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The API Insurance Gap

John Lim, a self-employed Korean American in Southern California, gets by without health insurance. Photo by Ji Hyun Lim.

By Ji Hyun Lim

Sixty-three-year-old Korean American liquor store-owner John Lim was diagnosed with the eye disease glaucoma in December of 1999. Living in Bakersfield, California, with his eyes clouded from the infection, he hired someone to drive him to the hospital to receive treatment for his infliction.

“It cost me $10,000 in hospital bills, time, and loss of wages. Even after the surgery, my eyes have never been the same,” Lim said.

Like many of the Korean Americans who are uninsured, Lim is self-employed and cautious about his expenditures. “I would have to pay around $350 a month for insurance and I still don’t think it would cover everything,” Lim said.

A recent report by the UCLA Center for Health Policy Research confirms that California’s Asian American communities still lack health insurance. Studies show 23 percent of Asian American and Pacific Islanders living in California lack health insurance coverage. In the Korean American community, statistics are particularly high. Lim is among the reported 45 percent of all Korean Americans who do not have health insurance.

Assistant professor in the School of Public Health and Senior Research Ninez Ponce said, “A lot of policy makers in the state dismiss that Asian Americans have a problem because they aggregate them. They can’t detect the vulnerability between each group.”

Ponce points out that among Koreans, many are self-employed and work in small establishments. Southeast Asians, such as Cambodians and Hmongs, had the lowest job-based coverage at 34 percent and tend to be low-income wage earners. Moreover, recent immigrants don’t have access to civil servant government jobs that offer health coverage plans because of their inability to speak English.

Cinderella Lee, marketing associate of Asian Health Services, believes there are misconceptions and stigma attached to seeking health insurance.

“The [API community] looks at Medi-Cal and other government-assisted programs as welfare,” Lee said. She adds, “One of the concerns is that it might jeopardize their chances of being a citizen in the future. They don’t understand that if they’re getting just medical insurance, it would not affect their status of becoming a citizen.”

According to Jan Liu, Policy Analyst for the Asian and Pacific Islander Health Forum, the cost of insurance is a major issue for the API community across the board. “If a job pays $25,000 a year, a family policy might be $4,000-$5,000. It’s really unaffordable,” Lui said.

The lack of job-based coverage may be a response to the type of coverage employers offer. “Even though some employers pay for a fraction of the cost, the share depends on the employers. If you’re barely making ends meet, that can be very expensive,” Lui said.

Many Asian Americans who may not qualify for job-based insurance may still be eligible for health insurance through public programs. Medi-Caid, Medi-Cal and the Healthy Family program can assist individuals and families with children. However, many APIs do not actively seek it. “I think there needs to be more education and outreach,” Liu said.

Some Asian Americans continue to seek herbal healers for their remedies. “I choose Eastern medicine most of the time because the medicine is pure. It is made of ginseng, deer horns and non-toxic ingredients. There are no additives. I never feel side effects from traditional medicine as I do with Western medicine,” Lim said. Many of the traditional healers speak their patients’ native language and do not accept medical insurance. The “cash only” policy for these establishments only deters Korean American and other Asian communities from seeking health insurance.

The alarming rate of uninsured Asian Americans continues to concern policy makers. Some low-cost programs may not help Asian communities because they choose not to participate.

“When people do not sign up for health insurance, they take a gamble on not being sick,” Ponce said.

Korean Americans such as John Lim eventually bear the brunt of high-cost treatment. “Because the monthly premiums are so high, I still feel I would have paid more for my surgery through an insurance policy than paying up-front,” said Lim.