College students and grads face tough challenges with health care

Amber Singam, 30, and her husband, Shankar, 34, are ready to start a family. They have waited for years, so when Singam graduated from Cal State Fullerton (CSUF) with her master’s degree in May, everything seemed ready for a new addition to their family. All she needed was insurance coverage.

Back in August, Singam applied for private health insurance. She filed the paperwork, gave her medical history and any medical procedures she had undergone, but two months later she still hadn’t received an answer. Singam called the insurance company and discovered that she had been denied coverage.

A letter from the insurance company arrived the next day, stating she was denied based on her “high risk for HPV,” or human papillomavirus. For years, Singam had abnormal PAP smear tests, a routine gynecological exam of cells scraped from the cervix to detect cancerous or pre-cancerous conditions. She underwent a procedure four years ago to remove the abnormal cervical cells.

Since the procedure, Singam has received normal results from her PAP tests and has maintained a healthy lifestyle, so when she was denied insurance, it came as a surprise.

Singam is one of the 21 percent of Americans who apply for insurance and are denied health care coverage based on what the insurance industry considers as “pre-existing conditions,” an issue that has come under fire in the recent health care reform introduced by President Obama.

As talks of improving health care focus on seniors and children, much of the debate has neglected the burgeoning population of college-aged students and recent graduates who may not be able to afford private insurance or seek jobs that offer health benefits in this recession.

The number of Americans insured through employers is 164 million, according to the Kaiser Family Foundation (KFF). However, with the economic recession and the new batches of graduates joining the work force every semester, looking for employers that offer health benefits are harder to find.

Though Singam was hired as a part-time instructor at a community college in September, her health benefits will not begin until next fall. She faces eleven months without health insurance coverage, but said she is willing to pay for private insurance, especially with their plans to have a baby.

“I can afford to pay for private insurance, but I can’t afford to give birth without insurance,” Singam said. “I am also not able to afford pre-natal care prior.”

Resources and services narrow when students graduate and lose the student status many insurance companies require. But currently enrolled students traverse an equally overwhelming path. They often rely on student clinics or government and public health programs.

College students who have medical conditions that require treatment, like Patrick Cruz, a 23-year-old living in Alameda, may not have the money for private health care.

Diagnosed with psoriasis - a non-contagious autoimmune disease that appears on the skin as raised patches or lesions - Cruz has been fighting for insurance to get treatment.

He was a working student, employed at a local Starbucks, and attending Alameda Community College when he was diagnosed last October. At that time, Cruz was insured by his employer and was able to get some treatment. But he lost coverage when he wasn’t able to meet the quarterly 240-work hour requirement to continue receiving health benefits.

“I was missing a lot of hours because there would be days…when I didn’t feel well,” Cruz said. “I had to quit because [the lesions] were all over my face, too.”

In December, he applied for Medi-Cal, but would not be seen by a specialist until February. By that time, his condition worsened and his plans of applying to the Respiratory Therapy program in a nearby college were put on hold.

Unemployed and short on money, Cruz and his family decided to go to the Philippines where his medicine and treatment would be cheaper. He returned to Alameda three months later with his skin partially cleared.

But flying back and forth to the Philippines isn’t much of an option.

“I can’t keep getting a quick fix. I need something that’ll last longer,” he said. “My condition gets so dependent on medications.”
Though he has received treatment on and off in the past year, his condition hasn’t improved. Regardless, he remains positive and hopeful that Medi-Cal will help him get the treatment he needs when he finally sees a dermatologist at the end of this month.

Until he gets private insurance, he relies on Medi-Cal and other low-cost options.

Knowing what’s out there

Many alumni associations offer discounted health insurance for association members and some grads may qualify for public programs for low-income individuals and families.

Most colleges and universities also include health fees in registration and tuition fees for enrolled students. This gives students access to the on-campus health clinics which usually offer basic medical tests and procedures for free or for a small fee.

Roughly 55,000 student appointments are scheduled per year at CSUF, said Mary Becerra, the director of health education and promotion at the Student Health and Counseling Center on campus. The health clinic is a full-functioning medical clinic, able to perform many basic lab tests and examinations, provide affordable medications through its own pharmacy, offer reproductive health services, and family planning services.

CSUF has an enrollment of 37,000 students and the school’s clinic is the most highly utilized student clinic in the entire CSU system, according to Becerra. Most students come during the high-stress times in their semesters - midterms and final examinations. With the flu season, the student clinic has also seen many upper respiratory issues.

About 70 percent of the students the clinic surveyed said they have some type of insurance, while the remaining 30 percent are the ones that are seen regularly - students who have limited or no access to any type of health care, Becerra said.

Though the student clinic offers a wide range of services, it is still limited. It is not equipped to handle medical emergencies and other serious conditions.

It is the emergencies - a broken arm or a chronic condition - that put students in financial troubles. This is where insurance becomes indispensable - for the “what-ifs.”

Becerra also noted that the University of California requires all students to have insurance coverage - either from a private provider or through the university. But based on tightening budgets of the CSU system and the recent tuition fee increase, it may be tougher to require insurance coverage for all students.

“Mandatory insurance may be out of the question,” she said.

Health care reform in the works

On February 4, President Obama spoke at the joint session of Congress and emphasized the need for a comprehensive health care reform. This speech marked the beginning of the heated debate about the condition of the nation’s health care system. Touted to be the biggest health care reform in decades, the reform aims to extend coverage to more Americans and control the sky-rocketing costs of health care.

About 46 million non-elderly Americans are uninsured, the KFF reports. This could be because of many reasons including unemployment, not meeting employer’s qualifications for insurance coverage or denied health insurance. Some college-aged students fall under these categories who, either willingly or not, forgo insurance coverage.

Recently, the House of Representatives passed an expansive health care bill that would guarantee medical coverage to 96 percent of Americans. The bill would place a tax surcharge on wealthier Americans as well as new taxes on individual and family plans whose values exceed the set amount, according to CNN. The plan would cost under $1 trillion in ten years.

Last week, the Senate Finance Committee introduced a health care reform bill that will cover 30 million Americans and would cost $849 billion over the next ten years. It is aimed to cut costs to individuals, companies and the government and increase efficiency.

Both bills include a public option plan, but with varying provisions and conditions. The House bill requires individuals to buy insurance, with steep penalties for not complying, which could reach up to 2.5 percent of the individual’s income. The Senate bill is a bit more forgiving with fines that could reach up to $750 for not having coverage.

Though both houses have different bills in the works, both agree on broad changes including cutting down costs and preventing insurance companies from denying coverage based on past medical histories.

The Senate bill moves to the floor after Thanksgiving recess for a full debate by lawmakers, giving them an opportunity to introduce amendments to the bill. A long process awaits and a final version of the two bills would have to be approved before the president can sign it into law.

Working with what they have

Currently, CSUF offers insurance coverage for purchase through Anthem Blue Cross. The student insurance offers low-cost group insurance coverage to uninsured students and their dependents on either an annual or semester basis.

Nathan Fletcher, 32 and his daughter have been insured through CSUF’s student insurance for two semesters now. Previously employed by a furniture store in Lake Forest, Fletcher was let go in February because of the recession and was concurrently attending college to fill pre-requisites for the credential program.

When he lost his job, he immediately signed up for health insurance through the university. It cost him $2,000 for health coverage. The fees include $1,100 to cover his daughter and another $1,000 for himself under the Domestic Student insurance plan.

Though he receives financial aid and works part-time as an Instructional Aide, Fletcher admitted that paying the fees at the beginning of every semester is stressful.

“I have no choice. If I have to be prepared [for next semester's payment], I will be,” he said. “It’s expensive to purchase, but the alternative is unfeasible.”

Despite the price, it is still cheaper than private insurance premiums and the school’s insurance gives him sufficient coverage for the price he’s paying, Fletcher said.

Fletcher is one of the lucky ones able to navigate the options available to him and could afford coverage. Also, since the insurance on campus is a group insurance, whoever enrolls will get covered regardless of past medical history.

But depending on the students’ age, status and dependents, premiums range from $500 to over $2,000. All the fees are payable on the day the student signs up for insurance.

Students who don’t have the money risk having no coverage and sometimes utilize the student clinic. Others see the fees and say no altogether, despite the ample coverage and low deductibles of student insurance. Some students just don’t know where to begin.

Most students who have no access to insurance would have to figure it out for themselves, said Joe Vargas, whose Populations in Multicultural Health class at CSUF studies the disparities in access to health care for different groups.

Many undergraduate students are covered through their parents and guardians’ health insurance but some, who are no longer eligible because of insurance requirements, are left with a difficult decision.

“Students today would have to learn how to maneuver the system,” Vargas said.

He noted that students with families, such as expecting mothers, face an even harder challenge.

“It must be challenging to balance pre-natal care, school, jobs and many other things,” he said.

The battle of costs and available resources forces many college students to gamble with their health. Many of them would have to rely on faith. Faith that their immune systems don’t fail and faith that nothing happens to them until they get a job with health benefits, or until the promise of a comprehensive health care reform becomes a reality.

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Francesca Gacho holds a B.A. in English from Cal State Fullerton. She is an intern at Minority Dreams Magazine, where she hopes to spread her journalistic wings, explore and hone her writing ability, and gain insight into the myriad of issues in today’s soundbite-focused world. Her writing interests include human interest pieces that delve into culture, arts, current events, and community service.

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This article was republished at New America Media on Nov. 26.

Every quarter counts in the drive to help homeless veterans.

Grant Deering and his Human Services group, Troops United, want your quarters.

On a cool November day, six or seven multicolored coin canisters are neatly placed in a tight row across a table along the Titan Walk at Cal State Fullerton. Students pass by during the midday rush and avoid eye contact. Caralie Kennedy, a member of Troops United, politely asks passersby to donate what they can. A few students stop by the table, fiddle around their pockets or wallets, and drop a quarter or two. But many say “No” or “I don’t carry change.” To which Kennedy replies with a smile, “That’s okay. We’ll be here tomorrow and next week!”

No donation is too small for Troops United and their fund raising event, “Quartering Our Troops”—a nod to the Quartering Acts in North American colonies that required colonial assemblies to provide food and shelter to troops deployed within each colonies’ borders.

As a class project for a Human Services course, Deering and Kennedy, along with four other Human Services students, are raising funds to benefit the largely unnoticed homeless veteran population.

This awareness, however, did not come too swiftly to Deering and his group mates. Assigned to set up a service to aid the “Troops & Veteran” community, Deering and his group had a little trouble getting started. Luckily, he picked up a local newspaper and read a front page story about David Michael Whittaker, who was once a homeless veteran and his 80-foot American flag that flew high and proud in Newport Beach. Though bound to a wheelchair, Whittaker travels to different states to bring awareness of the homeless veterans’ struggles. Deering e-mailed the story to his group and they all quickly rallied behind the cause.

After searching for organizations that support homeless veterans, Troops United came across New Directions Inc., a non-profit and community-based organization that provides comprehensive services for veterans in need including vocational training, housing assistance and substance abuse rehabilitation, as well as transitional workshops to help veterans rejoin the community. New Directions also has 156 beds in its Regional Opportunity Center in Los Angeles, where veterans get housing assistance as they get back on their feet.

With current reports putting homeless veterans at 23 percent of the national homeless population, organizations like New Directions will likely see more veterans returning from Iraq and Afghanistan.

Although the U.S. Department of Veterans Affairs aids an estimated 100,000 homeless veterans, roughly 160,000 veterans still do not receive ample assistance, if at all. Many are male adults, though females account for 4 percent, and come from poor communities. Shelters and transitional home organizations across the country have attempted to bridge this gap, but constant community support and outreach are needed to make such organizations effective and successful.

So far, “Quartering Our Troops” is getting a positive response from students on the CSUF campus and online.

Members of the group use social networking sites and modest advertising to raise awareness and so far, it’s working. The key to their positive following? Connectedness and shared experiences.

“I wouldn’t be surprised if they [the students] know someone in the military,” Deering said.

Numerous students have come up to their donation table with stories of who they know in the armed services. And this is why, with only three days of fundraising, the group has already raised approximately $500. If every student at Cal State Fullerton donated a quarter to help homeless veterans—and the campus currently has 35,000 students attending—Troops United would be able to raise over $8,000 in donations.

They hope to help fund transitional workshops, purchase computers and new software to help with job searches and training. Their efforts continue on campus this week, but the work does not stop there.

“We are going to direct our efforts toward military bases and see what kind of support we will get there,” Deering said.

Though their Human Services class ends in December and their fundraising ends early next month, Deering has hopes that this will not be the end of Troops United’s mission.

“I hope the next group of students coming in the class will pick this up and continue the fundraising,” he said.

It is a humble effort to involve the community, help give veterans access to services, and give back to our nation’s heroes—one quarter at a time.

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To contact Grant Deering of Troops United, e-mail him at futuredocgrant@hotmail.com
For more information on New Directions, Inc. and how you can help, visit www.newdirectionsinc.org

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Francesca Gacho holds a B.A. in English from Cal State Fullerton. She is an intern at Minority Dreams Magazine, where she hopes to spread her journalistic wings, explore and hone her writing ability, and gain insight into the myriad of issues in today’s soundbite-focused world. Her writing interests include human interest pieces that delve into culture, arts, current events, and community service.

Disabled Vet Standing on His Own New Feet

Chapter I

On May 23, at 6:00 a.m., Chang Wong and his tank crew were out on patrol when they were struck by a roadside bomb.

“I remember looking through my tank sight and a second later, my head was pushed way back, away from the sight,” Wong recalls. “I looked around and noticed that my both feet were severely damaged.”

Wong tried to stand and run, but couldn’t lift himself up. So he started yelling for help. “When they finally pulled me out, I was in so much pain and adrenaline I started cursing and yelling,” Wong says. “Throughout the entire ordeal, I was conscious until the field nurses and doctors put me to sleep.”

Doctors at the field hospital at the giant U.S. military base in Balad amputated both of Wong’s feet. They had initially hoped to save his right foot, but because of the severity of the fractures and poor blood circulation, they had no choice but to remove it as well.

Little did Wong know, his life was hanging by a thread. The blast from the Improvised Explosive Device (IED) did more than damage his feet; it sent shock waves that rippled throughout his entire body causing further complications.

L.A. Vets Project - Sgt. Chang Wong from New America Media on Vimeo.

Both lungs collapsed, which nearly ended his life; Wong was also given 55 units of blood. Because of the severity of the situation, the Army doctors had an extremely difficult decision to make: whether to use a medical device not approved by the military and face possible reprimands, or continue with conventional methods that were not helping Wong recover.

After eight very precious days, Wong was airlifted to Regensburg University Hospital in Germany, where he would be treated with the unapproved medical device, the “nova-lung.” This machine is intricate and unique for its size (it looks like a compact disc player with four tubes) because it mimics and performs like a set of real lungs. The “nova lung” is connected to the veins and arteries, found near the groin. And as the blood circulates throughout the body, it passes from the patient’s veins through the machine, where it releases carbon dioxide and picks up oxygen. For the next two crucial weeks, Wong was fighting for his life once again. He had fevers over 100 degrees, non-clotting nosebleeds, and tubes going into and coming out of his chest.

Once Wong was stabilized, they transferred him to Landstuhl Regional Medical Center in Germany, the U.S. military’s largest hospital in Europe. Finally, on June 22, 2005 – nearly a month after the IED blast – he was moved to his final destination, Fort Sam Houston, near San Antonio, Texas, where he would receive the remainder of his medical care and begin the long road to recovery.

Chapter II

Chang Wong’s mother, Lien Chu remembers receiving a telephone call. For one whole week, she said she cried her heart out. The military sent her and his father, David Wong, to Germany, where they spent three weeks, in and out of the hospital, caring for their son. After leaving Germany, both parents accompanied him to Texas.

For the first few weeks, his mother would accompany Wong, day and night, and speak to him until he slowly fell asleep. She would stay with him for the next five months.

As Wong was weeded off heavy sedatives, he began to realize that both his legs were amputated below the knee. And at the young age of 23, he found it extremely difficult to accept this reality. He immediately went into denial.

Wong speaks about his battle through depression with such strength and resilience. “I was scared; I was terrified; I was afraid that if I fell back asleep I wouldn’t wake back up again… I didn’t eat, didn’t drink, and didn’t feel like talking but also didn’t want to be alone. And it wasn’t until the 4th of July weekend that I fully accepted all the events leading up to present day and moved forward. I had friends and relatives, who flew in to see me but at that time, I didn’t care for visitors. I begged my mother to leave me behind, to go back home and carry on with her life. She defiantly refused and kept telling me that she would do no such thing. I then turned to my friend, Sara Zigman, and asked if she would convince my mom to leave me be; she also refused.”

“At this point, I gave up and decided to lay there, restless. My mom, thinking that I was finally calm decided to pour some water into my mouth and with no such luck, grew increasingly angry, upset, and tired. She wound her hand back and slapped me across the face; the pain registered, it felt real, I came to the realization that I was not dreaming, that this wasn’t some horrendous dream or trick my mind was playing on me.”

Following that incident, Wong gradually accepted his outcome and decided never to look back and pity himself.

Lieu Chu poured out her heart to take care of her son, consistent with Asian family values — filial piety, parental care and interdependency. These notions define specific rules of conduct in social relationships and place great importance on the family. The family provides support and assistance to each individual member; in turn, individual members provide support and assistance to the entire family. These relationships, interactions, and obligations are lifelong; and the goal of individual members is not necessarily autonomy or independence.

Charter III

After graduating from Alhambra High School in 2000, Wong had plans to attend a local community college but because he had just received his permanent resident status, he was charged as an out-of-state student. Not wanting to pay such a high fee for a community college, he decided to take that year off and enroll for the following fall semester.

Before the new school year began, a few of his friends approached him about serving in the United States military. They told him his college tuition would be paid for, that he would acquire leadership skills, and see different parts of the world. After giving the idea of serving in the military some thought, Wong took on the commitment. Without notifying his parents, he enlisted in the United States Army. His parents were shocked and extremely upset when they found out. It is atypical for someone with a Chinese heritage to enlist into the military voluntarily because in Asia, military service is a requirement.

August 2001, Wong was sent to Fort Knox, Ky., for basic training and one-station-unit training (OSUT). After completing the grueling, four-month training, he was deployed to South Korea for a one-year tour and from there, he deployed back stateside to Fort Irwin, Calif., where he remained before deploying to Iraq. On January 2005, his unit was activated and deployed to Iraq. Wong was a tank gunner in the 1st squadron, 11th Armor Calvary Regiment.

Born in 1982, in Malacca, Malaysia, Chang Wong is of Chinese decent. His family immigrated to America when he was two. Before enlisting into the U.S. military, he had just received his green card and was not yet naturalized. Prior to his deployment to Iraq, Wong sent in his application to be naturalized and was waiting for an interview and a swear-in date. He received notice in May and was relieved that he would soon become a United States citizen. But because Wong had joined the military, he never had a chance to make that interview; therefore, immigration authorities requested an immigration officer from Italy to set up a naturalization ceremony for him at the hospital in Germany. Wong was finally naturalized on June 13, 2005, three weeks after losing his legs in Iraq.

His naturalization ceremony was atypical. He doesn’t remember it because he was sworn in a medically induced coma.

Charter IV

In April 2006, Wong returned back home to the city of Alhambra. That following summer, he enrolled at Pasadena City College, the school he had planned to attend before joining the military. After completing his general education requirements, he applied and was accepted to California State University, Fullerton, where he is pursuing a bachelor’s degree in business. He is expecting to graduate no later than 2011. While attending Cal State Fullerton, he is staying with his aunt in Rowland Heights.

Chang Wong received his first prosthesis in August of 2005; the first pair of legs was temporary. After several major and minor adjustments and improvements, he received a pair of permanent prosthesis in early 2006. When he bathes, he sits on a chair and removes his prosthesis; afterwards, he puts his prosthesis back on.

After using the prosthesis for a period of time, they need to be adjusted, refitted and modified, but the prosthetics manufacturing company requires the approval of the Department of Veteran Affairs before they can begin any type of adjustment and modification requests. In order for this to occur, Wong needs to be seen by the VA prosthetists and this takes between several weeks and several months. He hopes that this process will become more efficient and less time consuming.

Oftentimes, Chang Wong will wear pants over his prosthesis, which makes him look like any able-bodied person. However, this “healthy” appearance also brings him problems.

For example, one time, when Wong drove himself to the campus, he parked his car in a disabled parking spot. Since he appears young and “healthy” looking, other people who are around, frown, look down upon him, and even harass him for parking in the disabled spot. Security guards and campus police have also questioned him—“How did you get this handicapped parking permit?” He had to produce his veteran certificate of disability, and sometimes he even lifted his pant leg to reveal his metal prosthesis before they believe him. As a veteran who sacrificed life and limb for this country, he feels he has been wronged but also understands why.

In the summer, Wong wears shorts and runs at a park near his home, using specialized running prostheses that resemble skis. Children are often curious and even follow him around to watch him run. Wong isn’t embarrassed by his appearance but finds it uncomfortable when adults stare at him like he has been cursed.

While at school, he does not participate in sports; but he plays wheelchair basketball with friends and occasionally swims and skis.

Chapter V

Today, Chang Wong is being compensated for his disability from the Veterans Administration and Social Security. In addition, he receives free medical services in military hospitals. Fortunately, even in this economic downturn, Wong is able to meet his financial obligations and live somewhat comfortably.

Wong, like many other wounded soldiers and marines, were in a fight for survival. Fortunately, due to advancements in body armor, medical procedures, and such, his chances of survival increased dramatically—compared to soldiers and marines who served in Vietnam or World War II.

With that in mind, soldiers would come back from the battlefield alive but with very serious, visible amputations and disfigurement. In addition, they came back with less visible injuries—post traumatic stress syndrome. Similar to the experiences of veterans before him, they all face the long and sometimes, very lonely road to recovery. Like all major obstacles in life, overcoming this or any hurdle requires perseverance, support, and a strong will to keep pressing forward.

Wong is a strong-willed individual who wanted nothing more than to recover—physically, mentally, and spiritually—and return back to his normal life. He began setting recovery goals that were very unrealistic and when he did not meet his goals, he pushed himself even further and harder. His ambition, focus, and dedication were unreal and he fully recovered in less than eight months.

But Wong’s journey is not over. As the years go by, it will become even more complicated. Not only will he have to overcome any difficulties that may take shape but also now he must deal with the degrading stares, misunderstandings, and discrimination.

Wong’s home is located in U.S. Rep. Adam Schiff’s district. The reporter called Yvonne Hsu, the congressman’s district representative, and asked how Schiff’s office can help veterans, such as Chang Wong. Hsu asked Wong to call the office—she would like to speak to him in order to determine what types of benefits he is eligible for. She also hopes Wong and other veterans know that if they require any assistance from the Department of Veterans Affairs (VA), they are welcome to contact their elected officials.

Chang said he would give her a call after midterms.

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This article originally appeared on New America Media.