At least once a week, Tanner Willbanks wakes up in the middle of the night to a searing pain in his right arm and a tightening in his chest. He’s drenched in sweat and can hardly breathe.

The symptoms mimic a heart attack, but that’s not it. Willbanks, Lawrence senior, is having a panic attack. And according to him, what’s going on in his mind is worse.

“Mentally, you think the worst things in the world are happening to you.”

In the grips of a panic attack, Willbanks will hunch over his desk for hours, tirelessly calculating his budget to prove to himself he has enough money to last him the month. Other times he’ll stay up all night cramming for a test that is still two weeks away.

But however bad it gets, Willbanks will not go to the hospital. He’ll call friends, drink, run the battery out of his calculator, do whatever it takes to avoid professional treatment.

Willbanks doesn’t have health insurance. In fact, he’s still paying off a trip to Lawrence Memorial Hospital for an anxiety attack that happened three years ago.

“I’ve learned ways to cope with my disorder without having to go to a doctor because I can’t afford to go to a doctor,” he said.

A 30-year-old, part-time employee with unmedicated anxiety attacks, Willbanks embodies just a few of the symptoms of America’s broken health care system affecting young adults today.

As employers drop health benefits and health costs skyrocket, young adults are vulnerable to the nuances of one of the world’s most expensive, most complicated health care systems.

Dropped at 23

Considered dependents, most full-time students at the University remain covered by their parents’ health insurance until the insurer decides to drop them. The drop age is arbitrary, ranging from 18 to 25. The average age to be dropped is 19.

Even still, nearly 19 percent of full-time college students in America didn’t have health insurance in 2006, according to the most recent Medical Expenditure Panel Survey.

Almost 22 percent of Kansans ages 19 to 34 ­­­— more than any other age group by almost 10 percentage points — are without health insurance this year, according to Kansas Health Institute estimates.

Kevin Athey was dropped as a dependent when he graduated from the University, jobless, in 2003.

Under his father’s pressure, Athey, now 29 and living in Lawrence, purchased a private health insurance plan, costing him a $100-a-month premium and an $500 annual deductible.

In the nine years he’s had the plan, Athey’s insurance company has modified it several times. Rather than paying more each month, Athey decided to take a hit from his deductible each time his plan changed. Since 2003, the cost of his deductible has tripled.

“Now I pay a $1,500 deductible, which is completely useless to me,” he said. “But at least I’m insured, I guess.”

Because his insurance company won’t start paying bills until he’s paid the $1,500 deductible, Athey has to absorb most of his health care costs out-of-pocket.

Even with health insurance, Athey has had to completely finance two trips to the emergency room because of epileptic episodes — one in 2004 and one in 2006. The ambulance rides and in-patient care have left him with a $10,000 tab. He pays $150 a month, which increases his annual health costs to more than $4,500. He is able to pay his bills through his salary as a general manager at the Goodwill store in Topeka.

Athey isn’t the only college graduate struggling to find affordable health care. According to a 2006 survey, 34 percent of college graduates spend part of their first year out of school without health insurance. This number is on the rise as employer-based health insurance declines.

Bye, bye benefits

If finding a job in this economy is difficult, even more rare is finding a job with health benefits.

Employer-sponsored health insurance has been on the decline since the late 1980s, with businesses large and small lowering their co-pays, decreasing employee dependents and even cutting worker health coverage altogether.

From 2000 to 2008, the percentage of firms offering health insurance benefits decreased from 69 percent to 63 percent, according to the Kaiser Family Foundation. A 2008 MEPS found that one in six Americans lost their employer health care coverage since 2006.

But this isn’t just affecting veteran employees. According to a Current Population Survey, 28 percent of employed adults ages 19 to 29 were uninsured in 2008.

According to a recent U.S. Census report, 541,000 residents — or 72 percent — of Douglas, Wyandotte and Johnson counties rely on their employers for health insurance.

The reason most often cited for the decline in employer-based coverage is the escalating cost of health insurance premiums, which have increased 131 percent in the last 10 years, according to a 2009 Kaiser Family Foundation report.

The effects of declining employer-sponsored health insurance are felt close to home, about 40 miles away at JayDoc, a free health clinic provided by University of Kansas Medical School students.

Every Monday, Tuesday and Wednesday night, Southwest Boulevard Family Health Care closes at 5 p.m. to make room for JayDoc. The waiting room fills with patients, each hopeful for a chance at free treatment. While some will be treated on site, others will be referred to other, affordable clinics in the area.

By the time Chris Cassidy, second-year medical student and one of the executive directors for the clinic, goes to make his first round, the lobby is packed, standing room only, with about 60 people.

According to JayDoc statistics, 91 percent of its patients don’t have health insurance. And most of them, Cassidy said, lost their insurance within the past year. Forty-five percent of JayDoc patients are between 20 and 35 years old.

“They are not the low-life people of the earth,” Cassidy said. “They’re people you go to lunch with at work. They don’t have health insurance because it’s ridiculously expensive.”

Affording the unaffordable

On the surface, when people buy health insurance they’re essentially paying to protect themselves financially from the cost of medical conditions. But those without that protection piggyback on those who have it.

In what is known as a “hidden health tax,” the uninsured millions still receive medical treatment, but the cost is transferred to the insured. Insurance carriers see the “tax” added to premiums and deductibles.

In the past 10 years, the average cost of health insurance premiums for one person increased 120 percent, from $2,196 to $4,824, according to the Kaiser Family Foundation. Premiums for an average family plan went up 114 percent.

With the increase in cost came an increase not only in those unable to afford health insurance, but also in the cost of unpaid health bills — leading to medical bankruptcy.

Douglas, Wyandotte and Johnson counties incurred $55 million in uncompensated health bills and had 1,200 health-care related bankruptcies, according to the most recent statistics from the Department of Health and Human Services.

Whether listed as their parents’ dependents or not, University students receive practically free health care at Watkins Memorial Health Center. The student health fee of $115.80 per semester allows students at the University to receive most office visits for no extra charge. The primary services the fee won’t cover are medical procedures and ancillary services such as X-rays, pharmaceuticals, physical therapy and lab fees, said Diana Malott, assistant director of Watkins.

Students attending Kansas Board of Regents universities and colleges also have the option of a student health insurance plan, which costs $915 a year per person. Between 3,500 and 4,000 students at the University purchase this plan, Malott said.

However, the Board of Regents plan has its faults.

Brian Platt, a graduate teaching assistant in environmental studies, has had the plan for seven years. He said he hasn’t had too many complaints for the relatively inexpensive plan except he wishes he could afford to add his wife, Sara, and his 17-month-old son, Henry.

Adding Sarah to the plan would increase his yearly payment to $4,691. Adding Sara and Henry would be $7,945 a year.

Platt said Sara has insurance through her employer, but adding Henry to her plan would cost an additional $350 a month or another $750 for the whole family. So Brian and Sarah decided to buy Henry his own plan at $124 a month.

“It doesn’t seem right that we should have to be on three separate insurance plans,” Platt said.

Another shortfall of the Board of Regents Plan, as with the majority of health insurance plans, is the coverage for people with pre-existing conditions.

Up a creek without an inhaler

Pre-existing conditions, known sometimes as chronic conditions, range from mental disorders and asthma to high blood pressure and diabetes.

People with pre-existing conditions often incur the highest medical costs, and as such, face consequences of either more expensive health insurance or no coverage at all. Most health insurance providers won’t accept someone with a chronic condition if the person has been without health insurance for two months.

Before receiving insurance, most health insurance providers require patients to prove they’ve been condition free for six consecutive months. The requirement leaves people with diabetes and asthma without much hope.

According to a Commonwealth Fund 2009 report, one in six young adults have a common, chronic condition such as high blood pressure or asthma.

In Douglas, Wyandotte and Johnson counties, approximately 10,900 residents suffer from pre-existing conditions, according to HHS.

Under the Board of Regents plan, people diagnosed or treated with pre-existing conditions within the past year can’t receive coverage for the condition until they’ve had the plan for eight consecutive months, unless they have had other credible coverage up until buying the plan.

Because many pre-existing conditions may require prescriptions, the student health fee doesn’t help students purchase supplies for the condition.

Nick Tallmon, Lawrence senior, discovered he had Type 1 diabetes in May 2008. Although he has had health insurance since before the diagnosis, Tallmon said his condition still costs his parents $12,000 each year.

Tallmon, 28, said he didn’t think the costs were fair, given his healthy lifestyle — he’s the president of the KU judo club ­— and his careful maintenance of his condition.

“Yes, I have a pre-existing condition,” he said, “but I’m actually really healthy for someone with that condition.”

Even with insurance, Tallmon said he paid about $1,000 per year for his prescriptions and co-pay for doctor visits.

He said the $160 he pays every three months for insulin would be about $1,000 without insurance — increasing his costs from $640 to $4,000 a year.

Life without insurance

When Willbanks felt pain shooting up his right arm on the first day of classes three years ago, he took the risk of missing the syllabus to calm down at Watkins.

When he arrived and described his symptoms, Willbanks said the staff at Watkins, knowing his family history of heart problems, immediately called for an ambulance to take him to LMH.

Knowing the ambulance alone would cost him $1,500, Willbanks’ anxiety worsened.

“It’s a horrible Catch-22 where to solve anxiety, you have to do something that fills yourself with anxiety,” he said.

After a 10-minute ambulance ride, an electrocardiogram reading, some medicine, an overnight stay and a plate of hospital food, Willbanks left LMH the next morning. Receiving anxiety treatment the first time in nine years cost him $10,200. He later negotiated the cost down to $5,000.

Working 30 hours a week in technology support with the University’s Instructional Development and Support department, Willbanks is paying his debt $75 a month. Three years since the incident, the bill is still $2,500.

“There’s a distinct possibility that at some point in the future, I’ll have to declare medical bankruptcy even for that $2,500,” he said. “Filing for bankruptcy for $2,500 seems ridiculous, but if you can’t pay, you can’t pay.”

Willbanks said he might have to declare bankruptcy because he wants to attend graduate school after he earns his bachelor’s degree in May. Because of his condition and his medical bills, he said he was looking, not for the best graduate program in the country, but for a university that offered reduced-cost health care for students.

“I don’t think it’s acceptable that in what is often called the greatest country on the face of the planet, we do not insure everybody,” he said. “I think that if we don’t cover every single human being in the country, then we are not able to call ourselves the greatest country in the world.”

Until then, Willbanks will continue to cope with his anxiety attacks on his own. Athey will continue to fund his own health care. The patients at JayDoc will continue to fill the waiting room. And Tallmon will continue to pay out-of-pocket for his diabetes medication.

— Edited by Tim Burgess