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The Washington State Office of the Insurance Commissioner estimates about 66,000 Clark County residents will be uninsured by Dec. 31, accounting for about 15 percent of the county’s population.
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For 40 hours a week, Jesse Wolff patrols the grounds of Vancouver's PeaceHealth Southwest Medical Center, keeping a watchful eye over the patients receiving care and the staff treating them.
The 26-year-old security guard's job presents an unfortunate irony.
The Type I diabetic is in desperate need of an insulin pump, but his employer, MetroWatch, doesn't offer medical insurance. He makes too much money to qualify for state insurance programs. And he can't afford to purchase insurance coverage or his medication on his own, Wolff said.
Doctors told Wolff if he doesn't get his diabetes under control, within a year he could face a coma or a stroke or heart attack.
"It scares me," he said.
Wolff was diagnosed with Type I diabetes in 2008. Type I diabetes is when a person's body is incapable of producing insulin. As a result, Type I diabetics must rely on insulin injections or an insulin pump, which delivers insulin 24 hours a day through a catheter placed under the skin.
Doctors prescribed Wolff insulin injections. But as an uninsured construction worker, Wolff struggled to find the money to pay for the medication. One vial of insulin, which lasts 28 days, costs $180.
About six months ago, doctors told Wolff he needed an insulin pump. The device can cost $1,800 to $2,500 — all of which would be out of pocket for Wolff.
Since his diagnosis, Wolff's insulin use has been sporadic. When Wolff can't afford the medication, he watches his diet closely, avoiding starchy foods with too many carbohydrates, and he monitors his blood-sugar levels.
When Wolff's blood-sugar level is too high, his mouth gets dry, his speech slurs and he urinates more than normal. When his level is too low, he shakes, stiffens up and sweats, he said.
Wolff's co-workers are aware of his medical condition and watch for signs that his blood-sugar levels may be out of balance, said Jerry Parkman, head of security at PeaceHealth Southwest Medical Center.
Wolff has been stationed at the hospital since May 2011. His medical condition hasn't affected his job performance, Parkman said.
"Not only is he a likeable guy, he's a good teammate for everyone," he said. "All the guys on the team like him and are supportive of him as well."
A month ago, Wolff was wheeled through the very halls he patrols.
On the verge of a diabetic coma, Wolff was admitted to the hospital for treatment. His electrolytes were out of whack and his body was fighting a virus.
"They were saying I was lucky to have come in when I did," Wolff said.
Any later and the 26-year-old would have slipped into a coma or be in a bed in the intensive care unit, he said.
Wolff is already experiencing symptoms doctors say are irreversible. He has nerve damage in his legs that leaves him in constant pain but numb to temperatures. The damage makes patrolling the hospital grounds a painful job, Wolff said.
"I'm trying to get all the bills paid and make sure there's a roof over the kids' head," he said. "I don't put myself anywhere in between."
Wolff has two sons — ages 7 and 18 months — who live with their mother. He and his girlfriend live together with her three sons, all younger than 9 years old. His girlfriend stays home with the younger kids and doesn't work. They live off Wolff's income, he said.
Wolff brings home about $650 every two weeks, after taxes and child support. After paying rent, a car payment, food and other bills, there's not much money left to buy medication or save for an insulin pump, he said.
"It's everyday life," Wolff said. "You support the family you care about and the kids you care about and wait for the next day."