Richard Angus had been managing just fine without health insurance. A careful skier and cyclist, the Glenwood Springs resident figured he could avoid the costs of health insurance, and avoid the risks of going without it, too. Then last year, he contracted a blood infection that nearly cost him his life.

Instead, it cost him his livelihood. Three weeks at St. Mary's hospital in Grand Junction left him with $90,000 in medical bills he says he'll never be able to pay off. His credit rating trashed, he's seeking bankruptcy protection to stay afloat.

“You're very happy that you get home. You're alive!” says Angus, 48. “Then three months, four months down the road, you have to deal with the bills and the people. You almost wonder why they're keeping me alive when they're just going to make my life hell.”

Angus isn't alone. Our congressional district has the highest uninsured rate in the state, behind only urban Denver. It's a vast district. That stretches from the deserts of northwest Colorado to the Eastern Plains around Pueblo. It's a land of gas fields, potato fields and mansions. It includes some of Colorado's wealthiest and poorest counties. Aspen's Pitkin County boasts the state's highest per capita income. Saguache County has the second lowest. 

But it's not just about rich and poor. Although statistics for the Roaring Fork Valley weren't available, plenty of your neighbors are going without health insurance, too.

Colorado has the 16th highest rate of uninsured in the country, with 17.2 percent uninsured. In our 3rd Congressional District, more than one in five residents – 21.4 percent – were uninsured last year, according to a U.S. Census report. For adults under retirement age, when they qualify for Medicare, the numbers are even more astonishing. More than a quarter of us – 26.8 percent – are uninsured. That's the state's highest.

Our congressman, Rep. John Salazar, (D,) voted for the health care reform last weekend. So did most of Colorado's other Democrats. But Rep. Betsy Markey, (D), voted “no,” even though a fifth of the adults 18-64 in her Eastern Plains district lack health insurance. Republicans Mike Coffman and Doug Lamborn voted “no,” too.

How did this become so partisan? Why are legislators from the states with the highest rates of uninsured some the least likely to approve meaningful health care reform? Why isn't there a massive groundswell from these states to insist their legislators – Republican and Democrat – vote for real health care reform? I don't get it.

The top 25 rates of uninsured are all in the South, West and Alaska – states that are most likely to be red. The West was the only part of the country to see rates of uninsured noticeably rise. That's not something to be proud of.

“Our rates of uninsurance are currently high and I think it's principally because of the types of businesses we have,” says David Adamson, executive director of Mountain Family Health Center, in Glenwood Springs, which specializes in serving the uninsured.

The valley's construction and energy industries rely heavily on subcontractors, and those small businesses often don't provide health insurance for their employees, Adamson says. Our retail industry typically doesn't, either. The valley's high numbers of illegal immigrants rarely carry insurance.

The same is true throughout Colorado and across the West.

“We have a high proportion of sole proprietors and small businesses,” says Colorado state demographer Elizabeth Garner. “Small businesses tend to have more of a challenge providing health care coverage, especially with the increased cost of health care coverage. Too, health care coverage tends to follow income. The lower income you are, the more likely you are working in retail, which is less likely to be providing health insurance.”

That's where Richard Angus comes in. Angus was working at one of Aspen's trendier eateries, but it wouldn't provide health insurance until he had worked there for a year. He also worked as a caretaker for a multi-million-dollar Aspen home, but that job didn't provide insurance either. He had private insurance until about four years ago, he says, when his monthly bills neared $500. So he went without.

That was fine, until the blood infection surprised him. He earned too much to qualify for indigent care but not enough to pay his massive hospital bills.

“They want $2,000 a month for the rest of my life,” he says. “There's just no way.”

For Angus, the financial burden he's been left with has become overwhelming.

“Sometimes you think it's not worth being alive anymore,” he says. “It's never-ending.”

Write to David Frey via his Web site, www.davidfrey.me.