Desperate for health care

August 31, 2009

When news came in mid-August that free medical services would be available at the Los Angeles Forum, thousands lined up outside the arena for care. Laura Durkay reports on what patients and providers had to say about the state of health care in America.

FOR EIGHT days in August, the Forum in Los Angeles' Inglewood neighborhood--the former home arena of the Lakers and host of mega-concerts by the likes of Madonna--was transformed into a strange parallel universe, where health care was available to all, free of charge and with no questions asked.

Remote Area Medical (RAM), a charity organization that began by providing free medical services to rural communities in the developing world, had chosen Los Angeles for its first-ever mobile clinic in a major American city.

Word spread quickly that from August 11 to 18, a small army of volunteer doctors, nurses, dentists and optometrists would be offering completely free medical, dental and vision care to anyone who showed up.

Patients weren't asked for proof of employment, insurance or citizenship status, and were only required to give enough medical history in order to be treated safely. Remote Area Medical was effectively conducting a small-scale experiment in free universal health care.

If you were to believe the right-wing hysteria about the dangers of socialized medicine, you'd expect scenes of chaos and depravity inside the Forum. But on the floor of the giant stadium, things were calm, quiet and remarkably efficient. Hundreds of patients waited calmly in the stadium seats or on folding chairs. On one side of the floor, dentists provided teeth cleanings, fillings and root canals at long rows of makeshift dental stations.

Volunteer dentists provide care on the floor of the Great Western Forum in Los Angeles
Volunteer dentists provide care on the floor of the Great Western Forum in Los Angeles

On the other side, behind large mobile health care trucks that had been driven into the stadium, optometrists performed eye exams and wrote prescriptions for new glasses, which patients could pick out from a large selection laid out on long tables. Medical exams, mammograms, gynecological care and other services were conducted in a slightly more private setting under the stands.

Breakfast, lunch and dinner were available for volunteers, although food and coffee sometimes went to patients who had been waiting a long time, particularly people with small children. The volunteer medical staff treated patients at a rate of up to 1,500 people per day, yet the atmosphere was calmer than any doctor's office waiting room.

THE RAM clinic provided something of a glimpse of what health care could look like in a system that simply connected medical professionals with those in need, without putting corporate profits in the middle.

Even more, the sight of hundreds of people lining up at the doors of one of the most famous stadiums in the U.S. exposed the staggering inadequacy of America's current health care system, where some 50 million people are uninsured.

By midnight before the first day of the clinic, a Tuesday, crowds had already begun to flood the Forum parking lot. Before dawn, all 1,500 tickets for the first day's appointments had been given out, and hundreds of people had to be turned away and told to come back the next day. Many chose not to take their chances, and spent the day in their cars or camped out on the sidewalk, waiting for the next line to form.

"This is our third attempt," said Irma, who was in line with a friend on Thursday. "We came Monday night and didn't even get out of our cars. Then we came the next day at 4 p.m., and they were out of tickets. I feel for the people who can't leave their jobs to come here. People shouldn't have to choose whether to feed their kids or get shots."

By Thursday afternoon, colored wristbands corresponding to appointments on Sunday and Monday were already being disbursed, and at 4:30 a.m. on Saturday morning, the electronic sign outside the Forum displayed a message reading, "Remote Area Medical event is full. All tickets have been given out."

Vision and dental care were among the most requested services--especially since state legislators recently eliminated those services from Medi-Cal, California's government-funded health insurance program for the poor.

While many of those seeking health care came from the surrounding neighborhood of Inglewood, a majority Black and Latino community directly under the flight path of planes landing at LA International Airport, some came from as far away as Orange County. For some, it would be their first visit to a doctor in years.

Joe Price, an emergency medical technician volunteering inside the Forum, spoke about an elderly, wheelchair-bound woman he met--she had been able to get new glasses for the first time in 20 years, and told Price, with tears in her eyes, that tonight she would be able to read her Bible.

He had also met a truck driver with untreated diabetes, who was terrified of failing his next Department of Transportation-mandated physical and losing his job. "Health care is a right; it's not a class privilege," Price said. "Getting health care by lotto, because you stood in line, is not the way it should be."

Many people waiting in the rows of stadium seats set up in the Forum parking lot in the early hours of Saturday morning had recently lost their health insurance when they lost their jobs. Others had insurance--but the services they needed weren't covered or were prohibitively expensive.

Barbara, a retiree who was number 309 in line on Saturday morning, had health insurance through the Teamsters union. But she said her Kaiser Permanente dental plan was unaffordable.

"They were going to charge me $629 for teeth cleaning and another $600 for a filling," Barbara said. The insurance companies aren't the only ones to blame, she added. "The drug companies are like drug dealers. They don't want you to get well. They always say 'We can treat that,' not 'We can cure that.'"

Darla, who was also waiting in line on Saturday morning, works for KTLA, a major Los Angeles television station. "A lot of people here have jobs," she said. "I'm permanent, but I'm part-time. I can't afford the health care plan that's available to me."

Some 25 million people in the U.S. who are underinsured, meaning that they spend over 10 percent of their annual income on health care. Medical problems contributed to some 62 percent of all bankruptcies in 2007, according to a recent survey published in the American Journal of Medicine.

Theresa was a cafeteria worker at Westchester High School in nearby Playa del Rey until earlier this year, when she was diagnosed with multiple sclerosis and had to stop working. She had been trying since Wednesday to secure an appointment, sleeping in her truck one night and even offering to volunteer in exchange for a guaranteed place.

By Saturday morning, she finally had a spot in line for her and her daughter--they had numbers 599 and 600, the last two spots given out on Saturday. Although she had come for vision and dental care, she was considering getting chiropractic services instead, since she had heard the lines were shorter.

Angel, who was on her second day of waiting for dental care and had camped out on the sidewalk, said, "I wish that Obama had a better process for trying to change health care. You can't do it without offending the insurance companies. Offend the insurance companies already!"

WHILE THE scenes inside the Forum were moving, everyone involved knew they were meeting only a tiny fraction of the overwhelming need around them.

There are an estimated 2.7 million people without health insurance in Los Angeles--meaning that even if this clinic ran at full capacity for all eight days and served only uninsured patients from the Los Angeles metro area, it would reach less than one-half of 1 percent of those without insurance. And on many days, the clinic suffered from a lack of volunteer doctors and dentists.

On Saturday, for example, only 600 appointment tickets were given out instead of the maximum of 1,500. Because of state regulations, only doctors licensed in California were allowed to volunteer, so medical professionals who arrived from other states to help were sometimes told all they could do was answer phones.

The scenes at the Forum show that the debate in Congress and in town hall meetings across the country hasn't even scratched the surface of the radical overhaul needed to fix the American health care system.

When thousands of people have to depend on a charity organization for health care in the world's richest nation, change is long overdue. "It's like Willy Wonka," said Joe Price, as he surveyed the line outside the Forum. "Everyone's waiting for a golden ticket. Americans deserve a better health care system than Charlie and the Chocolate Factory."

Sarah Knopp, Kurt Krueger and Katie Miller contributed to this article.

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