ANDREA SEABROOK, host:

Struggling banks, slumping house prices, surging gas prices. Those are the hot economic topics these days, but there's another big problem: health care and how to pay for it.

One in four say they're having trouble paying health care bills. That's according to a new NPR poll. It was done in Florida and Ohio with the Kaiser Family Foundation and the Harvard School of Public Health.

NPR's Joseph Shapiro has this report.

JOSEPH SHAPIRO: When Jamie Drzewicki was diagnosed with breast cancer, that was a shock of course, but she had health insurance, so she figured her medical costs were covered. She had her surgery last year.

Ms. JAMIE DRZEWICKI (Breast Cancer Survivor): And then the envelopes started coming: $12,000 was one bill, $40,000 was another, $2,000 was another bill. Today, Drzewicki owes more than $62,000.

Ms. DRZEWICKI: Well, I don't know everything. I just know, you know, that I had insurance, and it's just not good enough. It wasn't enough.

SHAPIRO: It turned out that although she had health insurance through her job, there was a limit. Her insurance would pay up to $100,000 a year. Everything over that got billed to her. Drzewicki says before she got cancer, $100,000 seemed like a lot of coverage.

Ms. DRZEWICKI: Not being greatly educated, it sounded like a lot of money to me, for someone who just needed a mammogram every year and a pap smear and nothing else. I'm a - was a healthy person.

SHAPIRO: Drzewicki has spiked hair. She's in tight jeans and a T-shirt. She's 58 but looks years younger. She tells her story from the small recording studio in the pink house where she lives with her husband, north of Miami. They're both musicians. They perform in clubs and on cruise ships.

She's also got a day job, one with insurance. She's the activities director at a nursing home. She recently switched jobs because, after her cancer, her boss gave her a hard time about missing work. Now she works at another nursing home. She gets paid less and, because it's much farther away, she spends a lot more on gas.

Ms. DRZEWICKI: I am living paycheck to paycheck, and I am making the decision between food and my cancer medication, and, I had to buy food on my Target card because I knew I could pay it off, and my husband killed me because he said do you know the percentage on that? I said, honey, I'll pay it off with my next paycheck. I'll never do that again.

SHAPIRO: Drzewicki is far from alone. In polling by NPR, Kaiser and Harvard, 28 percent of people in Florida say they're having trouble paying their medical bills. They're not the uninsured people you might think.

Professor ROBERT BLENDON (Health Policy and Political Analysis, Harvard School of Public Health): They're people with health insurance, but it's not covering the co-pays, the deductibles, some of the drug costs, the dental care that may be needed, the home services. It's not deep enough to protect people.

SHAPIRO: That's Robert Blendon, who runs polling programs for the Harvard School of Public Health. He says one of the biggest surprises from the poll is that one in five people in Florida, and one in four in Ohio, say they've got collection agencies chasing them. The number-one reason is unpaid medical bills.

Prof. BLENDON: And so the idea that middle-income people will be pursued by collection agencies, for many people, is not something they ever would have thought would happen to them.

SHAPIRO: People like Jamie Drzewicki.

Ms. DRZEWICKI: So they call my house two, three times a night, and the last collection agency guy said well, you know, we're going to have to send it to the lawyers now.

SHAPIRO: One part of the hospital is helping her apply for charity care, but so far, she hasn't been eligible. Another office, in the same hospital, called in the collection agency.

Ms. DRZEWICKI: And the harassment has been part of my stress while I'm trying to recover, no joke.

SHAPIRO: She's got new insurance from her new job. There's one more surgery ahead, in August, for breast reconstruction, but she's pushed it back a few days because she's got a gig in a 2,000-seat theater in a Florida retirement community.

Ms. DRZEWICKI: Yeah, I'm going to be at Wyn-more Village.

(Soundbite of laughter)

SHAPIRO: It's her first performance since the cancer.

Ms. DRZEWICKI: But my stage name is Jamie Danger, Joe, so keep that in mind. The Jamie Danger Show at Wynmoor Village. She's back again.

(Soundbite of laughter)

SHAPIRO: And what she loves most in the world is to sing.

Ms. DRZEWICKI: Oh, what can I sing? I sing:

Ms. DRZEWICKI: (Singing) What a day this has been. What a rare mood I'm in. Why it's almost like being in love.

(Soundbite of laughter)

SHAPIRO: Joseph Shapiro, NPR News.

(Soundbite of movie "Brigadoon")

Mr. GENE KELLY Actor: (As Tommy Albright) (Singing) All the music of life seems to be like a bell that is ringing for me.

SEABROOK: The full results of our poll and how residents of Florida and Ohio are feeling the economic pinch are at npr.org.

(Soundbite of movie "Brigadoon")

Mr. KELLY: (Singing) I would swear I was falling, I would swear I was falling, it's almost like being in love. When we walked up the brae…

Ms. CYD CHARISSE (Actress): (As Fiona Campbell) (Singing) Not a word did we say. It was…

SEABROOK: Just ahead, facing fear on the battlefields in fiction and in the shower. It's NPR News.

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