The brutal truth about America's healthcare

[Guest guest]

An extraordinary report from Guy Adams in Los Angeles at the music arena that

has been turned into a makeshift medical centre

 

http://www.independent.co.uk/news/world/americas/the-brutal-truth-about-americar\

squos-healthcare-1772580.html

 

 

They came in their thousands, queuing through the night to secure one of the

coveted wristbands offering entry into a strange parallel universe where medical

care is a free and basic right and not an expensive luxury. Some of these

Americans had walked miles simply to have their blood pressure checked, some had

slept in their cars in the hope of getting an eye-test or a mammogram, others

had brought their children for immunisations that could end up saving their

life.

 

In the week that Britain's National Health Service was held aloft by Republicans

as an " evil and Orwellian " example of everything that is wrong with free

healthcare, these extraordinary scenes in Inglewood, California yesterday

provided a sobering reminder of exactly why President Barack Obama is trying to

reform the US system.

 

The LA Forum, the arena that once hosted sell-out Madonna concerts, has been

transformed - for eight days only - into a vast field hospital. In America, the

offer of free healthcare is so rare, that news of the magical medical kingdom

spread rapidly and long lines of prospective patients snaked around the venue

for the chance of getting everyday treatments that many British people take for

granted.

 

In the first two days, more than 1,500 men, women and children received free

treatments worth $503,000 (£304,000). Thirty dentists pulled 471 teeth; 320

people were given standard issue spectacles; 80 had mammograms; dozens more had

acupuncture, or saw kidney specialists. By the time the makeshift medical centre

leaves town on Tuesday, staff expect to have dispensed $2m worth of treatments

to 10,000 patients.

The gritty district of Inglewood lies just a few miles from the palm-lined

streets of Beverly Hills and the bright lights of Hollywood, but is a world

away. And the residents who had flocked for the free medical care, courtesy of

mobile charity Remote Area Medical, bore testament to the human cost of the

healthcare mess that President Obama is attempting to fix.

 

Christine Smith arrived at 3am in the hope of seeing a dentist for the first

time since she turned 18. That was almost eight years ago. Her need is obvious

and pressing: 17 of her teeth are rotten; some have large visible holes in them.

She is living in constant pain and has been unable to eat solid food for several

years.

 

" I had a gastric bypass in 2002, but it went wrong, and stomach acid began

rotting my teeth. I've had several jobs since, but none with medical insurance,

so I've not been able to see a dentist to get it fixed, " she told The

Independent. " I've not been able to chew food for as long as I can remember.

I've been living on soup, and noodles, and blending meals in a food mixer. I'm

in constant pain. Normally, it would cost $5,000 to fix it. So if I have to wait

a week to get treated for free, I'll do it. This will change my life. "

 

Along the hall, Liz Cruise was one of scores of people waiting for a free eye

exam. She works for a major supermarket chain but can't afford the $200 a month

that would be deducted from her salary for insurance. " It's a simple choice: pay

my rent, or pay my healthcare. What am I supposed to do? " she asked. " I'm one of

the working poor: people who do work but can't afford healthcare and are

ineligible for any free healthcare or assistance. I can't remember the last time

I saw a doctor. "

 

Although the Americans spend more on medicine than any nation on earth, there

are an estimated 50 million with no health insurance at all. Many of those who

have jobs can't afford coverage, and even those with standard policies often

find it doesn't cover commonplace procedures. California's unemployed - who rely

on Medicaid - had their dental care axed last month.

 

Julie Shay was one of the many, waiting to slide into a dentist's chair where

teeth were being drilled in full view of passers-by. For years, she has been

crossing over the Mexican border to get her teeth done on the cheap in Tijuana.

But recently, the US started requiring citizens returning home from Mexico to

produce a passport (previously all you needed was a driver's license), and so

that route is now closed. Today she has two abscesses and is in so much pain she

can barely sleep. " I don't have a passport, and I can't afford one. So my

husband and I slept in the car to make sure we got seen by a dentist. It sounds

pathetic, but I really am that desperate. "

 

" You'd think, with the money in this country, that we'd be able to look after

people's health properly, " she said. " But the truth is that the rich, and the

insurance firms, just don't realise what we are going through, or simply don't

care. Look around this room and tell me that America's healthcare don't need

fixing. "

 

President Obama's healthcare plans had been a central plank of his first-term

programme, but his reform package has taken a battering at the hands of

Republican opponents in recent weeks. As the Democrats have failed to coalesce

around a single, straightforward proposal, their rivals have seized on public

hesitancy over " socialised medicine " and now the chance of far-reaching reform

is in doubt.

 

Most damaging of all has been the tide of vociferous right-wing opponents

whipping up scepticism at town hall meetings that were supposed to soothe

doubts. In Pennsylvania this week, Senator Arlen Specter was greeted by a crowd

of 1,000 at a venue designed to accommodate only 250, and of the 30 selected

speakers at the event, almost all were hostile.

 

The packed bleachers in the LA Forum tell a different story. The mobile clinic

has been organised by the remarkable Remote Area Medical. The charity usually

focuses on the rural poor, although they worked in New Orleans after Hurricane

Katrina. Now they are moving into more urban venues, this week's event in Los

Angeles is believed to be the largest free healthcare operation in the country.

 

Doctors, dentists and therapists volunteer their time, and resources to the

organisation. To many US medical professionals, it offers a rare opportunity to

plug into the public service ethos on which their trade was supposedly founded.

" People come here who haven't seen a doctor for years. And we're able to say

'Hey, you have this, you have this, you have this', " said Dr Vincent Anthony, a

kidney specialist volunteering five days of his team's time. " It's hard work,

but incredibly rewarding. Healthcare needs reform, obviously. There are so many

people falling through the cracks, who don't get care. That's why so many are

here. "

 

Ironically, given this week's transatlantic spat over the NHS, Remote Area

Medical was founded by an Englishman: Stan Brock. The 72-year-old former public

schoolboy, Taekwondo black belt, and one-time presenter of Wild Kingdom, one of

America's most popular animal TV shows, left the celebrity gravy train in 1985

to, as he puts it, " make people better " .

 

Today, Brock has no money, no income, and no bank account. He spends 365 days a

year at the charity events, sleeping on a small rolled-up mat on the floor and

living on a diet made up entirely of porridge and fresh fruit. In some quarters,

he has been described, without too much exaggeration, as a living saint.

 

Though anxious not to interfere in the potent healthcare debate, Mr Brock said

yesterday that he, and many other professionals, believes the NHS should provide

a benchmark for the future of US healthcare.

 

" Back in 1944, the UK government knew there was a serious problem with lack of

healthcare for 49.7 million British citizens, of which I was one, so they said

'Hey Mr Nye Bevan, you're the Minister for Health... go fix it'. And so came the

NHS. Well, fast forward now 66 years, and we've got about the same number of

people, about 49 million people, here in the US, who don't have access to

healthcare. "

 

" I've been very conservative in my outlook for the whole of my life. I've been

described as being about 90,000 miles to the right of Attila the Hun. But I

think one reaches the reality that something doesn't work... In this country

something has to be done. And as a proud member of the US community but a loyal

British subject to the core, I would say that if Britain could fix it in 1944,

surely we could fix it here in America.

 

Healthcare compared

 

Health spending as a share of GDP

 

US 16%

 

UK 8.4%

 

Public spending on healthcare (% of total spending on healthcare)

 

US 45%

 

UK 82%

 

Health spending per head

 

US $7,290

 

UK $2,992

 

Practising physicians (per 1,000 people)

 

US 2.4

 

UK 2.5

 

Nurses (per 1,000 people)

 

US 10.6

 

UK 10.0

 

Acute care hospital beds (per 1,000 people)

 

US 2.7

 

UK 2.6

 

Life expectancy:

 

US 78

 

UK 80

 

Infant mortality (per 1,000 live births)

 

US 6.7

 

UK 4.8

 

Source: WHO/OECD Health Data 2009