ST. PAUL, Minn. -- For years I've been buying coffee from Laura Kabylnick. She's one of the first people I see every morning as I walk through the lobby of the Science Museum of Minnesota on my way into KARE 11's Saint Paul newsroom.
Laura works the coffee and snack counter, which is owned by a private company that contracts with the museum. Even when I'm not stopping to grab a cup she manages to shout out a hello and a question or two about what story I'm off to cover.
One day recently Laura didn't seem like herself. She was downright down. Her dentist told her the lump in her tongue might be cancerous, and he was going to send her to a specialist in downtown Saint Paul where she lives.
It was a frightening enough, but even more so for Laura because she doesn't have medical coverage. She had to come up with $450 up front, just to see the specialist and get her biopsy. She had to put on a credit card.
The biopsy revealed cancer.
Laura was told she needed surgery, and possibly chemotherapy and radiation. She was also told her treatment would be very expensive and would not begin until she found some medical coverage.
I already knew Laura was uninsured. Back in the spring of 2008 I mentioned to her in passing that we were looking for an example of an actual uninsured person -- who wasn't part of a politician's news conference -- to go on camera for a story.
Laura freely admitted she was one of those people living without coverage. I wasn't surprised. I had heard that a lot of part-time workers in the food service industry lack health coverage. Laura's other part-time job is at the Ordway Theater just down the street, where she works as an usher.
Laura said she had a chance to buy coverage but the premiums were simply too much for her to afford at the time, and still pay her other living expenses. And, on that day in 2008, she politely said no thanks to being in our TV story.
She feared she'd get into hot water at work, and the last thing I wanted to do was to jeopardize her job for our little story.
The doctor's staff told Laura she needed to get on Medical Assistance, which is what we call Medicaid in Minnesota, so that she could treatment for the cancer in her tongue. Laura called the Ramsey County Human Services office to inquire, and was told she'd be sent an application form in the mail in the next couple of weeks.
Laura told them she had already filled out the form and wanted to come to the office in person to make her case. It's also just down Kellogg Boulevard, which is handy because Laura doesn't have a car.
She soon learned that, because of her two part-time jobs, she made too much to qualify for Medical Assistance, let alone General Assistance Medical Care or GAMC.
That program, for single Minnesotans making less than $7,800 per year, is being eliminated anyway as part of Governor Pawlenty's budget cuts. The governor is moving current GAMC clients to Minnesota Care, which is financed by a surcharge paid by medical providers.
Hospitals prefer GAMC because the plan can be billed retroactively for care delivered before the person's application is approved. That's why the scheduled demise of the plan is causing hospitals so much fiscal angst.
Hennepin County Medical Center's directors have already decided to eliminate non-emergency charity care to residents of other counties beginning next spring, unless the legislature intervenes.
Over the River
As for Laura the coffee lady, her next move was to apply for Minnesota Care. The intake people at Ramsey County cautioned her it could take many weeks to process the application. If she cuts back her hours, or gives up one of her jobs, that could also improve her odds of getting coverage.
Laura's father couldn't stand putting off treatment while the government got around to deciding if she's poor enough to qualify. He started calling around and learned, through the American Cancer Society, that HCMC might be an option.
One day as I walked past the coffee counter Laura was smiling, in spite of the fact that a rude customer was barking out an order in a very demeaning fashion. She gets people like that at times. It didn't phase her.
HCMC had agreed to see her regardless of how much she could pay upfront. As a lifelong Saint Paul resident, a true "eastsider" born and bred, she didn't expect the answers to come from that town across the river.
Over the course of a few days a life-saving treatment plan emerged at HCMC, one that will also be life-changing in the short run.
On December 10th surgeons will remove half of Laura's tongue.
As they explained it to her, they'll have to borrow muscle tissue from one of her legs, and a vein from her left wrist to rebuild the part of her tongue she's losing to cancer. Laura's arm will be in a cast for three months, and she'll be fed through a tube in her stomach until her new tongue is up and running.
She'll also have a trach tube installed for breathing. The goal is to keep the cancer from spreading. The good news is that so far it seems to be contained to that organ she uses for talking and tasting food.
Laura's taking it all in stride, and cracking jokes about how she'll be able to keep her mouth shut that long. She said she hopes to be able to hang onto her apartment, and keep living as independently as possible during her recovery.
Of course, her two part-time jobs will be impossible to do for the time being. Laura's managers at the Ordway have told her she'll be able to return to her job when she's strong enough to work again. The same goes for her supervisors at the food service company at the museum.
Paying the bills
Her temporary disability and loss of income may weigh into the equation for Minnesota Care. Laura doesn't have time to play eligibility algebra at the moment. Most people in a medical crisis don't.
For now she's stopped thinking about how she's going to pay the bills. Apparently the folks at H.C.M.C. chose not to think about that either, when faced with the prospect of saving Laura's life and her voice. They'll no doubt help her navigate through the unfamiliar territory of public health care.
Laura's friends are throwing a benefit for her this Sunday, December 6th, from 2 pm to 6 pm, at the Hat Trick Lounge, 134 5th Street in Saint Paul. It's spaghetti dinner -- $10 suggested donation -- with a silent auction. If you need directions or have questions you can call Ruthie at 651 983-7420.
One of the items up for auction is a super deluxe behind-the-scenes tour of the Science Museum, being offered by Jackie Hoff who is the director of collections there. In case you're wondering Jackie's also a regular customer at the coffee stand in the museum lobby.
Jackie has informed me that there's now a fund set up to accept donations at Affinity Plus Credit Union, 95 Sherburne Ave. St. Paul MN 55103. On the memo line note "Coffee Laura" to direct the gift.
Editor's note: this blog entry originally appeared on Friday, December 4th, 2009.
(Copyright 2009 by KARE. All Rights Reserved.)