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High Country News

The New Third World

People are desperate for medical care in the West's inner cities and rural areas.

Ray Ring

Before dawn every day, they stood in long lines outside the Roman Empire-style Forum arena near downtown Los Angeles. That's how desperate they were to be treated for painfully rotting teeth, blurry eyesight, cancer and other medical problems.

There were grandmothers and little kids, veterans and the disabled, the working poor and laid-off men and women. They couldn't afford to pay for what they needed, often because they had inadequate health insurance or no insurance at all.

During the eight days it was open, the event was the nation's largest free medical clinic. About 6,000 people received treatment before it ended on Aug. 18. But thousands more were turned away, because the organizers lacked the resources to serve everyone who showed up.

Though LA has smaller clinics providing such assistance, "We could be here three months, and we still wouldn't catch up on the demand for the service," Stan Brock, founder of Remote Area Medical, the nonprofit group in charge of the clinic, told NBC News. Based in Tennessee, the group originally organized volunteers to provide clinics in Third World areas. It's expanded to serve people in this country because the degree of suffering here increasingly resembles that in the Third World. Currently 46 million Americans lack health insurance and many more have sizeable gaps in their coverage.

"The people we're seeing here have teeth as bad as the people in the Upper Amazon," Brock told the Los Angeles Times. Patients included "a diabetic amputee who had not been able to buy his medicine for months, a retiree who couldn't afford an X-ray for a lung problem, and a 30ish female diabetic with a kidney ailment so serious that (a doctor) called for an ambulance to take her to the hospital," the Times reported.


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"I have people here with infected teeth, gums, abscesses," a dentist said. "I saw a lady bus driver who lost her job and she's walking around here crying. Her tooth is infected, she's in pain and she can die from this." An optometrist who has volunteered in Latin America found it "outrageous that vision and dental care are not in most U.S. insurance plans and are rarely part of any conversation on health care reform."

More than 2,000 bad teeth were pulled at the Forum, more than 1,700 pairs of eyeglasses were handed out and hundreds of potentially life-saving mammograms and colonoscopies were done. Remote Area Medical planned to run a free clinic the next week in Fort Duchesne, Utah, to serve people on and near the Northern Ute Tribes Reservation -- another indication of the size of this crisis.

Meanwhile, President Barack Obama came West to hold two town hall meetings about his efforts to reform health care. On Aug. 14, he faced about 1,300 people in an airport hangar near Bozeman, Mont., and on Aug. 15, he met with about 1,600 in a high-school gym in Grand Junction, Colo. The dialogue was similar in both venues, with Obama delivering a brief speech and then slipping off his jacket and rolling up his shirtsleeves to answer questions posed by people in the audience.

Obama described the incremental reforms that he wants Congress to pass,  including subsidies to get more people covered by health insurance, and rules to make it harder for insurance companies to deny coverage. He called for raising taxes on wealthy people to help pay for it. And he talked about creating a new "exchange" -- a nationwide marketplace or co-op through which millions of people could band together to buy insurance for cheaper rates.

"Because we're getting close (to some reforms)," Obama said, "the fight is getting fierce." Indeed, outside the town halls, crowds of protesters pressured him from both sides, some calling for a comprehensive government-run system like Canada and European countries have and others telling him to back off and leave the current system alone.The current system may work for those who have good coverage. But it certainly doesn't do anything for people like those at the LA Forum -- a scene that Steve Lopez, the Times' famous on-the-street columnist, described as "the perfect distillation of an unconscionable societal failure."

Ray Ring is Senior Editor at High Country News.  Ray has been writing about the West since 1979. He started freelancing for High Country News in 1985, did a stint as an editor in Paonia from 1994-1995, and has been back on staff since 2001, covering the Northern Rockies from his home base in Bozeman. He has won numerous awards, including the Sidney Hillman Foundation Journalism Award for his 2007 High Country News cover story “Death in the Energy Fields.” His favorite Western places include the Grand Canyon, Butte, Montana, Wyoming and any Mexican café.

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