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Farmers Drop Health Plans

By Raya Tahan, Associated Press Writer, Thursday, April 8, 1999; 1:30 a.m. EDT

SIOUX FALLS, S.D. (AP) -- Even though he has a wife, a 1 1/2-year-old daughter and a job that can involve dangerous accidents, Clint Jacobs says he had no choice but to cancel his health insurance policy.

``It was too expensive, and we didn't get any coverage. We had some really high deductibles and there was no way of paying the premium,'' said Jacobs, 30, who raises 200 cattle on his ranch near Amidon, N.D.

Like most farmers and ranchers strangled by the sour farm economy, Jacobs has fallen victim to increasing agriculture concentration and new government trade policies -- not to mention floods, blizzards and other weather disasters.

Until he dropped the policy in September, he paid $550 every three months and had a $1,000 deductible for each member of his family.

Jacobs tries to avoid thinking about what would happen if he were injured in a car crash or fell seriously ill.

``What happens, happens,'' he said. ``We're broke anyway. What's a little more brokeness?''

As for health care assistance from the government, some farmers and ranchers complain it is tailored to urban lifestyles and excludes needy farm families.

Farmers, who are self-employed, generally pay much more for private health insurance than do people who join their employers' health insurance programs.

One rancher in northwest South Dakota who has a $4,500 deductible said he worries every day that an accident or illness will bankrupt him, his wife and their baby. The family of three pays more than $6,000 a year on health insurance premiums because one member is epileptic and another is diabetic.

Although his ranch is not making money, he, too, is ineligible for government health care assistance, he said.

``If you've got any machinery, that's a liquid asset,'' said the rancher, who did not want to be identified.

In a recent survey of 82 farmers and ranchers, 26 said they had to drop their health insurance to make ends meet, said Sandra Simonson Thums, a rural specialist with Lutheran Disaster Response and Lutheran Social Services of North Dakota, which conducted the survey.

Forty-four respondents said they cannot sleep at night and 36 said financial problems have caused stress in their marriages.

``If you have four or five bad years and you tighten the belt every time, health insurance gets to be one of the things,'' Thums said.

Jim Long, chief executive of West River Regional Medical Center in Hettinger, N.D., a nonprofit hospital that treats mostly rural people, said patients have begun to skip important preventative care like mammograms, prostate screenings and physicals. Doctors sometimes do not charge for treatment and hand out medicine free.

``Our amount of uncompensated care is continuing to increase at significant rates,'' Long said. ``Sometimes we take ridiculous payment plans, like $10 a month on a bill that would take 30 years to pay off. In some cases, we don't get paid at all.''

Self-employed workers can deduct up to 45 percent of their medical payments when filing tax returns.

New legislation will help farmers and ranchers some by allowing the self-employed to deduct 60 percent of medical costs on their 1999 and 2000 taxes.

The legislation, which was attached to the omnibus spending bill President Clinton signed in October, makes medical costs for the self-employed fully deductible starting in 2003.

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