A few days each week Gail Mann scours local construction sites for scrap metal and remnants of aluminum wiring left behind and carts the metal to a nearby recycling plant which pays for what she’s collected. The job is temporary and sporadic, some days yielding an abundant load and other days close to nothing, but it’s a meager income that helps pay the bills — especially the health bills.

Beyond the sobering statistics of the growing uninsured –46 million Americans and 3.6 million Floridians — lies the human face struggling to pay for their well-being and dealing with a growing pile of unpaid medical invoices.

Perhaps none are as profoundly affected as those who recently lost their jobs, who are being slowly taxed by high utility bills, gasoline at $3.62 on average, local businesses cutting back on employee hours and health insurance programs that discourage the poor from receiving treatment.

Mann, 56, lives in Cape Coral and said she has been struggling for the last year to secure regular examinations from a specialist for Chronic Obstructive Pulmonary Disease, COPD, a disease that damages the lungs and constricts the airways, and bronchial asthma. Some 13 million Americans have been diagnosed with this disease caused by smoking or exposure to irritants such as pollution or chemicals.

Last year she was rushed to Lee Memorial Hospital in Fort Myers after her lungs filled with fluid and she was gasping for air. This was one of two visits she made to the hospital from October to November 2007.

“If I come down sick or whatever I have to go the hospital,” said Mann. “I can’t even see my regular doctor because I don’t have the money to go to him. I owe him $40 and I can’t even pay him.”

She has been alternating between Spiriva, a medication to treat COPD, an inhaler to help with the constriction of the lung’s passageways and a nebulizer which changes liquid medicine into droplets that are inhaled through a mouthpiece.

“I was fighting for awhile to get medication from a company because I don’t have it, and I can’t afford it,” said Mann.

Originally from New York state, she moved to Florida after her daughter suggested that the climate would benefit her condition, although now she wants to leave as soon “as she gets money in her pocket.” In fact, many people who have moved to Florida in the last five years are deciding to leave because of how local economies have affected their standard of living.

Although Mann has had COPD for nearly 20 years, she said she never had any trouble securing treatment for her condition until last year. In 2007 she worked for Bob’s Barricades — one of Florida’s largest construction barricade companies — until the heavy lifting became too difficult with COPD and she had to apply to receive disability services and Medicare.

Her only income is a monthly disability check for $835 and financial decisions are made in terms of survival rather than need. Monthly rent for her Cape Coral home is $725 per month while local utility prices have increased and phone bills vary month-to-month.

She won’t qualify for Medicare for another year — Medicare has a two year waiting period before anyone qualifies — and Medicaid, meant for individuals with lower income, will only cover her medical costs after she pays $635 each month.

On the other hand, waiting until the last minute and using the emergency room will cost her about $300.

“If I had a doctor I would have to come up with $635 out-of-pocket per month and I only get $835 a month. I have rent, electric, phone. Do I pay those bills and be homeless so I can go to a doctor or say forget about a doctor which is what I’ve had to do,” she said.

Financial troubles haven’t only affected her but other members of her family living in Southwest Florida, specifically her daughter Marjorie who has severe back pain but can’t find the money to schedule an MRI.

“She needs to go to specialist to get an MRI but she can’t, she doesn’t have the money,” Mann explained. “The doctors said if she doesn’t do anything soon she’ll be in a wheelchair.”

Recently, her daughter’s husband Mike had his hours cut to approximately 24 hours a week at a local glass company and the family can’t afford the private insurance coverage for three children.

“You are looking at half of his paycheck for three children, the mother and father,” said Mann.

His changing hours also put the family’s ability to receive food stamps at risk.

Like many who are uninsured or underinsured, Mann said she has to wait until the last minute to receive treatment for health problems. Recently, she had to take 2,000 milligrams of Penicillin after her jaw became infected from untreated, damaged teeth.

Today, her teeth are easily dislodged from the gum and rocked from side to side, appearing as if they could be plucked out by hand.

“I had an infection in my jaw because my teeth have busted out from my mouth. Busted off from my gum line,” she said. “I’ve been getting infections in my upper and lower jaw.”

From day to day she’s forced to eat foods no harder in texture than hot dogs, wash her mouth out with warm water and take a cocktail of over-the-counter painkillers when the throbbing becomes too intense. The Lee County Health Departments offers free dental care to those who apply, but Mann said the waiting list is filled with hundreds who are also trying “to get their teeth fixed.”

“They won’t take patients until September and there is no way to say whether I’ll be put on it then,” she said.

On Friday the Department of Children and Families denied her food stamps for September because she couldn’t report how much income she earns from scrap collections. While the part-time job was meant to help her with paying the bills she said she’s feeling punished for trying to earn something while living on disability.