Posted on July 29, 2008

Uninsured left in the lurch


Thousands pour into SW Va. this weekend seeking free health care

Richmond Times-Dispatch
Monday, Jul 28, 2008

WISE — They have come by the thousands.

They walk through the gates of the fairgrounds, give their most personal information to complete strangers and are ushered off for a battery of tests and procedures.

An expected 3,000-plus residents of Southwest Virginia and neighboring states are here through today for one reason — to get basic medical care they couldn’t otherwise afford.

A crowd began lining up in the wee hours of Friday morning for a coveted spot inside the fences at the Remote Area Medical clinic. Some would wait days for the free service. Some would never get in.

For the majority though, organizers and doctors said, this would be the only time all year they would get medical treatment of any sort.

Remote Area Medical, based in Knoxville, Tenn., has provided medical care for the poor and uninsured in the United States and around the world since 1985.

Since Friday, volunteer doctors, optometrists, pharmacists and dentists have been helping patients during 14-hour days.

Charles Sizemore, a 68-year old retired machinist from Wise County, got in line Friday about 2 a.m. for a basic physical and to get two fillings replaced.

Sizemore raised four children in the area but never had health insurance until he got Medicare when he retired three years ago.

“I wanted to,” he said, leaning against bleachers where patients were being registered as the sun rose over the mountains. “There just wasn’t enough money. I had to take care of my family, and I never made more than $10 an hour.”

All his children have left the area for better-paying jobs, but he’s too old to move, he said playfully.

Turning serious, Sizemore said, “I don’t mean to be ungrateful. I’m glad RAM comes out and does this. But it’s just damned sad that this is the only time most of the people around here are going to see a doctor. It’s a damned shame.”

Teresa Gardner said the RAM event is vitally important.

Gardner is executive director of The Health Wagon, a nonprofit organization that provides health care for the uninsured and underinsured in Southwest Virginia. It is the local organizer for the RAM event.

“The main problem is that these people don’t have access to even the most basic health care because they can’t afford it,” she said. “And those that can afford the insurance, or get it through their companies, can’t afford to pay the co-pays or the prescriptions.”

According to the figures released this year by the U.S. Department of Commerce’s Bureau of Economic Analysis, per-capita personal income in Wise County is $25,330. That’s about $14,000 less than the state average and several thousand less than in the Richmond area. The U.S. personal per capita income is $36,714.

A study by the Southwest Virginia Graduate Medical Education Consortium paints a bleak picture about health in this part of the state. In the study, Southwest Virginia is defined as the 16-locality area between and including Lee County to the west and Bland, Wythe and Carroll counties to the east.

The study found that people living in the region are 26 percent more likely to die from heart disease, 52 percent more likely to die from pneumonia or flu and 28 percent more likely to die from diabetes than other Virginians.

About 25 percent of the area’s residents have no health insurance.

Dr. Ross Isaacs of Charlottesville said numbers such as those are frustrating because most maladies are treatable if caught early enough. Isaacs, who specializes in kidney disease, said something as simple as monitoring blood pressure can help stop most of what ails people and increase life expectancy.

“These people urgently need treatment,” he said, getting visibly angry. “We need to put our resources into fighting” to get people adequate health care in the region.

“This is what we do — we take care of people,” Isaac said. “There isn’t a cash register between me and my stethoscope, nor should there be.”

Of the more than 3,000 people who will come into the fairgrounds this weekend, the majority will be there to see dentists.

About 53 percent of people here have no dental insurance, double the rate for the rest of the state, according to a study titled Health Care in Southwest Virginia. Those who do have coverage have limited choices in dentists.

The Virginia Dental Association in Richmond made the trip with a contingent of dentists and hygienists who set up camp in the middle of the fairgrounds with rows of chairs and trays of equipment. They will take x-rays, fill cavities, make dentures and pull teeth.

By Friday at 2 p.m., almost a thousand patients were waiting on metal seats under an awning to see the dentists. The crowd was muted. A few read books, some wrangled children and a great many smoked.

Dr. Terry D. Dickinson, executive director of the dental association, said the situation in the region is worsening as the price of gas and energy remains high.

“These people need to decide whether they are going to pay the rent or buy groceries for the kids. They’re not thinking about going to the dentist. They are just trying to survive,” he said. “But that they are here tells you how much they need this. Even with $4 gas, these people made the trip.”

RAM organizers expect a record crowd this year, almost double of what they saw in 2000, the first year the expedition came to Wise. The group does a total of 16 expeditions in the U.S.

“You see some of these people coming over and over,” said Dr. Lanny R. Levenson, a Midlothian dentist.

Contact Louis Llovio at (804) 649-6348 or