A sick woman's odyssey without health insurance

Ruby Spencer had a football-sized tumor in her gut and was turned away at Temple University Hospital's ER.

October 25, 2008|By Michael Vitez, Inquirer Staff Writer

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She asked her pastor at Greater Harvest Baptist Church in North Philadelphia to write a letter, and he agreed to pay her $100 a month to help clean the church, which she had been doing anyway for years as a volunteer. So she was now employed and disabled and eligible for MAWD.

She submitted the application last week.

Once contacted by the newspaper, welfare officials in Harrisburg took an interest in Ruby's case, and on Monday she was told she had been approved for MAWD - a process that can take 45 days - and will have insurance.

Story continues below.

The health-law project last week scheduled her an appointment for Oct. 30 at an outpatient clinic for women's health at Temple for which she does not need insurance. But now she will be covered for any tests and procedures - most likely at Temple.

One final footnote: Two weeks ago, Ruby received a $700 bill for her ER visit from Temple University Physicians, broken down into two charges.

One was for $230, for "emergency department visit," according to the bill. She intends to pay that. She was, after all, seen in the ER, even if she was unsatisfied with the outcome.

The second charge is for $470 for "Incise/Drain Bartholin's Abscess."

She has no idea what that could be but is sure that "nobody drained anything. I'm going to fight that one."

Cacciamani, the head of clinical operations at Temple, replied: "That must have been a mistake."

"She needs to call up our billing office. Sometimes there's paperwork from hell."

The bill was due last Tuesday.

"The last thing I need," Ruby said, "is collection agencies calling me."

What Went Wrong

Ruby Spencer, 61, has

a football-size tumor in her belly but no health insurance. A physician assistant sent her to

the welfare office where Spencer was told she was ineligible. She went to an emergency room and to a city clinic, but both referred her back to the welfare office. Turned down by everyone, she just went home. No one advocated on her behalf until The Inquirer got involved. The case shows how difficult it can be to navigate

the health system without insurance.