The cost of health insurance means many things for Cindy Keable.

It means she doesn’t close her North Mane Barber Shop in Pascoag during the weeks of July 4th and New Year’s as she used to.

“No more vacations,” she says.

It means that the cold she had earlier this week did not keep her from going to work.

“I cannot be sick — ever.”

It means that her husband, Nelson, has taken a part-time job delivering auto parts despite the restrictions imposed by 50 years of dealing with diabetes.

“I didn’t want him to take it but he insisted. He’ll do it as long as he can.”

But maybe the worst parts of it are the telephone battles, the calls to Blue Cross to try to explain why a treatment, a medication, should be covered. It is an experience in which the Keables know they are not alone.

“I’m so sick and tired of fighting with these people. That $21,000 has to come off the top of my income every year.”

Actually, it’s $21,249. That’s what the Keables pay for health insurance coverage for them and their son, Sloane. The cost has gone up every year. In 2000, it was $7,122.

A few years back, they heard that if they joined the Greater Providence Chamber of Commerce, they could get in on a group rate. So they did. They got the group rate. But then their bills started going up again.

“When we called they told us “we stopped doing that a while ago,’ ” says Cindy.

No one at the Chamber had apparently felt the need to pass the word. The Keables dropped their membership.

It was another one of those communications problems. They seem to be increasing.

“When I call Blue Cross, I say, ‘Listen to me, I’m not yelling at you, but somebody needs to listen,’ ” says Cindy.

Recently, she won one. It was pretty amazing. She tried the common sense approach.

Nelson Keable was suffering eye hemorrhages due to his diabetes. His doctor told him there was a shot that would stop the hemorrhaging, but it costs $750 and isn’t covered by Blue Cross.

“I called Blue Cross,” says Cindy. “I said ‘here goes the fight again.’ I told them, ‘You need to pay for this. It’s preventive. It’s cheaper than paying for all the treatments.’ ”

Blue Cross responded to the basic dollars and cents pitch.

And so it goes. Win some, lose some. And hate the phone calls, the arguments.

Thankfully, there are good things to offset the health care skirmishes. There are the doctors who have waived fees and copayments. There are good friends and good customers at North Mane Barber Shop. One customer, Ronnie Parenteau, owns Pascoag Auto Parts and needed a part-time delivery driver. His barber’s husband got the job.

Then there’s the boy the Keables adopted when he was just nine hours old and who grew and grew and is now a tall senior at Burrillville High School who loves to swim and hit the rock gym.

“He’s a great kid,” says Cindy of her son Sloane.

She sits in the kitchen of the red saltbox house in Chepachet which she and her husband built a substantial part of. Some of the primitive antiques which she sometimes sells from the barbershop give the room a very warm feel.

There is a good life that is becoming increasingly more expensive to hold on to. Cindy Keable doesn’t think she’ll ever retire from the barbershop.

“If I couldn’t do this, they might take my home. And we’ve worked too hard to get where we are to allow that.”

bkerr@projo.com