Fear and Waiting: What the Wise County Clinic Means This Year

A free medical clinic in the poor southwestern part of Virginia treated over 1,500 patients, some driving up to five hours and sleeping in their cars to secure a place in line.
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My neighbor Lisa has seen the Wise County Clinic personally. Her family owns a farm just over the mountain from the fairgrounds where the annual health care road show gathers. She described the experience of watching it in a recent email: "Just the line of cars -- literally for several miles -- and the sea of people, standing quietly in line for hours and hours to get care, was enough to bring you to tears. You feel as if you're in another country."

Every summer in the poor southwestern part of Virginia there's a free medical clinic at the Wise County Fairgrounds, conducted by the Remote Area Medical (RAM) volunteer corps. Last year, the 20-bed clinic treated over 1,500 patients, some driving up to five hours and sleeping in their cars to secure a place in line.

RAM founder Stan Brock started his organization with the intention of serving remote areas in underdeveloped parts of the world like the upper Amazon basin, where he once lived. But now sixty percent of RAM's work is in the United States. Though the Washington Post and 60 Minutes gave extensive coverage to the 2008 Wise County RAM clinic the tour of Appalachia lasts all year long with 13 stops in Tennessee, Kentucky, and Virginia and two out west in California and Utah. RAM uses the same wording for their trips to the Amazon as they do for Appalachia -- volunteers go on "expeditions" and are warned of "social unrest."

In Virginia, the Roanoke Times' Rob Johnson touched on the surrounding tensions in his interview with Barbara Hale, Chief Financial Officer of Norton Community Hospital, a non-profit acute-care facility that serves the Wise area:

We see an increase every year in the need. We've had a 381 percent increase in charity write-offs since 2001... It's all about insurance. Our unemployment here is high and many of our patients who do have insurance either have insufficient coverage or such large deductibles that they're still afraid to seek care.

The "consumer-driven" policies to which Hale is referring have been interpreted by consumer watchdog organizations as the health insurance industry's latest way to cheat their customers. Though some think tanks tout the affordability of consumer driven insurance, the Consumers Union investigated these policies in 2004 and sounded the alarm, testifying before Congress against them and warning on their website in bold letters:

Consumers Union believes that this coverage is misnamed, misguided from a policy perspective, and a dangerous distraction from the need to solve the health insurance crisis that faces 43.6 million uninsured consumers and tens of millions of underinsured consumers.

Bill Moyers of PBS recently interviewed Wendell Potter, the CIGNA health insurance executive who was inspired by the 2007 Wise County RAM clinic to abandon his senior position (and corporate jet) to work as a whistle blower for health care reform.

Potter described how Wall Street hijacked our health insurance industry and turned it into what Bill Moyers called "a giant ATM for Wall Street."

Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves... I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.

So let's put these pieces together. Organizations like RAM can rally volunteers and provide over $33 million in free health care to Americans so needy they're willing to wait for days in the Southern summer heat for it. The industry response is a "consumer driven" system that's also called a "dangerous distraction from the need to solve the health care crisis." Of course, Wall Street hates it when the health insurance industry spends premium dollars doing what it's supposed to be doing: saving our lives.

But for some reason Wall Street is not offended when health insurance companies pay out millions of dollars a day for K street lobbyists and campaign donations to Congress.

In a report released in June, Common Cause summarized health insurance payouts to lawmakers. The accompanying summary release presented the facts in a bulleted list:

Health industries - including health insurance, pharmaceuticals and health products, hospitals and HMOs, and health professionals - have contributed over $372 million in campaign contributions to members of Congress since 2000...

Political spending by the health industries has increased 73 percent since 2000...

The major health interests have spent an average of $1.4 million per day to lobby Congress so far this year and are on track to spend more than half a billion dollars by the end 2009.

Reading over that report, I couldn't help but think, "That's our money."

That's our money. That's our premium payments, the steep and rapidly climbing health insurance payments that many of us can no longer afford. That's our money, that's the health insurance premiums we pay so our kids will be covered, the premiums that make us worry about funding our retirements and our kids' educations. And we live in fear.

Some pundits, like Dr. Frank Luntz, have even become propagandeers. As Luntz's 28-page memo instructed Republican politicians to talk about health care reform in a particularly Orwellian way. According to Luntz himself, terms like "government takeover" and warnings of "WASTE, FRAUD, and ABUSE" in the memo are appropriate because health care reform is so popular.

We are literally being scared out of our wits.

We still have excellent doctors, nurses and hospitals and other dedicated medical professionals. Nevertheless, the best we can do is send them into the mountains where -- like some surreal jam band festival turned humanitarian feat -- those afraid of losing their livelihood can attempt to save their own lives.

There is something dangerous about this system. I've seen it. My friends have seen it. And I know you've seen it, too.

If you, or someone you know, will be at the Wise County health clinic this weekend or has attended any of the RAM clinics, either as a volunteer or as a patient, we want to hear from you. Tell us about your experience, about the treatment you receive and about the other people who attend. What do the volunteer doctors think about the heath care system and how to the patients want their elected officials to address? Send your stories from Wise County to us at ee+healthcare@huffingtonpost.com.

Annual Schedule for RAM Clinics Nationwide:
Jan. 31-Feb 1: Jacobs Building at Chilhowee Park, Knoxville, TN (D, Vis, M)
March 14-15: Pigeon Forge H.S. Sevier County, TN (D, Vis, M)
April 18-19: Van Buren County, TN (D, Vis, M)
May 2-3: Cleveland, Ohio POSTPONED (D, Vis, M)
May 30-31: Tex Turner Arena at Lincoln Memorial University, Harrogate, TN (D, Vis, M, Vet)
June 27-28: Pike County Central H.S. Pike Co. KY (D, Vis, M)
July 18-19: Cocke County (D, Vis, M, Vet)
July 24-25-26: Wise County Fairgrounds, Wise, VA (D, Vis, M)
August 11-18: RAM-LA, at The Forum in Inglewood, CA (D, Vis, M)
August 22-26: RAM Utah in Fort Duchesne, UT, Northern Ute Tribes Reservation (D, Vis, W)
Sept. 19-20: Roane County, TN (D, Vis, M)
Sept 26-27: Letcher County Central H.S. KY (D, Vis, M)
Oct 3-4: Grundy, Virginia at Riverview Elementary School (D, Vis, M)
Oct. 17-18: Franklin County H.S. (D, Vis, M)
Oct 17-18: RAM Veterinary Clinic, Newport High School, Newport TN:
The Big Fix: spay and neuter small animals (Vet)
Nov. 14-15: Union Co. H.S. Maynardsville, Tn (D, Vis, M)

A=Airborne, D=Dental, M=Medical, Vet=Veterinary, Vis=Vision, W=Women's Health

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