Truly something else. Any thoughts or comments? Uninsured Americans flock to free medical clinics
Dennis Cahill had his first heart attack at home on a Saturday in August 2008.
He had his second one the following afternoon and this time — in the only bit of Irish luck he had on a truly lousy day — his brother was there to get him in an ambulance and to a hospital.
Two days later, Cahill was wheeled out of the cardiac unit in Olathe, Kan., with two stents in his heart, $83,000 U.S. in medical bills and no way to pay them.
Fifty-two years old and without any health insurance since his divorce in 2007, the self-employed construction contractor is living — by any definition — a precarious American existence.
Cahill stopped taking his medications — Plavix, Crestor and five other drugs designed to keep his heart pumping — three months ago because he no longer could afford the $1,000 a month it cost to fill the prescriptions.
A painful hernia that bulges from his abdomen has gone untreated since 2005.
And don't get Cahill started about his knees. "The world's worst knees," he says.
His right knee is swollen so badly it stretches the fabric of his faded denims, and he leans heavily on a cane as he walks. His left knee bears the scars of four surgeries performed to fix rugby injuries 26 years ago.
Cahill suspects both need to be replaced.
But there is no money and — because of his "pre-existing conditions" — Cahill hasn't found an insurance company in the country that will offer him coverage.
So with nowhere else to go, this is where Cahill has come.
He has come to a cavernous convention hall in downtown Kansas City, Mo., that volunteer doctors and nurses have transformed for two days into a massive free health-care clinic — offering everything from routine physical checkups to electrocardiograms to dental care to HIV testing and H1N1 flu shots.
In the face of the U.S. Midwest's first winter blizzard, more than 2,000 other Missourians and Kansans joined Cahill because they simply have no other health-care options.
According to organizers, about 80 per cent of the patients have jobs but lack insurance because skyrocketing premiums, deductibles and co-pays make it financially untenable.
Many others were recently unemployed — recession victims who have lost their company-provided health care but don't qualify for Medicaid, the U.S. government program for disabled and impoverished Americans.
Some hadn't seen a doctor in 10 years.
They came with untreated cases of cancer, blood sugar levels that were off the charts and life-threatening hypertension. More than anything, they came with all the anxiety that goes with being sick and uninsured.
"I'm under all kinds of stress right now. I've got guys calling the house trying to collect debts. God knows what's going to happen to me next," says Cahill, who had last seen a doctor when one was operating on his heart 17 months ago.
"I read how they expect 44,000 people to die this year in America because they don't have health insurance," he says, citing a September study published in the American Journal of Public Health. "I might be one of them."
As the U.S. Congress battles over how to provide insurance to the estimated 46.3 million U.S. residents who were without health coverage last year, large-scale free clinics like the one held here this week are increasingly becoming a last resort provider.
A September clinic in Houston, Texas, drew 2,000 people. Another 1,000 people showed up at a New Orleans clinic in November, and 1,000 more came for care in Little Rock, Ark.
The huge turnout for the mass free clinics reflects a much larger demand at hundreds of smaller clinics across the country.
In 2008, more than four million patients sought out care at a free clinic in the United States. In 2009, it's estimated that number will grow to eight million, largely due to a surge in people who lost their health care along with their jobs.
"What we are trying to do is highlight the face of the uninsured," says Nicole Lamoureux, director of the National Association of Free Clinics, which is organizing the clinics. "Uninsured does not equal unemployed. These are people who are making the hard decisions about keeping food on the table and paying their bills or paying a very high insurance premium."
Cahill's brother, Glen, made that very choice. A married optometrist with two children, Glen cancelled his insurance once the premiums reached $1,000 a month and the deductible hit $5,000 a year.
He has tried to find cheaper insurance. But he was rejected by one company because his teenage son was on a prescription to treat acne, and his wife had a false positive Pap smear.
"Right now, my wife and I are living on the edge and hoping things are OK," said Glen, who hadn't been to a doctor in four years before attending the Kansas City clinic.
"It's kind of nerve wracking."
Mary Ann Vowels, 63, lost her health-care coverage in 2005 when she lost her job as — of all things — a health-insurance claims inspector. She suffers from arthritis and has digestive system problems. But she only rarely sees her doctor and leaves prescriptions unfilled to avoid piling up debt. She can't afford the $600 a month it would cost her for private insurance.
"I'm in a catch-22. If I don't get the medical care, the conditions get worse and deteriorate. If do try to get it, I go into debt up to my eyeballs," says Vowels, who saw the free clinic as a chance to address some long-neglected health concern.
"I do what I can when I can. But I know I'm basically just masking and treating symptons until such time that something gives."
Sitting next to Vowels in the clinic's waiting area, 48-year-old Michael Lopez expressed frustration with the pace of negotiations in Congress for universal health-care legislation. He's been out of work since his car broke down a couple of years ago, leaving him unable to travel to temporary jobs.
"I haven't been to a doctor to take a physical in seven years. When you ain't got insurance, you ain't got it," says Lopez, who received flu shots, dental care and a prostate exam at the clinic.
"It's a joke that I can't see a doctor in the United States of America. It's a joke. That's all I can say in polite language."
Dr. Bridget McCandless, one of about 100 physicians and nurse practitioners who volunteered their services in Kansas City, operates her own free clinic for diabetics in Independence, Mo.
"People are coming in sicker than they've ever been," says McCandless.
"In hard times, their chronic disease comes in 15th on the list of things — after child care, and a working car and living somewhere, paying utilities and dealing with banks. It's disheartening."
Many of her patients are "the new poor" who have no idea how to navigate the few safety nets available.
"For some of them, admitting that they are poor is so painful and overwhelming that they are waiting too long to engage," she says. "They have gotten to the point where the house is gone or their diabetes is completely out of control, where they have been out of medicines for three months and they realize they are not going to be able to scrounge the money to get this taken care of."
For Dennis Cahill, there's an urgency to the health-care debate that he fears lawmakers in Washington don't understand.
"Look around this place," he says, gesturing at hundreds of waiting patients. "These aren't people living in refrigerator boxes. These are everyday people, and they're all in trouble."
In four hours at the Kansas City clinic, Cahill's blood tests prompted enough concern that one doctor sent him to get an ECG. A general surgeon who examined his hernia told him he urgently needed an operation. An orthopedic surgeon arranged for a followup on his knees next week.
"I'm finding out I'm really a mess," he says. As Cahill contemplates what's next, he sees only glimmers of hope.
Under legislation that the White House hopes will pass before Christmas, health-insurance companies would be prohibited from denying coverage to people who are already sick.
But those changes might not take effect for several years, and Cahill isn't sure he has that long.
His hope is that Congress will embrace a new plan that would extend Medicare coverage — the government-run insurance plan for senior citizens — to Americans as young as 55.
"I got 2 1/2 to go before I turn 55," he says. "Whether I make it, I don't know."
Dennis Cahill had his first heart attack at home on a Saturday in August 2008.
He had his second one the following afternoon and this time — in the only bit of Irish luck he had on a truly lousy day — his brother was there to get him in an ambulance and to a hospital.
Two days later, Cahill was wheeled out of the cardiac unit in Olathe, Kan., with two stents in his heart, $83,000 U.S. in medical bills and no way to pay them.
Fifty-two years old and without any health insurance since his divorce in 2007, the self-employed construction contractor is living — by any definition — a precarious American existence.
Cahill stopped taking his medications — Plavix, Crestor and five other drugs designed to keep his heart pumping — three months ago because he no longer could afford the $1,000 a month it cost to fill the prescriptions.
A painful hernia that bulges from his abdomen has gone untreated since 2005.
And don't get Cahill started about his knees. "The world's worst knees," he says.
His right knee is swollen so badly it stretches the fabric of his faded denims, and he leans heavily on a cane as he walks. His left knee bears the scars of four surgeries performed to fix rugby injuries 26 years ago.
Cahill suspects both need to be replaced.
But there is no money and — because of his "pre-existing conditions" — Cahill hasn't found an insurance company in the country that will offer him coverage.
So with nowhere else to go, this is where Cahill has come.
He has come to a cavernous convention hall in downtown Kansas City, Mo., that volunteer doctors and nurses have transformed for two days into a massive free health-care clinic — offering everything from routine physical checkups to electrocardiograms to dental care to HIV testing and H1N1 flu shots.
In the face of the U.S. Midwest's first winter blizzard, more than 2,000 other Missourians and Kansans joined Cahill because they simply have no other health-care options.
According to organizers, about 80 per cent of the patients have jobs but lack insurance because skyrocketing premiums, deductibles and co-pays make it financially untenable.
Many others were recently unemployed — recession victims who have lost their company-provided health care but don't qualify for Medicaid, the U.S. government program for disabled and impoverished Americans.
Some hadn't seen a doctor in 10 years.
They came with untreated cases of cancer, blood sugar levels that were off the charts and life-threatening hypertension. More than anything, they came with all the anxiety that goes with being sick and uninsured.
"I'm under all kinds of stress right now. I've got guys calling the house trying to collect debts. God knows what's going to happen to me next," says Cahill, who had last seen a doctor when one was operating on his heart 17 months ago.
"I read how they expect 44,000 people to die this year in America because they don't have health insurance," he says, citing a September study published in the American Journal of Public Health. "I might be one of them."
As the U.S. Congress battles over how to provide insurance to the estimated 46.3 million U.S. residents who were without health coverage last year, large-scale free clinics like the one held here this week are increasingly becoming a last resort provider.
A September clinic in Houston, Texas, drew 2,000 people. Another 1,000 people showed up at a New Orleans clinic in November, and 1,000 more came for care in Little Rock, Ark.
The huge turnout for the mass free clinics reflects a much larger demand at hundreds of smaller clinics across the country.
In 2008, more than four million patients sought out care at a free clinic in the United States. In 2009, it's estimated that number will grow to eight million, largely due to a surge in people who lost their health care along with their jobs.
"What we are trying to do is highlight the face of the uninsured," says Nicole Lamoureux, director of the National Association of Free Clinics, which is organizing the clinics. "Uninsured does not equal unemployed. These are people who are making the hard decisions about keeping food on the table and paying their bills or paying a very high insurance premium."
Cahill's brother, Glen, made that very choice. A married optometrist with two children, Glen cancelled his insurance once the premiums reached $1,000 a month and the deductible hit $5,000 a year.
He has tried to find cheaper insurance. But he was rejected by one company because his teenage son was on a prescription to treat acne, and his wife had a false positive Pap smear.
"Right now, my wife and I are living on the edge and hoping things are OK," said Glen, who hadn't been to a doctor in four years before attending the Kansas City clinic.
"It's kind of nerve wracking."
Mary Ann Vowels, 63, lost her health-care coverage in 2005 when she lost her job as — of all things — a health-insurance claims inspector. She suffers from arthritis and has digestive system problems. But she only rarely sees her doctor and leaves prescriptions unfilled to avoid piling up debt. She can't afford the $600 a month it would cost her for private insurance.
"I'm in a catch-22. If I don't get the medical care, the conditions get worse and deteriorate. If do try to get it, I go into debt up to my eyeballs," says Vowels, who saw the free clinic as a chance to address some long-neglected health concern.
"I do what I can when I can. But I know I'm basically just masking and treating symptons until such time that something gives."
Sitting next to Vowels in the clinic's waiting area, 48-year-old Michael Lopez expressed frustration with the pace of negotiations in Congress for universal health-care legislation. He's been out of work since his car broke down a couple of years ago, leaving him unable to travel to temporary jobs.
"I haven't been to a doctor to take a physical in seven years. When you ain't got insurance, you ain't got it," says Lopez, who received flu shots, dental care and a prostate exam at the clinic.
"It's a joke that I can't see a doctor in the United States of America. It's a joke. That's all I can say in polite language."
Dr. Bridget McCandless, one of about 100 physicians and nurse practitioners who volunteered their services in Kansas City, operates her own free clinic for diabetics in Independence, Mo.
"People are coming in sicker than they've ever been," says McCandless.
"In hard times, their chronic disease comes in 15th on the list of things — after child care, and a working car and living somewhere, paying utilities and dealing with banks. It's disheartening."
Many of her patients are "the new poor" who have no idea how to navigate the few safety nets available.
"For some of them, admitting that they are poor is so painful and overwhelming that they are waiting too long to engage," she says. "They have gotten to the point where the house is gone or their diabetes is completely out of control, where they have been out of medicines for three months and they realize they are not going to be able to scrounge the money to get this taken care of."
For Dennis Cahill, there's an urgency to the health-care debate that he fears lawmakers in Washington don't understand.
"Look around this place," he says, gesturing at hundreds of waiting patients. "These aren't people living in refrigerator boxes. These are everyday people, and they're all in trouble."
In four hours at the Kansas City clinic, Cahill's blood tests prompted enough concern that one doctor sent him to get an ECG. A general surgeon who examined his hernia told him he urgently needed an operation. An orthopedic surgeon arranged for a followup on his knees next week.
"I'm finding out I'm really a mess," he says. As Cahill contemplates what's next, he sees only glimmers of hope.
Under legislation that the White House hopes will pass before Christmas, health-insurance companies would be prohibited from denying coverage to people who are already sick.
But those changes might not take effect for several years, and Cahill isn't sure he has that long.
His hope is that Congress will embrace a new plan that would extend Medicare coverage — the government-run insurance plan for senior citizens — to Americans as young as 55.
"I got 2 1/2 to go before I turn 55," he says. "Whether I make it, I don't know."