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Life without health insurance means letting issues linger — sometimes until they’re $56,000 issues
Cindy, left, and Joseph Crane on the front porch of their home on Wednesday, Nov. 20, 2019. Cindy Crane hasn’t had health insurance for four years, leading her to put off medical procedures that would improve her quality of life. - photo by Nick Bowman

Access to health care can look different for many people. Those who can’t afford health insurance aren't always down and out on their luck.

For the Cranes, they’re stuck in the middle ground of the middle class.

Cindy Crane has struggled with arthritis for a little over a year and now a doctor has told her she needs a hip replacement. She’s walking with a cane — a $20 fix for a $56,000 problem.

“It's $56,000 for the hospital, and that's not spending the night,” she said of the surgery, her cane leaned against her dining room table in her North Hall home. “That's outpatient.”

She said she doesn’t know what to do. She’s called just about every insurance company she can think of to get quotes for health insurance and has gotten numbers from $570 to $760 per month — a bill she and her husband, Joseph, simply can’t afford on top of rent, groceries and all the others.

They don’t see any solution to their problems, so they feel they’ll have to stay where they are unless something changes.

Lives on the line

This special weeklong series explores how cost and bureaucracy stand between local residents and their health care. Times reporters pored through the latest Community Needs Health Assessment, conducted numerous interviews with those in the local health care industry and those affected by it and examined the latest efforts by state government and politicians to remedy problems in our health care system. Read other stories in the series at

Both Cindy and Joseph work for small companies that don’t offer health insurance plans. It’s been about four years since Cindy last had health insurance, when she co-owned a business with her ex-husband.

Now that that health insurance isn’t there to cover costs, every time Cindy or Joseph have to go to the doctor, they pay out of pocket. Those charges can add up quickly.

Like when Cindy went to her doctor at Northeast Georgia Physicians Group in Flowery Branch back in September of 2018 to have her hip checked. She had been having some pain that was consistent with arthritis symptoms, so she wanted to get some help.

“When it first started, I would have pain in my hip,” Cindy said. “And then, it was like when I walked, sometimes my legs just felt like they were going to give out.”

Her doctor told her it wasn’t arthritis and did a blood test. After paying for that visit, Cindy went back a year later — just a few months ago — with the same pain and got the same answer, but her doctor did X-rays of her back in an effort to prove that her back was the problem, not her hip.

After paying out of pocket for that visit, too, Cindy’s friend recommended a doctor she had seen before at Emory in Atlanta.

She went, the doctor did X-rays of her hip and found that it was arthritis causing her all the pain. That trip cost her $1,000.

“He said if you would have gotten the help you needed a year ago, you wouldn't be in the spot you are today,” Cindy said.

Cindy Crane talks Wednesday, Nov. 20, 2019, about her family’s inability to afford health insurance while working for a small business in Hall County. With health problems mounting, the Crane family faces monthly insurance premiums of more than $700 if they were to get covered — a bill they can’t afford. - photo by Nick Bowman

That’s the other problem with not having health insurance. Cindy and Joseph feel they don’t get the same kind of care without health insurance as they would with it.

“Paying out of pocket, going to the doctor for your random sick visit — you don't get the same treatment as if you have insurance,” Joseph said. “It's like they push you in, get your money, pacify you and tell you what you want to hear and then get you back out. They ain't got time for you.”

As trips to the doctor get more frequent during the cold months, Joseph and Cindy sometimes choose not to go altogether. A few weeks ago, though, Joseph knew he needed to go in because of a sinus infection. He said they can’t let things get too bad or else they’ll end up in the hospital with an even bigger bill than the $300 quick care visit.

“We try to push it as much as we can and try to ride the course, but if it gets to the point to where it's unbearable, you can't,” Joseph said. “You have to break down and go to one of those quick cares.”

For Cindy, winter is when her arthritis flares up and hurts the worst.

“When it gets really cold, it's like all of my joints, they just hurt,” she said. “The colder it gets and when the rain comes, it's like I have a hard time functioning.”

Joseph and Cindy know they’re likely not the only people struggling like this. They feel there can’t be that many people that are “that well off and have all this money sitting aside for this insurance.”

To them, it’s a problem of making too much money, but still not enough.

“Obviously, upper class can take care of themselves, poverty level can get help … but middle class, low-end middle class doesn’t have anything,” Cindy said.

Joseph, only half joking, said it feels like being the middle child.

“We've been told about places like Piedmont (Healthcare) and places like that that have grants,” he said. “But your average person ain't going to get it. It's going to take somebody that don't work.”

And that’s not an option for them. While one of them could try to find another job that offers health insurance, they’d likely be taking a cut in pay, so it’s not as easy as it sounds. Plus, finding a new job isn’t as easy as it sounds either.

“Jobs are still hard to come by,” Cindy said. “Unless you have this huge college degree. I have some college, but I don't have a college degree.”

They don’t have a solution, and they're not sure who or what to blame the problem on. Still, they know it’s a problem, and it’s a problem they have to live with indefinitely.

“When you can go to a different country and you can get the same prescription you're getting here, and over there it's a heck of a lot cheaper, where's the breakdown?” Cindy said. “This is America. We're supposed to be better off than some of these countries.”

Cindy Crane now uses a cane to walk. She’s been told she needs a hip replacement because of her arthritis but can’t afford the procedure. Crane hasn’t been able to afford health insurance for years. - photo by Nick Bowman
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