RAM, the Uninsured, and the Underinsured

Approximately six months ago “Sixty-Minutes” reran a program about an organization called Remote Area Medical (RAM). RAM is a non-profit, volunteer relief corps dedicated to providing free health care, dental care, eye care, and other assistance to people in remote areas of the United States and the world. It is staffed by volunteer doctors, nurses, pilots, veterinarians and support workers. It originally concentrated on areas like South America but has been more active in the United States lately because of the overwhelming need here for free medical services.

The program described the opening of a free clinic for only one weekend in a Southern town and showed the large number of people who came from hundreds of miles around to be seen by the doctors. Many people who had arrived seven hours before the clinic was scheduled to open at 6:00 a.m. slept in their cars. They were given numbers, and when the doors opened, they entered one-by-one. One woman who had had cancer surgery, but could not afford to go for a follow-up, learned that her pap smear was negative but that there were other signs that the cancer may have returned.

I was moved by the story of another woman who was virtually blind and needed new glasses. She was almost too late to get in, but was finally seen by an eye doctor. She said that she had health insurance but that it did not cover eye examinations and glasses. She wept as she described her difficulties seeing and said that she was ashamed to ask relatives and friends for help. She wondered how America, the wealthiest nation in the world, could fail to take care of its own. RAM examined her eyes and gave her new glasses.

The most gut-wrenching part of the program was when the RAM clinic had to close after the weekend was over. The clinic treated over 1000 people, but more than 400 people had to be turned away. I cannot describe the looks on the faces of those people. They would not experience the caring and expert treatment of those noble people who volunteered to be there.

Those people who were treated or turned away were not the most impoverished people in America. There is Medicaid for the very poor. These were the “working poor,” part of the 47 million uninsured and 25 million underinsured people in America. Most of them have jobs and work hard for a living. Many of the underinsured have some insurance, but it does not cover routine medical care.

A study by the Commonwealth Fund found that the number of underinsured Americans has risen 60 percent since 2003. For adults with incomes above 200 percent of the federal poverty level (about $40,000 per year for a family), the underinsured rates have nearly tripled since 2003. Because of the skyrocketing costs of medical care, these people can no longer afford necessary treatment.

We think that we are a good people. We think that Americans are the most generous people in the world. We point to organizations like RAM that travel around the world helping poor people. But we are deceiving ourselves. Sure there are exceptions; the people who volunteer for RAM are heroes. But in a larger sense we are numb to the suffering of millions of our fellow Americans. While European nations provide free medical care for all of their people, we leave over 72 million people without necessary health insurance coverage. RAM and groups like it can treat only a tiny fraction of the people who need care.

Even though universal health insurance under a single-payer system would provide all Americans with medical, dental, eye care, and psychological treatment at a cost substantially lower than what we now pay for private insurance, we don’t care. We have been brainwashed by conservatives in the Bush Administration and in Congress who claim it would be “socialized medicine.”

Such thinking is shoddy and immoral. We have had Medicare for decades and it has not led us into socialism. On the contrary, the medical profession has thrived in under Medicare. Now it is time for Americans to start caring about one-another and provide Medicare for all of our people.