It's barely 9 a.m. at the Marin Community Clinic in Greenbrae, Calif., and already the waiting room is packed, humid and buzzing. Those waiting -- mostly young women -- step up one by one to the receptionist's window and hear the same dispiriting questions: Do you have insurance? Do your children? How much do you make a year? Do you have pay stubs with you today?
Within half an hour of opening its doors, the clinic is full. A voice from behind the appointment desk cries out, in a mock groan, to no one in particular: "This day is going to be not fun."
Marin County, just north of San Francisco, is among the wealthiest communities in America, but that doesn't mean the clinic's patients have health insurance. In fact, many of them are here on this early spring morning precisely because they don't.
A cramped prefab building resembling five or six trailers welded together, the clinic is one of the few facilities in the county that will treat the uninsured at low cost. Last year its staff saw more than 9,000 patients, and were still so overbooked, they turned away as many as 100 people a week.
The clinic's visitors probably aren't who you would expect. Eighty-five percent come from working families, and surprising numbers are middle-class. More than half are women. In the 1990s, the number of uninsured American women increased by roughly 20 percent, according to U.S. Census Bureau statistics; one in five non-elderly women nationwide now lack insurance. That translates to a remarkable 12.9 million uninsured women between ages 19 and 54.
Going without insurance for as little as one month can be harmful to your health, according to a recent report by the Institute of Medicine in Washington, D.C. Without coverage, the institute found, you're less likely to detect cancers early, head off a heart attack or heal after a car crash -- all raising your risk for premature death. When uninsured women get breast cancer, the report said, they're up to 50 percent more likely to die from the disease than women with private insurance.
Politicians often talk about America's health system train wreck. In three days at the Marin Community Clinic, SELF heard from the people who understand it best -- uninsured women themselves.
Fact: A single woman is up to two times more likely to be uninsured than a married woman.
Gayle Conway, 30, massage therapist said, "today was the first doctor's appointment I've made for myself in more than a year. Even if nothing were wrong, it costs me $25 for the initial appointment and I'm thinking, 'Where am I going to get that from?' As it turns out, the doctor suggested I have a needle aspiration to remove cysts in my breasts. Since the condition isn't life-threatening, I'm not going to deal with it now: can't afford it, don't have time."
"I work at a fitness center here in Marin, but they don't subsidize the health plan. Right now I'm raising two kids by myself and bringing in $2,400 a month. Once you start adding things up -- $1,350 for rent, plus groceries, utilities, gas for the car -- paying $300 a month for health insurance is insane. It's insane! If I break my arm, I figure that only costs about $800, so in the end it's cheaper for me to go without. You do hear about people who get really hurt and go bankrupt, but I have to take the risk."