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Tapping the keys   
Computers may be all the rage, but for some using those clacking typewriters is still a simple choice.

Ask Charlie Cox if he’d trade in his manual typewriter for a topnotch laptop and he’ll politely decline.

"I’m not faulting computers. It’s just not my cup of tea," the 94-year-old Vero Beach resident said.

The computer age may be raging, but Cox and many other retirees on the Treasure Coast and across the country prefer the simpler world of typewriters to living in cyberspace. Although considered obsolete for years, typewriters seemingly haven’t disappeared from homes or businesses. Sales aren’t increasing, but the Consumer Electronics Association reported that U.S. retail stores sold 434,000 electronic typewriters and word processors in 2002.

Cox makes a compelling case for choosing typewriters over computers.

"You buy a computer and six months later it’s obsolete," Cox said.

Cox bought his manual typewriter in 1977 for $75. He’s never had to upgrade. It’s never crashed or caught a virus. The annual maintenance cost is about $6 for new ribbons.

For him, the added value is in the simplicity. Because it’s manual, he said, "I can use it when nobody’s got electricity. Every business should have a backup system in case of a power failure."

And in fact many area businesses do still rely on typewriters, enough that Vero Typewriter, a repair shop on U.S. 1 south of Vero Beach, has stayed in business for more than 30 years.

"We get maybe 10 typewriters a week when I used to do 10 a day," said 70-year-old shop owner Frank Nugent, who started repairing typewriters along the Treasure Coast for IBM in 1955.

Since 1970, Nugent and his wife, Barbara Nugent, 65, have run the repair shop out of a prefab cedar building that now holds decades of familiar old musty smells. Typewriters, repair manuals and spare parts rest on shelves that stretch from floor to ceiling. Nugent repairs all kinds: Manuals, typewriters with electric motors and typewriters with electronic circuit boards. While new typewriters are getting harder to come by, the Nugents can still order and salvage parts for repairs.

Over the years, they’ve diversified to include paper shredders, cash registers and fax machines. They used to be open seven days a week, but now have limited hours Monday to Thursday. Barbara Nugent admits, "We’re a dying breed."

But the Nugents have no plans to quit anytime soon because in recent years they’ve seen a typewriter revival.

"People are taking their old typewriters out of the closets," Frank Nugent said.

There’s still a market for the original written-communication machines, he said, and it’s not just among romantics. Some real estate offices and insurance companies still use typewriters because they do one thing that computers can’t: Fill out forms.

Vero Beach real estate broker Polly Schwey used to carry a manual typewriter with her like a laptop, so she could type contracts on-site.

"Now we have a whole system of computers, but sometimes they don’t work. So we still have one typewriter," she said.

Typing away on an old electric at Buckingham Wheeler, a Vero Beach insurance agency, accounting manager Amy Thompson said she still uses typewriters but she admitted, "Eventually they won’t be used."

Michael Kuhle of Davis Typewriter Co. in Minnesota said he now primarily sells computers.

"Typewriter sales are about 2 percent of our overall sales. People are moving to computers," he said. He contends it won’t be long until typewriters die off for good, especially since younger generations continue to be weaned on computers. Now 90 percent of Americans between the ages of 5 and 17 use computers, National Telecommunications and Information Administration reported.

These statistics don’t impress Cox.

"Kids today don’t know what they’re missing."

Bigger and faster isn’t better, he said explaining his typewriter preference almost as a life philosophy. By writing his letters and speeches without the benefits of spellcheck or a delete button, he must contemplate before he acts.

"With that manual typewriter, I have to crystallize each phrase before I put it down."

-Originally published by Scripps Treasure Coast News and republished by the Associated Press. 

UNCOVERED: Faces of the uninsured

Medical bills can be catastrophic for those without health insurance

Hospital bills are stacked about a foot high on Scott Smiarowski's kitchen counter. The dollar amounts of those bills are climbing to more than $500,000, the 29-year-old Vero Beach resident said.

When his wife, Cathy, 30, was in a one-vehicle rollover accident last summer, she was one of the 46 million people in the United States without medical insurance. She was airlifted to Holmes Regional Medical Center in Melbourne. While she remained there in a coma for two weeks, the medical bills began arriving at their modest, one-story house. The helicopter ride alone cost about $6,000.

"The bills just kept coming. One of them was $157,000," Smiarowski said. "I can't pull the money out of the air." Their story is a worst-case nightmare for 15 percent of U.S. residents who are not insured. The scenario of how Cathy Smiarowski ended up without insurance is common among lower middle-income families. As a stay-at-home mother, no employer insured her.

Her husband works in one of Indian River County's main industries: Service. As a repairman, he worked for the maintenance department of the Grove Isle housing complex association. Unlike some service-related jobs in the area, Grove Isle offers health insurance to their four maintenance employees. But Scott Smiarowski's insurance does not cover his wife or his three children: Ashley, 10, Dustin, 5, and 8-year-old Tiffany, who has cerebral palsy.

"It covers me, but there's no option to add dependents," he explained. Florida Blue Cross/Blue Shield health insurance officials said that not having an option to add dependents was unusual. Grove Isle board members declined to participate in an interview.   Rising costs of coverage Other area small-business owners expressed frustration with affording medical coverage for their employees.

"Insurance costs have gone out of reach and more and more small employers have to look at the bottom line and ask, 'Can we continue to afford a small group health plan?'" said Penny Chandler, Indian River County Chamber of Commerce executive director.

In 2003, U.S. businesses with three to nine workers saw the largest increase in the cost to provide coverage, a health-research organization, the Kaiser Family Foundation, reported. Premiums surged by 16.9 percent. About 96 percent of Indian River County employers experienced an increase in health insurance premiums in the past 12 months, a statewide Florida Chamber Federation survey found. Of the employers surveyed, 50 percent said they would be forced to consider eliminating health insurance benefits for their employees if they saw additional premium increases.

"This is a staggering, alarming issue," Chandler said. Craig Thomas, Florida Blue Cross/Blue Shield product development vice president, attributed the rising premiums to health-care costs increasing in the past 10 years as the population ages.

"The problem we're seeing is not a rare one. It's a significant one in Florida," Thomas said. The problem is that many of the plans are too expensive and finding affordable basic coverage plans is difficult. Only one other state has more health insurance mandates than Florida, Chandler said. This makes it difficult for insurance companies to offer basic affordable small group plans.

"There needs to be a statewide effort for health insurance reform," Chandler said. Gov. Jeb Bush proposed legislation at the end of January to allow small businesses of up to 25 employees to join together to buy coverage. As part of a cooperative, businesses could have more leverage to bring small group health plan costs down.

The aftermath 
For the Smiarowskis the proposal won't help, but the state's Medicaid system might. The family didn't qualify for full coverage under Medicaid, a medical assistance program providing health care to low-income families and individuals.

"They say I make too much money," Smiarowski said in disbelief. After working at Grove Isle for nine years, he now makes $12.75 an hour, but for his family to qualify for Medicaid, he would have to make $5.33 an hour.

"(The income eligibility level) is very low. It's the same income level as the welfare program," said Shawna Mackin, of the state Department of Children and Families. "There are a lot of people who get shut out, but there are ways to get around it."

The family does qualify for the state's medically needy cost-share program, which they signed up for after the accident. Under this program the Smiarowskis would have to pay the first about $600 of the expenses each month and then Medicaid should cover the rest.

"I'm fighting with Medicaid because the bills (from the accident) are supposed to be covered," Smiarowski said. "I get bills and I bring them over to them and they're supposed to pay, but who knows. I don't understand it."

In a system that's complicated, time-consuming and frustrating, Smiarowski feels lost and doesn't know what to tell the collectors who keep calling. "Some days I want to pull my hair out of my head, but I try to take one day at a time," he said. "I can't do anything else."

UNCOVERED: Faces of the uninsured
Latino population more likely to go without health insurance

Humberto Silva held his head in his worn, wrinkled hands, suffering silently, praying the pain would go away.

The 72-year-old Vero Beach resident has diabetes, shingles, failing kidneys, high blood pressure, gout, heart problems, cataracts and arthritis.

"I'm hurting," he whispered. When the pain overwhelms him, Silva doesn't visit his local family doctor. He doesn't have one. That's because he doesn't have health insurance.

"Nobody will see him," said his caretaker and friend, Angie Pape, 40. Once Pape explains that Silva does not have coverage, the clinic doors close. Doctors' doors are constantly closing on foreign-born U.S. residents, who are twice as likely as natives are to be without medical insurance, the 2002 Census
reported. Hispanic people in particular are more likely to be uninsured than anyone else.

But this is an epidemic reaching far beyond the lives of the uninsured. "When one person doesn't have insurance, everybody suffers because somebody is bearing the cost," said Pat Schoeni, National Coalition on Health Care executive director. "It's more expensive for everybody."

Preventative and primary care clinics can refuse patients, but federal laws require hospitals to treat all emergency room patients regardless of whether they have medical insurance to pay for treatment.

And there the problem begins.

Uninsured people tend to wait until a minor complaint becomes critical, said Rich
Rasmussen, spokesman for the Florida Hospital Association. They then go to the emergency room where the cost of care is exponentially higher. Emergency room hospitalizations for uninsured non-citizens in Florida cost an average of $63,155 per patient in 2001, Rasmussen said.

When uninsured people don't pay, hospitals are left with the bills. To recoup losses, most hospitals shift their extra costs by charging more to treat people with insurance. This in turn translates into higher premiums.

But there is even more at stake than monetary cost, health experts say.

"We are a country that once put social welfare at the top of our priorities, but over the last couple decades there's been an obvious downturn in the overall concern for the less fortunate," Schoeni said. "What many people who are insured don't realize is that they are just one job away from losing their insurance."

Such was the case with Humberto Silva.

Silva had insurance when he worked as a car mechanic up until 2001 when he had to quit at age 69 because he was too sick to work. After working and paying taxes for 35 years, most U.S. residents would at age 65 be eligible for Medicare, the federal health-care insurance program. Silva received a Social Security number in the 1960s when applying was easier than it is today. Since then he has paid more than $33,000 in taxes. But because Silva is not a legal resident, he is ineligible for the program.

A cultural divide
When Silva crossed the Mexico-U.S. border he, like other immigrants, didn't think about aging and getting sick." (Health insurance) is not something they even realize they can have access to," said Angelina Castro, Silva's attorney who works for the Fort Pierce office of the Florida Immigrant Advocacy Center. "Many Latinos are used to paying cash for everything, including health care."
Latinos also may not realize the cost of care in the United States can be drastically higher than in Central America. People spend more per capita on health care in the United States than any other nation, the National Health Care Coalition reported.

"It is not uncommon for Mexicans to drive to Mexico for medical and dental care. Even after factoring in the cost of transportation, the fees are far below those in the U.S.," Castro said. But when a trip across the border isn't feasible, uninsured immigrants end up using emergency rooms and some hospitals demand payment, Castro said. An uninsured Haitian student told Castro that when she went to a St. Lucie County hospital emergency room to get treated for severe stomach pain, she received
blood tests, antacids and a bill for $6,000.

"She paid it off over six years. She gave between $10 and $300 a month, whatever she had, to pay off the debt," Castro said. The girl's father works as a crew leader at an area citrus grove. Her mother works at a packinghouse. Neither of the employers offered insurance. But some area citrus companies do offer health coverage.

"At our company, all employees are eligible for company-sponsored medical insurance after 90 days of employment," said Jeff Bass, president of Graves Brothers Co., a citrus grove and packinghouse in Wabasso. "Only a very small percentage of our seasonal employees, of all races, choose to participate in our medical insurance plan."

Bass's company pays 80 percent of the plan cost, and employees must contribute about $16 a week. In most cases, Schoeni said, the reason people don't buy insurance is that it's too expensive for their means even if employers share the cost. "They choose between paying rent, buying food and paying for health insurance."

But Bass said he has noticed, "The typical seasonal uninsured person, in general, has figured out that if they have no insurance, by law they will receive indigent care at no costs. This is a big burden on our health-care system."

The Indian River Memorial Hospital emergency room is almost the only option left for Silva. He tries to get care at the Indian River County Health Department clinic, which provides a primary care to people on a sliding-fee basis. But the clinic doesn't have the specific medication he needs. When Silva goes into diabetic shock, Pape calls 911.

Pape has driven Silva to the hospital as often as three times in one week. Silva ran out of money to pay for care long ago and now he falls into the indigent category. Local tax dollars pay for indigent care at Indian River Memorial. Indigent care spending was reached $6.4 million in 2003, rising dramatically from $4.13 million in 2002 and $3.2 million in 2001.

Describing the cyclical routine of 911 calls and emergency visits, Pape said, "We don't know what else to do."

But Silva's story may have a happy ending. At the beginning of March, Silva was approved to receive Social Security and was promised Medicare benefits would kick in July. He has been granted an interview set for April 2005 with the U.S. Immigration Services to get a green card, which allows for legal residency.

When the first check for $1,200 arrived March 1, Silva grasped it in his frail hands. Across a face that had reflected so much suffering, there spread a smile of relief.

UNCOVERED: Faces of the uninsured
Young adults try to navigate without insurance

First Mary Rebholz, 25, and Ken Kaplan, 23, found each other. Then the young couple found employment. Now they've found an affordable apartment. From afar, the Vero Beach couple seems to have succeeded in establishing themselves in the adult world. But one missing item could change all that.

Health insurance. Without it, one illness or injury could take a lifetime to recovery from financially.
Rebholz and Kaplan are two of the millions of young people who face the precarious health insurance void as part of growing up in the one industrialized nation without national health-care coverage. Eighteen- to 24-year-olds account for just 15 percent of the U.S. population but make up 30 percent of the country's growing numbers of uninsured, the 2000 U.S. Census reported.

“I think about it all the time. I really do," Rebholz said, who has severe scoliosis and a history of other medical conditions that could resurface at any time. Rebholz has not had insurance for more than two years and isn't likely to be insured anytime soon because coverage isn't offered through her job as an office assistant for a small Vero Beach chiropractic practice.

"I just keep thinking, 'What if? What if we start a family early? What if something happens?' If something disastrous happens, your life is ruined," she said.

A regular pregnancy and delivery costs at least $10,000, said Sarah Gosney, executive director of the Healthy Start Coalition in Martin County. Any complications can raise the bill dramatically. There's no limit on the dollar figure of the other "what-ifs" that worry Rebholz. In December something did happen. Rebholz started feeling ill and decided she needed to see a family practitioner.

"A 5-minute consultation cost me $172. I was totally taken by surprise," she said. In those 5 minutes, the doctor recommended some blood tests to look at her cholesterol and calcium levels. The tests would have cost $1,800.

"That's the down payment of a house," Rebholz exclaimed. "I can't afford that."

She went without the tests and just hoped the illness wasn't anything terribly serious. So far the young couple has avoided medical catastrophe.

"The reality is that most folks don't have the ability to weather a siege of medical bills," said Howard Dvorkin, president of Consolidated Credit Counseling Services Inc. in Fort Lauderdale. "Medical debt can happen overnight. You can generate thousands upon thousands of dollars."

Filing for bankruptcy is often the only way out from under a deluge of medical debt, he said. Some have argued, he said, that medical expenses are the leading cause of the rise in the number of bankruptcy filings, which is at an all-time high with more than 1.6 million filing last year.

Bankruptcy has consequences, Dvorkin said. It means a 10-year smudge on a personal credit record visible to potential employers, home-mortgage loan officers, and automobile and life insurance agencies. The impacts reach even further.

"When one person files for bankruptcy over medical debt, everyone pays," said Todd Zywicki, the Federal Trade Commission's Office of Policy Planning director and associate law professor at George Mason University in Arlington, Va. "The hospital usually gets nothing back, so at least some of those costs get passed on to other people."

Costs are recouped through raising prices for medical services, which translates to higher insurance premiums. But Dvorkin said that doesn't explain why medical costs and insurance premiums are so high.

"It's because doctors are so afraid of getting sued," he said. "Doctors are prescribing extra tests, to make doubly sure they're prescribing the latest and greatest treatments so they don't get sued."

However the costs are rising, for Rebholz it means market-rate insurance plans are climbing out of reach. The average family health plan is about $9,000 a year, said Pat Chaney, executive director of the National Coalition for Health Care. That's expected to ascend to $14,000 by 2006.

"It's too expensive. They don't make enough money," Chaney said. "Young people, by the force of economy and by their own sense of invincibility, they end up going without insurance."

Kaplan didn't worry much about being without coverage for 11 months after he graduated last May until his benefits kicked in from the job he started in December, working in medical billing and marketing for a local medical firm.

"I look at it as if I think I'm well, I am well. You just have to keep a good attitude," said the healthy young optimist. That's easy to say for someone who hasn't been to a medical doctor since he was 6 years old.

Kaplan and Rebholz see only one way to safety: Get married. Then Rebholz could purchase coverage through her new husband's insurance. But the wedding isn't scheduled until next January. Until then, Rebholz will continue to go without coverage and the "what-ifs" will continue to linger in her thoughts.

This series was originally published in the Scripps Treasure Coast News and won a Scripps award for best non-deadline reporting.

An old world tradition in a modern time   
Instead of losing their language and customs, Mexican immigrants strive fervently to keep the old ways alive or at least meld their long-held traditions into their new surroundings. The quinceanera, an ancient Mexican coming-of-age celebration, is one of the cultural icons that followed these immigrants across the Rio Grande.

The 15th birthday bashes continue in the name of tradition for more and more second-generation, Mexican-American girls including 15-year-old Evelia Solis of Fellsmere, who feels torn between conforming to American ways and embracing her heritage to meet her father's expectations.

The intergenerational clashes flavor her bittersweet 15th birthday fiesta, but certain constants cross cultural boundaries: Growing up can be daunting and fathers always seem to want their daughter to remain their little girls.   

When musicians serenaded her outside her bedroom window at 6 a.m. on her 15th birthday celebration, Evelia Solis didn't know the womanly response to such a gesture was shedding tears of joy.

"I thought she was going to come out in tears," said a somewhat disappointed father, Ramiro Solis, who secretly set up the predawn serenade. "But she handled it like a girl." 

Standing in pink slippers on the front stoop of a modest one-story salmon-pink house on South Elm Street in Fellsmere, Fla., Evelia's emotions didn't overcome her. She tried to stifle yawns and look as if she appreciated being awakened in the early morning darkness after six hours of sleep on the day that would be one of the most glamorous of her life.

The quinceanera, a Mexican social and religious coming of age celebration for 15-year-old girls, symbolized the end of Evelia's childhood. For that day, she would look like a princess and be treated like a queen, but there was no instruction book for how royalty should act before the expectant eyes of her father, her family and society. The baby girl of the Solis family said she wasn't looking forward to womanhood.

"It's kind of sad to not be a kid anymore," Evelia said.

Tussling with her nieces and nephews and playing with toys were supposed to end. "It feels like I won't be able to anymore. There will be no Barbies for sure," she said.

She didn't want to discard the stuffed animals decorating her bedroom. "But my brother said, 'You're getting old, you're not allowed to be playing with teddy bears anymore.' " The bears were banished.

Becoming a woman  
For the rest of the quinceanera morning, the 15-year-old was primped into maturity. Her long dark hair was twisted and pinned up. Eyelashes were curled with a spoon. Eyelids were painted pink.

Long, artificial fingernails tapped together nervously. She never had such long nails before and predicted she'd end up breaking or biting them, but her womanly appearance only had to survive the day. Expectations for the days following hadn't been established, she said.

Historically, the quinceanera marked the time when a girl can date, said Uva de Aragon, Florida International University's Latin American Center assistant director. Tradition dictated that her father's sheltering rules -- no dating, no calling on the phone, no extracurricular activities, no going to the movies without a chaperone -- would be lifted once she turned 15.

But Evelia wasn't sure if freedom would actually follow. The discussion seemed taboo, she said.

Communication, especially regarding sexuality, has become difficult between traditional Mexican fathers and their second-generation immigrant daughters, said Phillip Williams, co-director of a Ford Foundation study of Florida's Latino immigrants. 

"Traditionally, the father's role is controlling the daughter's sexuality. He attaches different meaning to the quinceanera than she does. He expects she will continue to value her virginity and purity," Williams said. "But for young girls growing up in the U.S. who have access to media, they're viewing youth expressing themselves sexually in ways that don't jibe with their parents' traditions."

Although forbidden, Evelia said she has had boyfriends in the past. She would only see her suitors at school or church -- not on private dates -- but Evelia felt she had to hide them from her parents.

New freedoms  
Five days before the quinceanera, Ramiro Solis watched his daughter and her escorts practice the traditional dances for the reception. Gesturing proudly toward Evelia, he said to nearby male relatives, "After Saturday she can go to the movies. Now she can date."

He would bestow trust, so she learned to respect that trust.

"She can have a boyfriend, but if they want to go out, he'll have to pick her up at 6 o'clock and have her back home by 10 p.m.," he said, tapping on his wristwatch authoritatively.

When Evelia later learned of her father's proclamation, her eyes shone with surprised excitement as she pondered the possibilities before her. Becoming an adult suddenly seemed more enticing. She could try out for the basketball team, get a job, buy a cell phone, go to the movies with her friends and maybe even stop hiding her relationships.

"I hope everything changes. I'll enjoy the freedom," she said.

Decisions loom  
As she glided down the church aisle, the upcoming changes seemed far from Evelia's mind at the start of the ceremony that recognized her as an adult in the church. With her father escorting her out afterward, Evelia looked like a bride. For the first time, being a bride was possible because the quinceanera honors the gender roles of females becoming wives and mothers.

Hispanic girls in the United States aren't expected to marry as teens anymore, de Aragon said. But in the Solis family, it's not unusual to marry at age 16. If Evelia followed three of her four older sisters, she would marry in the next year and not complete high school.

Since sixth grade, however, Evelia has wanted to attend college and become a second-grade teacher.

"When I was small I played school with my nieces. I was always the teacher. I told my parents that I wanted to be a teacher and they said, 'Fine.' My dad was proud of me," she said.

With marriage as a possibility though, she's torn about her plan to attend college.

"I want to get married, but I also want to go to college. I see the pluses in both options," she said.

Difficult decisions loomed just ahead, but Evelia postponed them during her quinceanera. For that day, her concerns were keeping her makeup fresh, walking gracefully and remembering the steps for her debut on the dance floor.

Looking on at his young sister-in-law, Andy Cantu, 41, said he had high hopes for the bright-eyed teenager.

"Evelia is a good girl. She's made it to here and has followed the rules. This party is to show our affection for her. It tells her 'You're grown now. You have to look at your future and your life. You have to be a smart person with a good heart.' "

Cantu said he hoped her future decisions would coincide with her parents' wishes. Evelia's sister, Asalia Solis, 28, agreed.  "We just want her to make something of herself, to get ahead in life."

Smiles lit Evelia's face through the day, but her father didn't get proof of her happiness until the father-and-daughter dance. He presented Evelia to the community and she was given a doll, representing her last childhood toy.

"Are you happy? Aren't you going to cry?" he asked, smiling at her. This time Ramiro Solis wasn't disappointed. Tears welled under Evelia's painted eyelids. In one day, she had made the transition.

Clutching the doll to her chest, she rested her head on her father's shoulder in a childlike manner. But by her father standards she had expressed adult emotions in her tears.

"I could tell she was happy and so I was happy," Ramiro Solis said.

Quinceanera basics  
The quinceanera began as an ancient Mexican celebration of a girl's 15th birthday with origins within the Aztec communities as far back as 500 B.C. The tradition has evolved into a religious and social initiation into adulthood and has been adopted throughout Latin America. 

While each celebration varies depending on the family's personal preferences and economic status, generally the day begins with a religious service for the girl and her extended family where she reaffirms her baptismal vows. A reception follows with friends and neighbors joining in for a dinner and dance. 

Solis quinceanera costs: $13,300

Top four expenses: 
1. Cumbia band from Mexico hired for the reception. 
2. Framed, full-length portraits of the 15-year-old. 
3. Renting the fairgrounds pavilion for reception. 
4. Decorator hired for reception hall. 

Other expenses: Lincoln Navigator limousine, beef steer to be slaughtered for the dinner, chef to prepare the beef, mariachi band to play at church service, $500 dress, videographer to document the event, musicians to serenade the 15-year-old at dawn and multi-tiered birthday cake. 

While Ramiro and Carmen Solis covered most of their daughter's quinceanera expenses, the custom is that sisters, aunts, uncles and padrinos, or godparents, each sponsor parts of the party.  

This story was originally published in the Scripps Treasure Coast News and won a Scripps award for best non-deadline reporting.

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