A ru­ral health clinic in south­west Vir­ginia is the face of blocked Med­i­caid ex­pan­sion.

The Washington Post Sunday - - METRO -

When the Vir­ginia-Ken­tucky Dis­trict Fair re­turned to Wise County re­cently, it brought fun­nel cakes and whole fam­i­lies smil­ing— a sight not too com­mon here in the coal­fields.

This week, another gath­er­ing on the Wise County fair­grounds will see thou­sands of peo­ple stand­ing in the bright sum­mer sun: the 16th an­nual Re­mote Area Med­i­cal clinic. Some of those same fam­i­lies and their friends will be among those who travel to Wise not for fun rides or lo­cal band fa­vorite Folk Soul Re­vival but for some­thing lack­ing in this county, this state and this coun­try: ac­cess to health care.

And tak­ing pic­tures with these down­trod­den folk will be our politi­cians. Lo­cal rep­re­sen­ta­tives of south­west Vir­ginia will travel to the fair­grounds to stand on a coal bucket and as­sure us they’re fight­ing against Pres­i­dent Obama and the “war on coal.” These politi­cians won’t men­tion that with their votes to block Med­i­caid ex­pan­sion, they en­sured that the lines at RAM won’t be get­ting any shorter. But hat­ing Obama in these parts is good pol­i­tickin’.

If, as lo­cals like to say, “coal keeps the lights on,” the lights have been get­ting pretty dim over the decades when you con­sider the price of nat­u­ral gas, mech­a­niza­tion and a nat­u­rally dwin­dling energy source. The coal­fields are dark these days. Clouds of poverty, un­em­ploy­ment and poor health hang over us.

While there’s no feel­ing quite like com­ing home to these moun­tains, you can’t help but no­tice the suf­fer­ing be­hind these Ap­palachian walls. Good health isn’t ex­actly plen­ti­ful here. Folks who live in this area are far un­health­ier than those in the rest of Vir­ginia. Ac­cord­ing to the lo­cal mo­bile clinic that trav­els around Wise and a few other sur­round­ing coun­ties pro­vid­ing free care in be­tween the clin­ics, we’re much more likely to die from things such as heart dis­ease, pul­monary dis­or­ders or un­in­ten­tional in­juries. We’re also 50 per­cent more likely to die from sui­cide.

At 25 years old, I have a list of health is­sues that stem mostly from bouts with Hodgkin’s lym­phoma as a child. I’m lucky that I can stay on my par­ents’ in­sur­ance for another year. Thanks to my hard­work­ing mother, a nurse, and my step­fa­ther go­ing into the mines, I’ve al­ways man­aged to have the care I need.

While I might be in line at RAM next sum­mer, I’m for­tu­nate now. Oth­ers aren’t as lucky. My aunt, a sin­gle mother of two, works full time at a nurs­ing home and makes too much to qual­ify for Med­i­caid. She is a breast-can­cer sur­vivor who hasn’t had screen­ings or scans in sev­eral years be­cause she can’t af­ford them. A few years ago, my grand­fa­ther, a re­tired miner and elec­tri­cian, joined those who camp out at the fair­grounds to en­sure a fa­vor­able num­ber in the RAM clinic lines.

I’ve al­ways been op­ti­mistic, with a hope that things would change. I used to think, “If they just saw what was hap­pen­ing here, they would do some­thing about it.” Ev­ery year, how­ever, the na­tional media flock to the place I call home and tell the world about our suf­fer­ing. And another year goes by.

The peo­ple who can change this don’t care. The en­tire south­west Vir­ginia del­e­ga­tion, Repub­li­cans who have thou­sands of peo­ple in each of their dis­tricts who could be helped, proudly voted against Med­i­caid ex­pan­sion.

This week, they will come to Wise County and shake the hands of peo­ple reach­ing out in need while stand­ing in that hot July sun. In the com­ing months, they will go to the RAM clin­ics for nearby Buchanan and Lee coun­ties, which lost their only hos­pi­tal a few years ago.

This I’ve learned: One can­not com­pro­mise with peo­ple who have a com­pro­mised con­science.

I still love this area. It’s an Ap­palachian love story — with more than its share of heart­break and tragedy.

MICHAEL S. WIL­LIAMSON/THE WASHINGTON POST

Lines formed be­fore dawn at the 2014 Re­mote AreaMed­i­cal event in Wise County, Va.

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