Nevada lands at or near the bottom of almost every national healthcare survey. While comparatively the numbers equal an underfunded system, they may not add up until someone you love is among the statistics.
"I have a hard time just staying around the house all day long. I have to fidget with something," said Josh McGrath.
The last two years of Josh McGrath's life have been a nightmare. In 2006, doctors diagnosed a him with a chronic condition -- an inflammation of the pancreas that causes abdominal pain, nausea, and vomiting. In the simplest terms, McGrath can't keep anything down.
"Two weeks out of high school, I was a construction worker. Now I can't do anything. Can't hold down a job, can't make anything for myself," he said.
Instead of a hard hat, McGrath sports a backpack filled with Total Patient Nutrition, or TPN. The liquid diet helps to manage his symptoms. But without health insurance, McGrath is losing hope he will find a cause, let alone a cure.
Kathy McGrath is Josh's mom. "All we want is a little help, you know, to keep Josh around and to try to find some way to make him better," she said.
As a 23-year-old single man with a pre-existing condition, McGrath is virtually uninsurable in Nevada. State health-care programs, funded among the lowest levels in the nation, provide primarily for women and children. Outside of that population, only the aged, the blind, and the disabled may qualify for Medicaid.
"Our eligibility is very restrictive and if you don't let many people through the door -- 234,000 sounds like a lot, but compared to other states, they have much more flexible eligibility and many more programs and more people can access healthcare," said Mike Wilden, director of the State Department of Health and Human Services.
For McGrath to gain access, he must qualify as disabled through the Social Security Administration, a process he initiated in 2006. "We've gotten several denials and we just keep putting them back in and for them to re-evaluate to see if he does qualify. And they keep saying 'No,' so we're waiting," said Kathy.
Finally in January of this year, McGrath received a preliminary disability determination and with it, a Medicaid card. But the coverage expired within in months of its arrival. In March, a final decision deemed McGrath ineligible.
"They don't really know what I go through each and every day. We try to tell them when we're on the phone with them. They're turning their other ear and they don't even listen," he said.
Without a payment source, McGrath's only healthcare option is a hospital. To date, bills for his multiple admissions total some $200,000. "We spend so much money in the deep end of the swimming pool, emergency rooms and chronic disease and those kinds of things, that we need to find a way to shift funding to more services at primary and preventive care," said Willden.
Until that day, McGrath will again appeal to bureaucrats he's never met and his parents will pay out-of-pocket for all that they can. "Nobody will cover him under any insurance. Cash price for TPN is $200 a day. And so, we'll end up losing the house over that because we've got to keep him alive," said Kathy.
The McGrath's learned just Monday that their latest appeal had been denied. They plan to re-submit.
The process is especially painful for them because they lost Josh's little sister Cassie to a genetic disease just two years ago. Without the proper testing, it is not known yet whether that same disorder may be the cause of Josh's condition.
Click here to email reporter Colleen McCarty.
