulder a purse decorated with casino patches and cradled in her left arm a clipboard -- useful both for taking notes and keeping hospital staff on their toes, she said.

Having dropped health insurance this spring after her monthly premium nearly doubled, Magulick has been hunting down sources of free care, including hospital health fairs and community center screenings. Her bus trip was planned so she could get information about a University of Pittsburgh study in which she hopes to receive free tests for her diabetes.

The uninsured are surrounded by a wealth of health care resources. As more people lose coverage, Magulick's case stands out as an unusual example of trying to work the system to get care through the back door.

"I live on the edge here a little bit," said Magulick. "It's tough to wish your life away, but I'm waiting until I'm 65 when at least I can go on Medicare."

Experts on the uninsured applaud her pluck, but say the broader trend is a dangerous one.

"She's fairly unusual in that she makes a point of getting the preventive work done, even though it's not covered," said Geoff Webster, executive director of the Consumer Health Coalition, a Pittsburgh group that helps people find health insurance. "But in terms of her lack of coverage and needing to piece together a back-door solution, that is a very common occurrence.

"There are others who don't have the knowledge or wherewithal or capacity to do this," he said.

Magulick said she learned about the virtue of perseverance when her husband needed long-term care in the mid-1990s. When she visited him in the hospital and then a nursing home, she made a point to carry her clipboard, wear big hats and walk in shoes with noisy heels. That, along with her forceful personality, prevented him from being prematurely discharged, she believes.

After her husband's death in 1997, Magulick continued to receive health insurance through his labor union but soon couldn't afford the monthly payments of nearly $500 to keep the coverage. It was her first brush with being uninsured and she decided she would pay out-of-pocket for one doctor visit per year and supplement that care by attending hospital health fairs.

Test results from a fair in 2001 helped confirm that she had developed diabetes. She went back to her husband's union and found she could buy coverage for $380 a month -- still an "out-of-sight" price, she said, but better than the previous figure. Plus, she felt a more acute need for insurance.

That coverage lasted until earlier this year, when the monthly premium jumped to nearly $700.

A poker player on Monday nights, Magulick is the first to say she's not the picture of poverty. She took Social Security early as a widow, which gives her a monthly income of $865. That's not much, but she does have a modest home, thanks in part to the money she and her husband made from selling a previous home.

"I don't try and poor-mouth -- I never thought that was fashionable, even though some people think it's so," she said. "But if I have $865 coming in monthly, which is what's supposed to pay my monthly bills, how in the world can you pay $700 for health insurance? Who would do that?"

For now, Magulick is paying out-of-pocket for the less-expensive medicines she takes. For the more expensive pills, she's relying on free samples from her doctor plus a neighbor's unused prescription.

"We all want security, and you can't be 63 years old, not have health insurance and feel very secure," she said.