US healthcare: Profits before patients

What is the point of having the world’s best medical facilities if citizens don’t have the money to access healthcare?

As many as 45,000 people in the US die every year because they can’t afford healthcare [Photo: Rose Aguilar]

When Stan Brock started Remote Area Medical (RAM) in 1985, never in his wildest dreams did he think his services would be needed in the United States, the wealthiest country in the world.

RAM began as an all-volunteer mobile medical clinic that provided free and immediate health care to people living in remote areas of the Amazon rainforest. In 1992, he was asked to bring the clinic to Knoxville, Tennessee. He was shocked by what he saw.

“People were in desperate need of the most basic care,” he said at RAM’s most recent expedition in Oakland, California last month. “It didn’t occur to me when I first came to this country, but it wasn’t long before I could see there were similarities between people who don’t have access to healthcare in a place like the Amazon and people who have access but can’t afford it in America – and they’re all in the same boat.”

An estimated 50 million Americans are uninsured and another 25 million are underinsured, meaning they can’t pay the difference between what their insurance will cover and the total cost of their medical bills. Someone files for bankruptcy every 30 seconds in the US because of a serious health problem, according to a Harvard University study.

Since 1992, RAM has conducted 640 expeditions in the US. When the travelling medical clinic comes to town, the lines begin forming at around midnight. An average of 3,000 people are treated at a typical four-day event. Over 90 per cent of the patients are in desperate need of basic dental and vision care. Each clinic costs roughly $100,000 to run, requires over 1,000 volunteers, and takes an entire year to organise.

When patients entered the clinic at the Oakland Coliseum, they were greeted by smiling volunteers, rows upon rows of dental chairs, optometric stations, and tables covered with medical tools, gloves, and equipment.

When Milka Guiterrez heard that free healthcare was being offered, she moved her schedule around to get a good place in line. On Sunday night, long after her three kids were sound asleep, she left her house at 1am. She was number 474 in line.

Shortly before patients began entering the makeshift clinic five hours later, Guiterrez ran home, grabbed her kids, and returned with her fingers crossed. She got lucky.

She and her kids had eye exams and dental work. Her eight-year-old daughter Paloma was in pain from the drilling, but managed to crack a smile. “When I used to smile, there was yellow stuff everywhere,” she said wiping away tears. “I was so embarrassed. I stopped smiling when I was six. It hurts, but now I’m happy.”

After 12 years with the US Postal Service, Anita Moore was hurt on the job and lost her health insurance. She got in line at 3:30am. By 6pm, she had her eyes checked, her teeth cleaned, two fillings, and four extractions.

Six months ago, she had an injury and hasn’t been able to lift her arms above her shoulders. The pain went away after 15 minutes of acupuncture at the clinic. “I was so happy because I couldn’t lift. I was just shocked. Now I can move them around,” she said. “It’s a blessing.”

Les Kuller, an unemployed construction worker who got in line at 5:30am, lost his health insurance when his wife passed away two years ago. He got a molar fixed, had his blood pressure checked, was given a pair of eyeglasses, and had chiropractic and physical therapy work. He was so touched by the care he received and the volunteers he met, he came back the next day to join them.

“The least I could do is give back,” he said. “On one hand, this is so incredibly amazing that all these volunteers can pull this together. On the other hand, it’s a sad commentary about what the hell is going on in Washington and why the hell these knuckleheads can’t walk across the aisle and shake hands and figure this thing out.”

Kuller says he hopes people standing in overnight lines for basic medical care “embarrasses the hell” out of politicians. I heard similar sentiments from several people receiving care at the clinic.

When profit comes before care

Democratic politicians proudly point to the Patient Protection and Affordable Care Act, the bill that was signed by President Obama in March 2010, as real progress, but Physicians for a National Health Program (PNHP), an organisation of doctors who support healthcare for all, say the bill is nothing more than a false promise of reform.

Instead of eliminating the real problem, the new legislation will enrich and further entrench the profit-driven, private health insurance industry, and leave 23 million people still uninsured in 2019, according to PNHP.

If Republicans have their way, the 45 million seniors and people with disabilities who rely on Medicare will see their out-of-pocket costs double – or do without treatment altogether. 

RAM founder Stan Brock doesn’t like to talk about politics. He’s too busy making sure people get treated. RAM’s next stop is in Pikeville, Kentucky. From there, he and his team will head to Cocke County, Tennessee, Wise County, Virginia, and Chicago, Illinois. Because he’s has had so many requests from all over the country, he sees no end in sight.

This is what happens when profit comes before care.

UnitedHealth’s first quarter profits this year rose 13 per cent to $1.35 billion from $1.19 billion last year. UnitedHealth CEO Stephen Hemsley’s total compensation of $101.96 million last year made him the highest paid executive in the country.

The US is the only major country in the industrialised world that doesn’t guarantee healthcare to all of its citizens. It’s unconscionable that 45,000 people in the US die every year because they can’t afford care.

Senator Bernie Sanders, an independent from Vermont who believes that the US should put patients over profits, recently re-introduced the American Health Security Act, which would provide every citizen with healthcare coverage through a state-administered, single payer program.

Here’s a fact from the PNHP that never made its way through the noise machine during the so-called healthcare debate – which was shaped by the insurance industry from the beginning. It should be repeated over and over again. the bureaucracy and paperwork of the profit-making health insurance industry consume one-third of every healthcare dollar.

Streamlining payment through a single-payer system would save more than $400 billion per year – which is enough to provide comprehensive, high-quality coverage for all.

RAM’s Stan Brock says a single-payer system, as long as it covers dental and vision, would put him out of business in the US. “That would allow us to go back to the Amazon, Central America, Haiti – and other places where we belong.”

Rose Aguilar is the host of Your Call, a daily call-in radio show on KALW in San Francisco. She’s the author of “Red Highways: A Liberal’s Journey into the Heartland.”

The views expressed in this article are the author’s own and do not necessarily represent Al Jazeera’s editorial policy.