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The New Health Dialogue

A Blog from New America's Health Policy Program

COVERAGE: Uninsured and Desperate for Medical Care

Published:  November 11, 2008

At this point, every American knows that there are millions among us who do not have health insurance. Sometimes, we talk to each other about what this means - the neighbor who puts off her mammogram because she can't afford it, the uncle who keeps not going to the dentist despite increasing pain, the eight- or nine-hour wait we had at the local emergency room that was overflowing with people who don't have access to preventative care. Indeed, the presidential candidates clearly got the message on the campaign trail. Despite the frightening drama of the financial crisis, both candidates vowed to make health reform a priority once in office. Here's a quick refresher from the second presidential debate:

McCain: Frankly, I'm not going to tell that person without health insurance that, "I'm sorry, you'll have to wait."

Obama: I can't tell you how many people I meet who don't have health insurance. . . So one of the things that I have said from the start of this campaign is that we have a moral commitment as well as an economic imperative to do something about the health care crisis that so many families are facing.

Still, few of us are surrounded by people who lack health insurance. So it took us a moment to absorb the disturbing reality reported in the Washington Post Magazine this Sunday about how thousands of uninsured people flocked to a make-shift clinic on a county fairgrounds in Wise County, Virginia, to receive free medical care from an army of volunteer health care workers. Some of the more harrowing stats include:

  • On the first day of the clinic, 1,500 waited in line—many of whom had camped out overnight; a total of about 2,700 people were served in 3 days
  • About one-third of the mammograms and chest x-rays performed at the clinic lead to further testing; but accessing follow-up care is often challenging without health insurance
  • One 60-year-old woman had not undergone a mammogram for 18 years; her mammogram results lead to a recommendation for further testing
  • One man had a disfiguring, egg-sized cyst removed from his cheek. It had been growing for eight years.
  • There are patients "literally dying of diabetes"

This is the ninth year the Remote Area Medical Volunteer Corps has set up a clinic on the Wise County fairgrounds. About 800 volunteer doctors, dentists and nurses provide medical care for free.

Even the guy that runs this clinic knows that this amounts to slapping a Band-Aid on a gaping wound. Approximately 46 million Americans lack health insurance and another 25 million are underinsured. The angel-man that runs this clinic, Stan Brock, wrestled anacondas on the 1970s show Mutual of Omaha's Wild Kingdom. He founded a nonprofit medical relief corps in 1985 after being disturbed by medical epidemics he witnessed while touring South America. In 2000, he was persuaded to bring his medical volunteer army services to Wise County, Virginia—where the people of Appalachia are unusually poor, isolated and uninsured. Brock wisely notes: "Hospitals on county fairgrounds are not the answer." Brock discussed further some of the challenges he faces in a Q&A with the Post yesterday saying:

The greatest impediment to RAM's ability to provide this type of free care throughout the United States are the laws that exist in each state that prevent willing Doctors and other medical workers from crossing state lines to provide these much needed services. A change in these laws for charitable purposes would be at no cost to the government or the taxpayer. We changed the law in Tennessee in 1995 and it allows licensed medical practitioners from out of state to provide free care in Tennessee without restriction.

We could stop there, assuming that this problem is isolated to Wise County, Virginia. Unfortunately, we also know that other massive efforts to fill a health care need are taking place across the county. A few more examples we came across:

  • On Martin Luther King, Jr. Day, Kaiser Permanente Neighbors in Health Fair attracted thousands of uninsured Coloradans for screenings and tests.
  • Since 1996, doctors in Western North Carolina's Buncombe County provide needed care for the county's some 40,000 uninsured. As part of Project Access, Doctors (both specialists and primary care physicians) agree to provide free health care to low-income individuals who do not have insurance, or qualify for public assistance. In 2006, over $9.5 million in documented free care was donated to low-income residents of Buncombe County through Project Access.
  • In recognition of Veterans' Day the Washington Redskins, GlaxoSmithKline, Men's Health Network, Prostate Cancer Education Council and the American Heart Association hosted a health screening and education event on November 9, 2008 in the Redskins team locker room at FedEx Field to encourage mlitary veterans to be proactive about their health. Several hundred veterans were screened for cholesterol, diabetes, osteoporosis, blood pressure and prostate problems.

Thank goodness these programs exist -- but health care shouldn't be something you can only get at a fair ground or FedEx Field. If thousands of people are taking advantage of these opportunities to receive free health care services, no further evidence should be necessary to demonstrate our desperate and imminent need for affordable, sustainable health reform. President-elect Obama, we have one word for you: hurry.

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