Hundreds of low-wage and poor residents received free dental, vision and other medical care over the weekend at a medical clinic in Charleston, West Virginia sponsored by the Remote Area Medical Volunteer Corps and West Virginia Health Right. The makeshift clinic, held in a local middle school, attracted residents in dire need of health care from the depressed coal mining counties in southern West Virginia and other areas, with patients traveling as long as three hours to get care.
Patients arrived as many as 12 hours early and camped out in their cars or sleeping bags before the event opened Saturday at 6 a.m. Many had not had access to dental or vision care for years, although infected teeth and gums can produce sepsis, a potentially life-threatening organ dysfunction.
Patients could be seen coming in with oxygen tanks, canes and walkers. The event attracted young and old from a state suffering an acute health care crisis bound up with deep poverty, the proliferation of low-paying jobs without health insurance and an opioid drug epidemic, which has resulted in the highest drug overdose death rate in America. The life expectancy in the state,75.4 years, is the second to last in the United States, with only Mississippi worse.
The event gave a real picture of the scale of human suffering in the United States that is barely reported in the corporate-controlled media, which is obsessed with the rising stock market and claims any serious exposure of America’s social ills must be due to the work of Russian agents creating discord and chaos. It also revealed the disastrous conditions that prevail under Obama’s Affordable Care Act, which will only be exacerbated by the Trump administration’s planned attack on Medicaid and Medicare.
Organizers said 512 patients were seen over the space of two days and services valued at $221,249 were dispensed free of charge, including some 400 pairs of glasses. Patients also received general medical exams, women’s health exams, dental cleanings and extractions, eye exams, prescriptions and eyeglasses, as well as educational information on drug addiction and training in the use of Naloxone, a life-saving drug that counteracts the effects of opioid overdose.
The clinic was manned by 548 volunteers, including 11 medical doctors, 11 eye doctors, 22 dentists, 43 nurses and nine hygienists. There were also dozens of dental, optometry and other medical students from West Virginia University, Ohio State University, Slippery Rock University in Pennsylvania, and other colleges. In a model of efficiency, the dedicated and hard-working health care professionals and support staff screened patients at a triage center set up in the school’s main hallway. Dental fillings and extractions were performed at dozens of portable dental stations set up in the gymnasium. The school’s chapel served as a center for eye examinations, and glasses were made to order in a mobile high-tech trailer. Though on a small scale, the well-coordinated operation gave a glimpse of what would be possible if medicine were not subordinated to private profit.
Angie Settle, the executive director of Health Right, a Charleston-based free and charitable health clinic that sees 20,000 patients annually, told the WSWS, “We’re proud of the work we did but there are still tons of people who need help. I got 80 people telling me on Facebook that they couldn’t make it because they couldn’t get the gas or transportation to come up here, or the childcare. There is so much need we could be doing this all day, every day,” she said.
West Virginia, which has a 17.9 percent poverty rate, is one of the 31 states that expanded Medicaid for low-income recipients and children under Obama’s Affordable Care Act. The number of state residents enrolled in Medicaid has jumped by 57 percent since 2013 and there are now 564,000 residents, or 29 percent of the population enrolled, the highest percentage in the nation.
While the number of uninsured has fallen, the state’s expanded Medicaid program does not cover vision care or preventative dental care, Settle said, and will only pay dentists for emergency tooth extractions. “A lot of times people come to our office with one tooth that’s deemed an emergency, three that are really bad but not quite emergent and three that need filling and a cleaning. Our clinic will do all of that for free, while a dental office will only do the one deemed an emergency. So, we have really bad oral health in our state. We do a lot of prevention, which is totally against the theology of private medicine.”
The state’s Medicaid program covers adults with incomes up to 138 percent of the poverty level—which is officially $24,563—and pregnant women with incomes up to 158 percent of poverty. Children in households with incomes up to 300 percent of poverty level are eligible for CHIP (Children’s Health Insurance Program).
Settle pointed to the Catch 22 faced by low-paid workers who make just above the threshold to qualify for Medicaid. They were either uninsured or had to pay huge deductibles and co-pays under the private insurance plans mandated under Obamacare. There were nearly 700,000 West Virginians described as near-poor or living below twice the poverty line in 2016.
“Suddenly Obamacare came in and we expanded Medicaid for the low-income, but then you have the working poor, which are the people with two and three part-time jobs, working at McDonalds and washing cars, and their income level is too high for Medicaid,” Settle said. “They don’t get insurance from their employer, or if they do, like at Walmart, it is so expensive and out of their range, they don’t get it. We heard all of this great stuff: ‘Go on the market place, there are subsidies and this and that.’ Well that’s great if you get the subsidies and the card, but a lot of times, the plans are only catastrophic plans. They are $5,000 or $10,000 deductibles before you get a penny in insurance. A lot of our patients are on 12 different medications and have to pay a $20-25 deductible for each one. That’s impossible when they’re living on $800 a month.
“They raised the minimum wage in the state, which is great, but suddenly you don’t qualify for Medicaid any more. Back in the day, when there was no insurance, it was the poorest of the poor, which we still see. But now, we have a new layer that needs help, and it’s the working poor. Eighty-three percent of our patients are employed.”
The WSWS spoke with several patients at the free clinic about what brought them there. Melissa, an elementary school teaching assistant, told the WSWS, “I’ve had to work two jobs since my husband retired after 30 years with the Kanawha schools. I’m making $24,000, and we can’t afford medical care. That’s why I’m here.
“The big corporations don’t care about the little man that makes them all the money. My granddad died in the coal mines, and my cousin Dillard Persinger was killed at the Upper Big Branch mine disaster in 2010. He left behind two little boys. [AT Massey CEO Don] Blankenship only thought about making more money, not the children. It was selfish greed.” Referring to the attack on health care by the Obama and Trump administrations, Melissa said, “I’ve always said, the Republicans stick it to you while they look you in the face, while the Democrats do it to you behind your back—it’s all the same.”
Dawnette, a former health care worker who was getting care at the clinic, described the social changes that had taken place since she was young. “When I graduated from college with an associate degree, I was able to get a very good job. But now our young adults are coming out of college without any hope of really getting a job that pays them what they are worth. It’s not like it was. Coal is our livelihood here. But over the past 20 years, all of these mines have shut down, along with affiliated companies. For jobs that pay well, you have to go out of state.
“My children are challenged with things that I was never challenged with. Two of my niece’s close friends overdosed on opioids and died. These young adults have been at my home, and I was at their funerals. They came from good families and good homes. I have a son in college, and I’m very concerned about him. I want it out of here! This drug problem is everywhere you go, it doesn’t matter what neighborhood you live in.”
James, a West Virginia state worker, told the WSWS, “My insurance will pay 80 percent of my wife’s medical bills, but I have to come up with 20 percent out of my pocket. I’ve been working for the state of West Virginia for 38 years, and I don’t make enough.”
His wife Cindy said, “We choose between food and going to the doctor to get help. We just don’t have it. No one knows what that’s like, you have to be there. Without this [free clinic], I would never get any dental care whatsoever, no eye care whatsoever. I probably would just die and never have it.”
James added, “They don’t think about the people, they just think about what they can put in their pockets, and I don’t think that’s right.” Commenting on the lower life expectancy rate in the state, James said, “I’m hitting 63. If they would take care of us we’d live longer. Actually, I think the government is trying to kill us off.”