Brutal truth about US healthcare

Saturday, 15 August 2009

An extraordinary report from Guy Adams in Los Angeles at the music arena that has been turned into a makeshift medical centre

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

This article made for interesting reading. This rich country compares to a Banana Republic when it comes to health care for the working poor. The main problem is that the American public is being lied to about the European Public Health Care System.
Mainly by Republicans. Why is that? Why doesn't anyone show during prime time how the system works, for example, in Germany and other European countries? Once they would air those facts, I doubt it that many Americans would oppose such a system. Health care should be a birth right.

Posted by alex hammer | 19.09.09, 03:26 GMT

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America as has thei highest rure rates for serious disease in the entire world....something to think about.

Posted by matt | 10.09.09, 12:15 GMT

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Lulu said, "You pay for it through a heavy taxation, which in turn impacts what you can afford to buy, such as a house, a car, food, etc." - Do any of these things matter if you can't get the medicine or treatment you need?

Food for thought - The Philippines has a nation health insurance program. Is it optimal? No. It is a 3rd world nation. However, if you mean to tell me that a nation where a quarter of it's people live in nipa (bamboo) huts with no running water and electricity can at least grasp the idea of providing health care and the US which tells all of us on a daily basis how we are the best nation in the world can't make anything health care related happen, you're nuts.

What I am seeming from the opposition is people who for one do not want to get adequate health care and two, would rather give all of their money they put towards health care to go directly into the pockets of the insurance CEO's. I would rather not "donate" my money to the fat cat's club.

Posted by Ryan | 22.08.09, 14:30 GMT

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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

TWO QUESTIONS

Who is being quoted above - "evil and Orwellian" - can you provide the source - or is this your interpetation

and who is enjoying "free" healthcare

( maybe one of the reasons the NHS is portrayed as Orwellian is your propensity to call it "free" - up is down, black is white, 2+2=5 - and a taxpayer funded service is "free" - oh yes - Winston would have understood it )

Posted by Pogue Mahone | 18.08.09, 16:39 GMT

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To Lulu.
SELFISH!!!

Posted by steve | 18.08.09, 13:53 GMT

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LULU Said: "We Americans object to socialized medicine and Obama's poorly thought out healthcare reform bill. We look at England's healthcare and shudder. You pay for it through a heavy taxation, which in turn impacts what you can afford to buy, such as a house, a car, food, etc. We're rapidly losing respect for our president and his idiotic ideas on healthcare!"
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Ummmm, I'm an American and agree with nothing you said in your post, so please don't try and impose your ignorant ideas upon the rest of "we Americans".

Posted by LeFish | 18.08.09, 13:34 GMT

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The biggest problem in the USA is the sensational coverage of the media. Anchor people and moderators push those interviewed to explode and then cut off calm answers from the other guests. They never ask. " which section of the health care bills being debated is that in? "
Supposedly there are pdf versions of the bills out there on the internet but they never tell us where. The news puveyors would rather get everyone stirred up rather than help us make corrections.

Posted by John | 17.08.09, 19:11 GMT

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I have often described the country of my birth as a brutal and barbaric place to live and the failure of our health care system to deliver basic care to the whole population is a classic manifestation of my assertion above. I feel like a stranger in my own country, we have only one political party "The Corporate One" with 2 wings, Democrats/Republicans. they both suck off the teat of corporate slush money so it's no big deal that real reform doesn't get done. The American people are too stupid and dumbed and sheepish to rise up and overthrow this corrupt, so I've lost any hope that the situation will improve anytime soon.

Posted by Dan smith | 17.08.09, 11:14 GMT

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Thank you for posting this. I'll bet we won't see any of this here in the States. All we hear are the crazy lies that the opponents of Obama's proposal are spewing. One commenter to this article said that people just have to go to an ER to be treated here, when that isn't quite accurate. Only if it's a public hospital, and for life sustaining treatment. They don't have to treat you otherwise. Some hospitals are sending patients by taxi to other hospitals because they don't want to treat the, particularly the indigent.

Also to rebutt the person who spoke about dental care, I have health insurance, and one of the best in the US, but I still have to pay dearly out of pocket for dental care. Right now I have work to be done that will cost several thousand dollars that I can't afford, so I have to put it off.

Posted by Sissy | 17.08.09, 06:47 GMT

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We Americans object to socialized medicine and Obama's poorly thought out healthcare reform bill. We look at England's healthcare and shudder. You pay for it through a heavy taxation, which in turn impacts what you can afford to buy, such as a house, a car, food, etc. We're rapidly losing respect for our president and his idiotic ideas on healthcare!

Posted by LuLu | 17.08.09, 04:14 GMT

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It makes me want to cry when I read such true stories found in the foreign Media, such as yours,
with facts about our great Medical Health Care
non system!
Stories which are hard to find in numerous areas of the USA, as the local small newspapers are full of Medical advertisements, local sport news, babies born, and Bio of our departed!
Too numerous Americans, are under the believe that our Medical System is the best in the World.And it explains why all the screeming and pushing!!!

Posted by Krapotkin | 17.08.09, 03:59 GMT

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Did the reporter ask the people what they were doing with their money instead of going to the dentist? I've never had dental insurance and have always managed to go to the dentist on my ordinary office job income. I'd bet they had plenty of money for lottery tickets and junk food. Signed: East Coat American

Posted by CAROL | 17.08.09, 01:50 GMT

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There is free health care! All you have to do is go to the local clinic/emergency room-hospital. The hospital cannot turn you away! It is Fedral Law! They must treat you regardless of insurance.
Obama Care, wants to enforce obligatory end of life counseling after the age of 65. Tax payer funded abortions on demand, contraception on demand and sex education taught by the government. Should that not be the right of parents to instill morals, values and ethics! Its Government by the people. Not government of the people by buracratic grey men!

Posted by Stephen | 16.08.09, 20:43 GMT

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Thank you for this article. Nothing as intelligent and comprehensive is written on the subject here in the US. This is exactly what is going on and so many on the right do not see and do not care. The greatest country in the world is shooting itself in the foot and doesn't even get to hear about it from our news organizations. Instead they are making fun of Bill Clinton and Hillary Clinton for remarks that many agree with. They cover it like a boxing match instead of the important issue that it is.

Posted by janet | 16.08.09, 19:24 GMT

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I would become a british citizen for healthcare.

Posted by Ryan | 16.08.09, 15:25 GMT

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The right wingers claim to be "bible believing Christians" in the main but then oppose universal health coverage for the poorest and weakest as they're afraid of "socialism"

If there was ever a good example of cognitive dissonance, this is it.

Posted by Dublin | 15.08.09, 15:18 GMT

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