Struggling for health coverage in Sisters

Many Sisters area residents take a major risk every day. They go without health insurance coverage.

They’re some of the estimated 45 million Americans who get little or no medical care because they cannot afford health insurance.

That number rose in recent years, mostly due to a loss of coverage by employers. With the number of small employers in Sisters and the numerous part-time and seasonal jobs, this community has a large share of uncovered families.

People either go without or struggle to pay for an insurance policy on their own.

“Who can afford that?” said one retail employee in downtown Sisters.

Robin Tawney is in a situation similar to many employees. She prefers the quality of life in Sisters and enjoys working for a family-run business, Garden of Eden, rather than driving to Bend for a job that offers health insurance.

Tawney said, “You hope you find a doctor who’s willing to take payments.”

“There’s a certain number of people who can’t pay and you see them anyway,” said Dr. Steven Greer of the Sisters office of Bend Memorial Clinic.

Fewer than 10 percent of the patients who visit BMC have no insurance. Dr. Greer points out the uninsured population is hard to count since many people without insurance simply don’t enter the medical system at all.

In Sisters, the lucky few work at jobs in the schools, government or a larger company such as Ray’s Food Place. The grocery store, owned by C & K Market, Inc., provides company-sponsored health insurance to all eligible employees and their dependents at no cost to the employee.

For some of the bigger locally-owned businesses in Sisters, offering health insurance is possible — but takes effort.

O’Keeffe’s Co., maker of O’Keeffe’s Working Hands Crème, offers health insurance to its seven-plus employees. Since the company’s founder, Tara O’Keeffe, began her career as a pharmacist, she says it’s a “very important” benefit.

“It’s a high priority for me in my business,” said O’Keeffe. “We have tried to think of creative ways to make it affordable.”

O’Keeffe reviews the usage of her company’s plan each year and makes changes so both employee and company benefit. For example, she was paying $120 each month per employee for a prescription drug benefit. Upon review, she found it wasn’t being used very much due to the relatively young age of her employees.

So O’Keeffe’s dropped that coverage and added a more tangible benefit to her company’s policy. This year diagnostic care is better covered, which helps dependent kids who are active in sports.

“We have young people with kids and that means accidents,” said O’Keeffe.

She added that by assessing how coverage was used and shopping for a better policy, her premiums went down and employees are better covered.

As retail employee Tawney points out, too many working people fall into a coverage gap.

“You make too much for the Oregon Health Plan but not enough to buy it yourself,” she said.

For some uncovered employees in Sisters, a solution is in sight.

The Sisters Area Chamber of Commerce recognizes health insurance is often too costly for small businesses to offer to their employees.

“I know it’s an issue,” said the Chamber’s Executive Director Cheryl Rhea.

She knows that chambers in other small towns have worked to provide a group policy so that health insurance is a more affordable benefit for the chamber’s member businesses.

“It’s something worth investigating,” said Rhea, adding she is doing research to see if that is a viable option.

One group that doesn’t have an easy answer to health coverage is the self-employed.

Real estate brokers are a well-represented profession in Sisters.

But they are not employees, so they must decide whether or not to pay for a costly individual policy if a spouse does not cover them.

“It’s a huge issue for our members, or for any independent contractor,” said Andrea Bushnell, CEO of the Oregon Association of Realtors.

Bushnell said there are drawbacks for health care providers to insure any trade association because the membership changes frequently. Insurance companies are reluctant to insure trade associations because they have a hard time getting a handle on exactly who they would be insuring.

However, Bushnell says her association is working through the problem with the current Oregon state legislative session.

“We’re trying to work toward a solution that would entice providers to come into the state,” said Bushnell. That would benefit Realtors as well as any self-employed person who belonged to a trade association.

More help came to the uninsured last year when the Volunteers In Medicine Clinic of the Cascades opened near St. Charles Medical Center in Bend. VIM provides basic health care to residents of Deschutes County who have no medical insurance and meet the eligibility criteria.

The Clinic, which opened in March 2004, estimates more than 12,000 residents of the county are in need.

Should universal health coverage be considered a right? Should society ensure that everyone have health coverage?

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