Ap­palachian poor seek free care

The Expositor (Brantford) - - LIFE -


WISE, Va. — They ar­rived at a fair­ground in a deep cor­ner of Ap­palachia be­fore day­break, hun­dreds of peo­ple with throb­bing teeth, fail­ing eyes, wheez­ing lungs. They took a num­ber, sat in the bleach­ers and waited in the sum­mer heat for their name to be called so they could re­ceive the med­i­cal help they can’t get any­where else.

Among the visi­tors at the free, once-a-year med­i­cal clinic was Lisa Kantsos, whose first stop was the den­tal tent — a sprawl of ta­bles and chairs where vol­un­teer den­tists and stu­dents per­formed clean­ings, filled cav­i­ties and pulled teeth. Af­ter get­ting a clean­ing, she made a stop at a mam­mog­ra­phy van. Last year, it was free glasses.

“It’s a bless­ing. It re­ally is,” said Kantsos, a 52-year-old di­a­betic, “be­cause I don’t have to worry about th­ese things.”

Kantsos and many of the es­ti­mated 2,000 oth­ers who turned out at the Wise County Fair­grounds in late July are the health care de­bate’s for­got­ten.

Even with the pas­sage of “Oba­macare” in 2010, they have no in­sur­ance be­cause they ex­ist in a des­per­ate in-be­tween zone, un­able to af­ford cov­er­age but in­el­i­gi­ble for Med­i­caid. And be­cause they haven’t ben­e­fited from the Af­ford­able Care Act, the de­bate on Capi­tol Hill over re­peal­ing it has been all but ir­rel­e­vant to them.

“Whether there was an Af­ford­able Care Act or not, it re­ally hasn’t made any dif­fer­ence for th­ese peo­ple,” said Stan Brock, who founded the free trav­el­ling Re­mote Area Med­i­cal Clinic in the 1980s.

The need for bet­ter, more af­ford­able care around here is un­de­ni­able.

The cen­tral Ap­palachian area that in­cludes east­ern Ken­tucky, south­ern West Vir­ginia and western Vir­ginia has long been one of the sick­est and poor­est re­gions in the coun­try. More re­cently, it has been rav­aged by the de­cline of coal min­ing.

“Ev­ery­thing re­volved around coal,” said Matt Suther­land, a fre­quent vis­i­tor to the clinic from Castle­wood, Vir­ginia. “Now there’s not a lot of work, not a lot for peo­ple to do.”

Peo­ple in cen­tral Ap­palachia are 41 per cent more likely to get di­a­betes and 42 per cent more likely to die of heart dis­ease than the rest of the na­tion, ac­cord­ing to a study re­leased in Au­gust by the Ap­palachian Re­gional Com­mis­sion and other groups. The study also found that the re­gion’s sup­ply of spe­cialty doc­tors per 100,000 peo­ple is 65 per cent lower than in the rest of the na­tion.

And peo­ple from south­west­ern Vir­ginia die on av­er­age 10 years sooner than those from wealth­ier coun­ties close to Wash­ing­ton, said Au­gust Wallmeyer, an au­thor who lob­bies the Vir­ginia leg­is­la­ture on health is­sues.

Opioids are also tak­ing their toll in Ap­palachia. In Vir­ginia in 2014, drug over­doses be­came the No. 1 cause of ac­ci­den­tal death, ac­cord­ing to Wallmeyer’s 2016 book, “The Ex­tremes of Vir­ginia.”

But Vir­ginia was among 19 states that chose not to ex­pand Med­i­caid as part of the Af­ford­able Care Act. Many states cited the cost, even though Wash­ing­ton pledged to pick up nearly the en­tire ex­pense. An ex­pan­sion in Vir­ginia would have cov­ered an ad­di­tional 400,000 peo­ple.

“A lot of peo­ple, when the Af­ford­able Care Act was first en­acted and went into ef­fect, had the mis­taken be­lief that it was go­ing to help the very poor peo­ple, par­tic­u­larly in Ap­palachia and other parts of Vir­ginia,” Wallmeyer said. “And it’s just not true.” THURS­DAY, SEPTEM­BER 14, 2017

Wallmeyer said the clinic in Wise County doesn’t see as many pa­tients as it once did from Ken­tucky, a state that ex­panded Med­i­caid un­der the act.

Teresa Gard­ner Tyson, ex­ec­u­tive di­rec­tor of Vir­ginia’s Health Wagon, a free clinic that takes part in the Wise event, lamented that the politi­cians “for­get at the end of the day that they’re our ser­vants.”

“They can’t get away from the par­ti­san pol­i­tics, but here we’re faced with peo­ple dy­ing on a daily ba­sis,” she said.

Among the pa­tients at the free clinic was Joey John­son, who shot him­self in the head while play­ing with a gun when he was a teenager and has been in a wheelchair for 25 years.

No longer re­ceiv­ing health ben­e­fits from his step­fa­ther’s union miner’s in­sur­ance, he came to the clinic to get a den­tal fill­ing and have his eyes checked. His Med­i­caid doesn’t pay for den­tal check-ups, and he gets just $735 a month in fed­eral dis­abil­ity pay­ments and $20 in food stamps.

“If it wasn’t for this (clinic), my teeth would rot out of my head and I would be in bad shape,” he said be­fore his checkup, sit­ting shirt­less in the heat. John­son’s as­sess­ment of law­mak­ers’ work on health care is more suc­cinct than any tweet: “They don’t care about us.”

Kantsos voted for Don­ald Trump last fall in the hope that he could shake up Wash­ing­ton. She said the pres­i­dent needs to con­cen­trate more on his job and less on Twit­ter.

Suther­land sup­ported Trump, too, and said he thinks the pres­i­dent de­serves more time. But Suther­land, who comes to the clinic for den­tal work and medicine, wishes law­mak­ers un­der­stood how hard life can be in Ap­palachia. Last year, he said, he walked 50 kilo­me­tres to the Wise clinic be­cause he had no car; it took more than seven hours. Oth­ers have it bad, too.

“I’m not the only one,” he said, sit­ting in a tent where peo­ple were get­ting teeth pulled a few feet away. “I’m re­ally not the only one.”

A pa­tient re­ceives an eye exam at a free health clinic on July 22, in Wise, Va. Hun­dreds of Ap­palachia res­i­dents re­ceived free med­i­cal, den­tal and vi­sion ser­vices at the Re­mote Area Med­i­cal (RAM), clinic held an­nu­ally at the Wise County Fair­grounds in western Vir­ginia. The county is one of the poor­est in the state, with a high num­ber of un­em­ployed and un­der­in­sured res­i­dents.

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