ANDERSON — The average price for a 100-pill bottle of Tylenol pain reliever is about $7.50.

For some people, that’s pocket change. For those working a minimum-wage job, that’s more than an hour’s worth of work. 

But for those who are under the poverty line, that may be impossible.

Given the state of the nation’s economy, it’s no wonder that some people in need are forced to make difficult decisions about their health care.

Why would someone with minor pain or cold symptoms give up a day’s worth of work to visit the doctor, knowing that the refrigerator’s nearly empty and an eviction notice may be only days away?

According to Jon Nelson, men’s program assistant at Christian Center Rescue Ministries in Anderson, the decision is easy — they wouldn’t.

“A lot of people in need are in circumstances that tend to make them shortsighted when it comes to their health,” said Nelson.

Local hospitals are seeing the effects of people bypassing preventative health care.

“People put off going to the doctor for so long that the emergency room has practically become their family doctor,” said Terri Rinker, director of reimbursement cycle at Community Hospital.

Uninsured on the rise at local hospitals

The number of uninsured patients the hospital is receiving is on the rise. Rinker said that in June 2007, about 7 percent of patients were uninsured. By June 2008, the number had increased to about 10 percent.

But when living expenses and medical expenses compete for limited resources, how can struggling Madison County residents afford health care?

According to Rinker, the Healthy Indiana Plan is one option for those in a financial bind. HIP is a health-insurance program targeted at uninsured adult Indiana residents.

The program offers benefits that include mental-health care, physician services, diagnostic exams, hospital services and disease management. Certain qualifications, including age, income and a lack of access to employer-sponsored health insurance programs, must be met.

Since HIP began last year, more than 1,500 Madison County residents have been accepted into the program. Statewide, about 49,000 people are enrolled.

“HIP has grown fast,” said Rinker. “It has quickly become one of our top five inpatient payers here at the hospital, and there are a lot of incentives to push the preventative-care idea within the program. Users have to pay a co-pay only if they use the emergency room inappropriately.”

Though HIP is an invaluable resource to Indiana residents without health insurance, it does have a limited reach.

“This program allows people who had no insurance before to get coverage,” said Keith Trent, vice president and chief foundation officer at Community Hospital. “But it’s funded by an increase in taxes, so it does have a limited amount of money.”

Points of access available in county

In addition to HIP, other local programs also aim to help Madison County residents with access to health care.

On the first Thursday of every month, Dr. Patrick McGill of Saint John’s Health System, with the assistance of nurse-practitioner student Heather Sheets, conducts a free medical clinic for residents of the Christian Center.

Joe Smith, the men’s director at the local ministry, collects a list of men who need medical attention. After that information is sent to the hospital and the men are registered, they can be seen at the clinic.

“When they come to the clinic, they are greeted by a nurse volunteer — either an AU nursing student or a Saint John’s nurse volunteer,” said Sheets.

Then the volunteer obtains the patient’s vital signs and collects basic information such as the patient’s current medications and chief complaint.

The patients are then able to see McGill or Sheets. McGill sends prescriptions to Walgreens, where Smith picks them up.

“I found out I had diabetes at the clinic,” said Christian Center resident Bryan Johnson. “I didn’t know that before. I had no symptoms.”

Stories like Johnson’s are not unusual at the clinic.

“High blood pressure is probably the most common (condition) I have seen,” said Sheets. “And those conditions have the potential to be serious.”

Another provider of low-cost health care is the Madison County Community Health Center, which has offices in Anderson and Elwood. Clients pay fees on a sliding scale that takes into account income. It’s part of a network of community health centers nationwide, and there are plans to expand and remodel the Anderson center.

A new development on the health care-access front is the Covering Kids and Families Madison County Coalition, which is intended to help those who lack insurance and medical care.

An important part of such efforts is getting the word out.

“A lot of people don’t know that these programs are available,” said Jorge Torres, health-access worker at Saint John’s Medical Center.