Health care reform: A man with heart troubles has change of heart [BC-HEALTHCARE-CHANGEDMIND-ADV03:TB]

CHICAGO _ Until about a year ago, Tim Fraas was largely indifferent to the debate over health care reform.

The Elgin, Ill., man was employed as a land surveyor, and his health insurance covered most of the medical bills related to his heart troubles.

"My attitude was: If it's not hitting me on the head, I'm not thinking about it," said Fraas, 52. "And honestly, if it was going to cost me money, I wouldn't have been in favor of it."

Since then, however, a heart transplant and the loss of his job have given Fraas a new perspective, teaching him that insurance offers incomplete protection to someone with a catastrophic illness.

Today, Fraas speaks publicly about the need for reform, citing his experience. Once solidly middle class, this burly, plain-spoken man has depleted his 401(k) savings account, taken out a home equity loan, accepted charity from family and friends, and even asked his dad for help.

Unlike many people who fall out of the work force, Fraas has affordable health care coverage through his wife's employer. But with co-payments for each doctor's visit, medical test, hospital stay and prescription, mounting costs can easily overwhelm someone with a limited income.

"What happened to me could happen to you," he tells friends, neighbors and church groups. "Don't count on insurance covering everything you need when you get sick. It won't, and you'd better be prepared."

Indeed, three-quarters of people who file for bankruptcy citing high medical expenses have health insurance, according to an August study in The American Journal of Medicine. A significant portion of 1.5 million adults who declare bankruptcy each year do so because of medical bills.

As Congress prepares to pass a health care reform bill, lawmakers in both parties are hearing from many voters like Fraas. Some think the benefits of overhauling the health insurance marketplace are worth the costs, but many are not convinced.

Fraas has dealt with heart problems for years, but until he was laid off over the summer, he had worked throughout.

In 1993 his aortic valve was replaced; when his condition worsened, a pacemaker was installed, and then a defibrillator. Heart failure followed, and in March 2008 he was put on the transplant list at the University of Chicago Medical Center.

As his health deteriorated, Fraas gave up time in the field for a desk job that didn't require much physical exertion.

"Being a surveyor, using trigonometry and getting my fingernails dirty _ that's what I really enjoyed doing," he said. "But I've adapted."

Two years ago, he was recruited to join a Chicago firm, Environmental Design International Inc. Fraas said he disclosed his medical issues, and company President Deborah Sawyer confirmed she knew about his physical limitations.

But Fraas' problems accelerated, and he landed at the University of Chicago Medical Center in early October 2008, barely able to walk across a room. Three weeks later, he got a new heart.

"I don't know anyone more blessed than me," said Fraas, whose U. of C. physician, Dr. Savitri Fedson, said he's doing "quite well."

But illness took its toll on the family's finances. Fraas wasn't paid during his medical leave, and bills for the mortgage, car loans, their daughter's college and medical care began piling up. His wife, Kathy, a teacher's assistant at an Elgin middle school, makes barely $20,000 a year.

As collection agencies called, his wife took on extra work as a cook and a driver, and Fraas found himself doing what had been unthinkable: applying for Social Security Disability Insurance. After he was approved, the government started sending a check for $1,700 a month, a fraction of what he'd previously earned.

Meanwhile, Fraas learned that even with good insurance, medical care can break a family's bank. Since January, he's run up bills of $812,000 on his Aetna insurance policy; co-payments for his prescriptions alone cost hundreds of dollars a month.

Each time Fraas goes to the University of Chicago for a checkup and tests, expenses accumulate; he now owes nearly $6,600 to the medical center and an associated physicians group. In addition to his medical issues, his wife needs to have both knees replaced _ an expense the couple can't afford at the moment.

The hardest blow came in June, when Fraas was finally ready to return to work, and bosses at Environmental Design told him that his job was no longer available. Fraas suspected his medical issues affected that decision, but Sawyer said they weren't a factor. The firm has laid off six surveyors since June as work dried up, she said.

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Asked about an opening for a land surveyor that the firm is publicizing, Sawyer said Fraas wasn't qualified. "He doesn't have the skill set," she said. The job description calls for someone with at least 15 years of experience in project management; Fraas' resume indicates he has 24 years of experience.

"It was horrible," Fraas said, describing his reaction to losing his job. "I didn't realize how much of me was a land surveyor until I couldn't work anymore."

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Fraas said he's sent out more than 50 resumes but hasn't had a single in-person interview.

Until the economy recovers, his job prospects are dim.

"There's just no work in surveying right now," said Bob Church, executive director of the Illinois Professional Land Surveyors Association. The association has lost one in five members as engineering firms lay off surveyors, he said.

Fraas said he is exceedingly grateful for his new heart, but he is now marked with two unexpected labels: disabled and unemployed.

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"I was raised old-school: You don't put your hand out, you don't borrow. When I needed to move something, I just put my shoulder against it," said Fraas, who teaches Sunday school and organizes evening activities for children at the couple's church. "But this economy, I can't seem to get around it."

Volunteering at a soup kitchen several weeks ago, Fraas looked across the room at people eating hungrily and thought for the first time: "That could be me at the end of this winter."

This holiday season, his wife put up a small artificial Christmas tree bought on sale in 2008.

"I haven't had much spirit this year," she said, her voice shaking. "It's just so hard for us; it hurts so much."

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Fraas lies awake worrying about how he's going to provide for his wife.

"My time is limited. ... How am I supposed to provide any type of security for her and her long retirement?" he said. "It kills me as a man to be in this situation."

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