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Farihah Zaman

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What Attending a Free Clinic Can Teach Every American About Health Care

Posted: 07/02/2012 11:12 am

2012-07-02-RamDentalSmall.png

In the wake of Senate Minority Leader Mitch McConnell's callous and very public proclamation on Fox News Sunday that providing health care coverage for 30 million uninsured Americans "is not the issue", it's disturbingly necessary to reiterate: the fact that 30 million Americans live in pain, constant fear of becoming ill, and may even die of treatable conditions because they don't have basic health care coverage is, in a first world nation, the only issue. While this should be self evident, McConnell's statement only added fuel to a lingering suspicion that to some politicians the health care "issue" is just one more partisan identity signifier, when health is by definition about people, not politics.

I witnessed the visceral need for care firsthand this April while filming a documentary about a free "pop-up" medical clinic set up on the NASCAR Motor Speedway in Bristol, Tennessee by an organization called Remote Are Medical. While McConnell so blithely dismisses the importance of providing insurance for all Americans, thousands of his constituents and others from Tennessee, Virginia, West Virginia, and beyond flock to these clinics for medical, dental, and vision care they couldn't hope to receive otherwise. The feature-length Remote Area Medical documentary is in the works (expect it in early 2013), but in the meantime, here is a three minute clip that illustrates what goes on at a clinic:

Remote Area Medical | Jeff Reichert & Farihah Zaman from Focus Forward Films on Vimeo.

Do you think the woman who slept for twenty-four hours in a parking lot to get her first visit to a dentist in a decade, just hoping she was early enough to make it inside, cares if her provider is a Republican or a Democrat? Probably no more than her volunteer dentist (all RAM clinic providers are volunteers, and some travel from further afield than the patients to donate their time) cares if she is a Libertarian, Muslim American, immigrant or anything else one has the right to be in this country. Perhaps I'm naive, but it is difficult for me to understand how politicians of every party can't simply agree that a person in need should be able to see a dentist some time before their only option is the extraction of an entire row of teeth and a prescription for dentures that are comically unaffordable for someone who couldn't even pay for a cleaning.

In my three days at the Bristol clinic, not a single local politician came to see what their constituents had to endure just to get their blood pressure checked or have their chest X-rayed; the RAM team says that that is usually the case. Here is what they might have learned if they had made the effort:

1) The need is greater than I had ever possibly imagined, and I am originally from Bangladesh, one of the poorest countries on earth. The knowledge that the resources and infrastructure are available here makes the sight of people lining up by the thousands for a donated pair of glasses so incongruous with our country's perceived wealth. Many of the volunteers and doctors I spoke with noted that knowing the numbers of the uninsured was one thing, but meeting the struggling patients face-to-face was something else entirely.

2) The demographics of these clinics are not what you might expect. The full or partial lack of care is so widespread that there is a much greater mix in the financial backgrounds of patients. RAM patients are not always homeless or unemployed; the vast majority work but have come to the cruel realization that simply working hard in America is not enough to get by anymore.

3) The ramifications of being uninsured go far beyond physical health and discomfort. People missing half their teeth, or essentially unable to see because the best they can do in terms of vision is a $9.99 pair of readers from the neighborhood pharmacy, are not going to get hired in a sluggish economy and so can do nothing to better their situation. Similarly, certain issues of pride and self-image are tied up in deteriorating or neglected health. Val Crosby, who we featured in the Remote Area Medical clip above, used to work as an assistant bank manager but was unemployed and unable to kiss her husband for over a year because her degenerative dental condition had become so visible and painful.

4) Seeing people's health care needs brings up uncomfortable questions about class in American society. Who receives care and who does not? What does it mean to be middle class in the U.S., and what does it mean to be one of the working poor? How clear is that distinction anymore? What does poverty in America look like? It is too easy to ignore the daily reality of this large swath of our population and act like their plight is an anomaly. The world knows that we are not taking care of our own.

5) One of the most painful lessons learned during the shooting of Remote Area Medical is that no matter how wonderful a job RAM may do, no matter how much they toil and persevere, it can never possibly be enough. These generous volunteers make miracles happen in the middle of a racetrack, a fairground, a high school, or any other public space that happens to be available, but there just aren't enough miracles to go around. RAM could never accrue the resources required to become primary care for everyone who is currently falling through the cracks, let alone every hopeful patient who shows up at every clinic, and our film will show the painful consequences for those who are turned away without care. Institutionalized charity will never be the answer. The good folks at RAM love to say their greatest hope is that a better system will come along and put them out of business

While Obama's Affordable Health Care Act is far from perfect, the Supreme Court's decision to uphold it last week still felt like a triumph, not for Obama or for Democrats, but for all of us, because it signified an acknowledgement of our broken system and a promise to begin fixing it. The question is, are the people responsible for doing so really committed to seeing the ACA as a first step to be built upon as quickly as humanly possible? Or will it take another four years to inch closer to the kind of coverage and access that people need right now? Yes, it is absolutely crucial to aim towards tangible, realistic solutions, and to consider the political ramifications of any system that is put in place, but how can we possibly do that if we turn individual lives into an abstraction, making it a battle of words and ideologies while closing our eyes to immediate needs and the neglect of basic human rights taking place within our borders?

 

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In the wake of Senate Minority Leader Mitch McConnell's callous and very public proclamation on Fox News Sunday that providing health care coverage for 30 million uninsured Americans "is not the iss...
In the wake of Senate Minority Leader Mitch McConnell's callous and very public proclamation on Fox News Sunday that providing health care coverage for 30 million uninsured Americans "is not the iss...
 
 
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oilfield
large employer per obamacare
08:12 PM on 07/02/2012
" the fact that 30 million Americans live in pain, constant fear of becoming ill, and may even die of treatable conditions because they don't have basic health care coverage is, in a first world nation, the only issue."
false....i asked an employee today if he had insurance....nope....then i asked if he went to the va hospital and he said he never had.....some folks dont seem to care or get sick. if he does he can go to charity hospital or the va, if he needs to go to the doctor, he can pay less than 100.00 and go for a visit.
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HUFFPOST BLOGGER
Farihah Zaman
09:30 PM on 07/02/2012
Here are my issues with your argument:

1) Everyone gets sick some time. I'm glad your friend is healthy but what if, heaven forbid, he were to be diagnosed with cancer tomorrow? How long would it take for him to even find out since he is not seeing a doctor regularly?

2) The pain or fear that I'm referring to could be minor - a toothache, a sprained back - but you never know when a minor issue will lead to something far worse.

3) I don't think it's right or fair to base national policy on the apathy of a minority of people who can manage to afford care if things go south.

4) For these reasons everyone deserves the security of knowing they will be taken care of if they fall ill, or be better educated in preventing illness, whether they are bothered about it or not.

5) Your friend seems to have options that many, many Americans do not, including: VA services, an accessible charity hospital (I will repeat ad nauseam, charity-based clinics will never be enough to provide for everyone without care, and often operate under conditions that make access a challenge because they are stretched so thin), and the ability to spend around $100 at a moment's notice without batting an eyelash. That last one in particular is not doable for more people than we choose to acknowledge, at least not without some major sacrifice from other crucial expenses like food or rent.
oilfield
large employer per obamacare
01:00 AM on 07/03/2012
so folks cant spend 100 on a whim but will be able to afford 500 a month for insurance?  louisiana has a charity hospital system that the government operates which is my belief of why some take the risk..under ocare he will pay a very small penalty and join the insurance if he needs it as they cant deny him. 
05:52 PM on 07/02/2012
I wonder how many of the 30 million are republicans?
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ruthtruth
seeker of truth, willing to listen
04:47 PM on 07/02/2012
While working in the medical field for over 30 years, I saw things like this all the time. I'd like to see all those who say we don't need everyone to have healthcare work for a week in one of these clinics or emergency rooms where many times it too late to save someone due to their lack of health care . The kids get to me the most. Ryan, McConnell, Boehner, Cantor and all the rest of you heartless wonders you can't possibly see something like this and not get it, can you?
marion1
your entitled to your opinion, not your own facts
04:06 PM on 07/02/2012
I worked at a nonprofit for two years, that provided services for adults with mental illness. Most if not all were missing either some or all of their teeth. We had dentists who came in to give hygiene talks, free toothpaste and brushes but didn't volunteer to take one client and help them. The average income of our clients was about $650 a month. These people had multiple health problems in addition to their chronic mental health issues. In the two years since this nonprofit disbanded the state of Louisiana has seriously cut back services for the mentally ill and medicaid recipients. Obviously, with their income, deciding to eat, pay the rent or get a prescription refilled was a monthly agonizing decision.
I receive my healthcare from the state of Louisiana's Hipaa Plan with is the high risk pool for Louisiana. I pay over $600per month with $5000 deductible and a $1250 drug deductible. This is a very large chunk of our income. I took my Social Security early so that I could pay the premiums and deductible. I'm fortunate that I was able to do that or I wouldn't be able to have any health insurance. My husband has Medicare and I will be able to have Medicare next year. We are the richest country in the world and have the most expensive crappy healthcare in the world we should be ashamed, very ashamed.
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ruthtruth
seeker of truth, willing to listen
04:51 PM on 07/02/2012
I was lucky enough to have worked at a union job for many years and after getting hurt on the job and lost the use of my right hand at least when I was forced to retire I kept my health insurance but my husband , who is a cancer survivor doesn't because we can't afford it. I keep my fingers crossed that he will stay healthy until 2014 so he can get healthcare. I hope the TP/GOP lose big time so that this law stays and is improved.
oilfield
large employer per obamacare
08:08 PM on 07/02/2012
shouldnt we do something to actually lower the cost of care?
MHT73
words matter
03:14 PM on 07/02/2012
I've become convinced that the only way we'll get full health care coverage is to deny it to all Congressmen and their families until every other American has full access. When every one of us has full access to quality health care, then they get it too. It should take about a month, and the problem would be solved.
Divine thought
hate knows that love's the cure
02:54 PM on 07/02/2012
Thank you for your story.
Every CITIZEN of this country deserves adequate healthcare.
If other countries can do it, I don't see why this supposed great nation can't come up with a solution.
We gotta make it work. Healthcare providers can still get paid a descent fee.
It can be done.
JUST DO IT!
01:55 PM on 07/02/2012
How is a free clinic free when someone is paying for it.
HUFFPOST SUPER USER
feelingdisposable
Obama 332 - Romney 206
02:12 PM on 07/02/2012
It's free for the patients via the good will of caring people who donate their time, energy, skills, and supplies. For some people, it's the only chance they might have in the foreseeable future to actually get to talk to a doctor. I wish there could be more "free" clinics so that more people would have a chance to at least have a check-up. (You can't fix something if you don't know what's wrong.)
06:25 PM on 07/02/2012
They can do like the others in the city do and call the fire dept. to take them to the hospital for free. Its free to them because they give a fake name.
HUFFPOST SUPER USER
Anne Rutherford
02:27 PM on 07/02/2012
It is run by donations of time, supplies and offered to people who have no access to regular care. You should attend the next clinic and ask for a compassion transplant - you need it.
This user has chosen to opt out of the Badges program
01:51 PM on 07/02/2012
Sure our system will take anyone from overseas who has the cold hard cash to pay. Those US citizens in this country without insurance absolutely would not have access to equal treatment. There are many reasons for this but one of them has to be that our health care system is being run by for profit companies who put their bottom line ahead of what's best for patients. People like me, who gets health insurance through my employer, has access to the care you speak of. I am a medical professional who is currently beginning a battle against breast cancer. Ive seen both sides and its ugly for sure if you dont have means or good medical benefits My charges were almost $8000 before I even stepped into the hospital for surgery My insurance took care of the lions share. So ACA or not changes will come whether and younwillhave no choice. The present system is not sustainable
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ruthtruth
seeker of truth, willing to listen
04:56 PM on 07/02/2012
I wish you health. My husband is a cancer survivor and has been healthy for a very long time so don't give up and think about how great will be once you are free of this disease.
HUFFPOST SUPER USER
feelingdisposable
Obama 332 - Romney 206
01:23 PM on 07/02/2012
I'm 56 years old, have been the "heat-stroke queen" for most of my life, had a heart attack 9 years ago, and near kidney failure about 10 years ago. Right now, I'm unemployed and have been constantly dizzy & nauseous for over 2 weeks, my legs hurt to even lightly touch them, shins or thighs, and signs of kidney failure are with me again. I've been trying to get qualified for Medicaid, but haven't had quality doctor care for most of my life (never have been able to afford health insurance - it's always come under the heading of a "luxury"), therefore, I don't have much in the way of medical records. The Medicaid office won't send me to a doctor until they have written"proof" from a doctor that I need medical attention. It's a serious case of Catch-22. Damned if you do & damned if you don't. How do you get the "proof" that you need if you can't afford the office visits, not alone afford the tests?
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feelingdisposable
Obama 332 - Romney 206
02:06 PM on 07/02/2012
P.S. - Took my blood pressure this morning because I was feeling REALLY bad. It was 75/59. That's definitely NOT normal for anyone.
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HUFFPOST COMMUNITY MODERATOR
BannedFromCommenting
♼ ♼ PLEASE RECYCLE TROLLS ♼ ♼
03:33 PM on 07/02/2012
There is no such laws that Medicaid office (DSHS it is) needs you to see a doctor first. That is false.

If you are a U.S. citizen (born in the U.S. or one of its territories) and provide a valid
Social Security Number (SSN), a match with Social Security Administration (SSA) will
verify your SSN, date of birth/age and U.S citizenship. If SSA verifies this information,
no further proof is needed. The SSA match cannot verify birth information for a naturalized citizen.
You will need proof of naturalization (e.g., Naturalization Certificate (N-550 or N-570) or a U.S. passport).
Proof of age (if not verified by SSA), like a birth certificate
Proof of citizenship or immigration status*
Four week of recent paycheck stubs (if you are working)
Proof of your income from sources like Social Security, Supplemental Security Income (SSI), Veteran's Benefits (VA), retirementUnemployment Insurance Benefits (UIB), Child Support payments
If you or anyone who lives with you is 65 years old or older, certified blind, or certified disabled, or certified disablled, you need to give information on bank accounts, insurance policies and other resources
Proof of where you live, like a rent receipt, landlord statement, mortgage statement, or envelope from mail you received recently
Insurance benefit card or the policy (if you have any other health insurance)
Medicare Benefit Card (the red, white and blue card)
01:19 PM on 07/02/2012
I've seen this movie before. It was called Cognitive Dissonance.
Welletsee
Trying hard to understand
12:56 PM on 07/02/2012
Nothing to see here, move along....
We have the best health care system in the whole wide world.
People come from all over the globe to get their elective surgery done here , rather than wait a few months at home. We are the best. We are the brightest. USA USA USA
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ruthtruth
seeker of truth, willing to listen
04:59 PM on 07/02/2012
And you are living in LaLa Land. Go to a local clinic and get a reality check.
Welletsee
Trying hard to understand
01:33 PM on 07/03/2012
Nope not la la land, Sarcasm land,
next time I'll try to lay it on a bit thicker so you'll catch it.....
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HUFFPOST BLOGGER
Farihah Zaman
06:18 PM on 07/02/2012
The fact that people travel to the US for surgical procedures speaks to the existence of quality care in this country for those who can afford it, not quality health care insurance. The fact that quality care exists but is inaccessible to so many only makes it worse. Interestingly enough the opposite of what you are describing happens as well; Americans travel to Mexico or India for surgery because the price of the ticket plus the procedure abroad might be less than the cost of the procedure alone here at home.

If we had the best health care system in the whole wide world, people wouldn't have to sleep in a parking lot over night just to see a doctor. Period.
Welletsee
Trying hard to understand
01:36 PM on 07/03/2012
Sorry you missed the sarcasm......
You make excelent points though...
F&F
apoyo
Micro-bio? Sounds serious.
12:40 PM on 07/02/2012
Hope those 30 million keep that in mind when they go to the voting booth.
MHT73
words matter
03:11 PM on 07/02/2012
and the rest of us, too.
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HUFFPOST SUPER USER
MeinNH
Ooooo Silly Me
12:13 PM on 07/02/2012
These are the people that Mitch McConnell says "aren't the issue".....
12:10 PM on 07/02/2012
"There are none so Blind than those who will NOT see . . . " All RepubLIEcans in Congress would not and will NEVER come "free clinic" events. They're WILLFULLY BLIND. Hell will freeze over before these soulless Ideologues waste tiny thought on people like those at free medical care events. THEY DO NOT CARE! They have NEVER CARED! And they NEVER WILL! Can anyone picture Paul Ryan or Rand Paul showing up? I don't believe even a lot of Democratic Congress people worry much about uninsured poor who can't access basic medical care.American Congress lives like Royalty!! They are happy to stay in Bubble of Wealth, enjoying their self-voted Goodies. Maybe small number of Democratic Congress people really Care. Ted Kennedy genuinely worried about people with no access, Hillary & Bill Clinton, Gabby Giffords, President Obama & Michele, Nancy Pelosi, some other Democrats. Except for Kennedy, it seems those Not-to-the-Manor-Born, who grew up lower Middle Class or close to Poor, are only Congress persons who have a CLUE. Does anyone in their right mind believe HW Bush or George Bush or Mitt Romney has EVER had a passing thought of people who have NEVER had money/insurance to access to best medical treatment MONEY CAN BUY?! Does anyone believe The Very Rich even PRAY for them? I honestly can't think of single Republican in Congress who actually CARES a flying flip about people who can't afford health insurance pay directly for medical care. NADA!
12:05 PM on 07/02/2012
Reality check U.S.A. ???? The majoity of americans are working poor. Hard working poor I might add. Corporate windfalls are not the answer.