Ruby’s Story

In 2008, Ruby Spencer’s story made headlines in Pennsylvania’s newspapers after the combination of no insurance, a medical mystery, and the need for an advocate left her with nowhere to go and no one to turn to.  Ruby, a petite mother and widow in her early sixties, and her son were living off of $23,000 per year, somewhat less than double the $14,570 poverty line for a family of two living in the 48 contiguous states and the District of Columbia. Because of her income level, Ruby was ineligible to get welfare and was left uninsured — she just assumed she would never get sick. Over that summer, she noticed that her stomach was getting increasingly “thicker.”  Attributing the girth to getting older, Ruby thought nothing of it and continued on with her life as best she could.

But something was really wrong. When Ruby realized this, she found an ad in the paper for a physician’s assistant who performed an ultrasound, concluding that Ruby was in desperate need of medical attention. Her “thick” stomach was actually a 35 cm mass — about the size of a football — that needed immediate medical attention. Ruby was instructed to go to the welfare office to get coverage for her surgery, but once there was turned away because of her income and went to the emergency room for attention. Once at the ER, unfortunately, she again was turned away, this time after seven hours. She had patiently waited, hoping and praying that she was going to find the medical attention she so needed. But once the staff at the hospital realized she did not have health insurance coverage she was immediately sent out the door and instructed to go to a city clinic, which also turned her away. Frustrated and devastated, Ruby and her son felt they were out of options; the country’s insurance system had failed them.