Corporate control of health care inevitably puts money, rather than well-being, at the system's bottom line. That's the premise of Michael Moore's Sicko, the film that has recently cast light on the ugly reality that millions of people in the world's wealthiest country are without the medical attention they need.
The statistics are startling. A 2004 report by the S.C. Department of Insurance found that 19.4 percent of our state's citizens are uninsured, and we rank 46th in overall health nationwide. One in nine American children is without insurance, a condition passed on like a disease from uninsured parents. Insurance premiums have risen 58 percent over the last seven years, while incomes have grown only 2 percent.
Sicko is rife with tales of the insured who are denied coverage for lifesaving operations, and others unable to obtain coverage due to preexisting conditions, including heartbreaking stories of children and spouses who died because a company denied them coverage. The stories are not unique to any geographical region of the country.
Ian Riggs is a 30-year-old Folly Beach surf instructor with Crohn's Disease. He was diagnosed in 1998, when he was covered by his parents' insurance plan. Today he leads a healthy lifestyle and has had no complications in nine years, yet he is unable to obtain health coverage, even for primary care. "I'd have to get a cubicle job that provides insurance to be covered, which is worse for you than not having insurance," says Riggs. "I've definitely had to change my diet to compensate for knowing I can't go to the doctor affordably."
Although Moore's film calls for a national, single-payer system that covers all citizens, bringing that about would require toppling some of the world's largest and most powerful corporations, all of whom assert influence by donating heavily to political campaigns. Change, it seems, will have to come from a local, grassroots level.
Citizens of New York state now have the option of joining the Ithaca Health Alliance, a nonprofit group in which members contribute $100 a year in exchange for coverage in the event of a major illness or accident. Last year they opened a clinic for members, and founder Paul Glover recently published a book detailing the legal intricacies of starting a "community insurance fund" in other states, with copycat groups already springing up in Minnesota and Washington state.
Although South Carolina has yet to mimic Ithaca in shaking the finger at profit-driven health insurers, there are a number of Lowcountry organizations working to provide health services to the uninsured. A 2004 City Paper cover story ("For Pete's Sake," Nov. 24) detailed the work of Access Health Care, Tri-County Project Care (TCPC), and other programs in their planning stages. Some of those have fizzled while others have grown.
Robert Spencer, owner of Madra Rua Pub in North Charleston, had hoped to start a network health fund for food and beverage employees. "Some of the restaurants felt like it was on the verge of unionization," he says. They ultimately scrapped the plan in favor of pointing employees toward low-cost providers.
S.C. Small Business Chamber of Commerce president Frank Knapp tried to design a similar plan for small businesses, but "simply ran out of steam trying to promote it," he says. "Nobody in the state government seems eager to come up with solutions unless they involve using an existing insurance company."
Since the 2004 article, however, TCPC has begun the second phase of their program, a concept similar to Knapp's that allows small business owners and employees to contribute equally ($85 total, per person, per month) into a shared fund. TCPC is subsidizing the program heavily, but hopes to transition into a third phase that utilizes funding from both community nonprofits and government funding to sustain itself.
"Our objective is to see if there is a market for small businesses with employees at that income level (no more than 200 percent of the total poverty level) who are willing to make a prepayment," says Suzanne Kuppens, a registered nurse and program director for TCPC. "We're trying to generate systemic change, encouraging preventative care rather than trips to the emergency room, which run up the cost of health insurance premiums when patients are unable to pay."
Gene Murray signed up his Mt. Pleasant State Farm office to participate in the TCPC program. "Most small businesses can't afford insurance," says Murray. "I jumped all over this. It helps with retention, it's a benefit to everyone, and it's not costly at all. Three of my employees have had major medical problems, and it's been a godsend."
A growing trend in the medical world is what Access Health Care's Dr. Dave Albenberg dubs "concierge medicine." At his downtown and Mt. Pleasant practices, he doesn't accept health insurance plans. Most patients have a high deductible plan for catastrophic illness and injuries, but for regular care, they pay a reasonable monthly fee that allows them unlimited access to the clinic, as well as house calls and emergency 24-hour care.
"Concierge medicine doesn't believe in universal health care," says Albenberg. "If you can empower the patient to control their dollar, then they'll find the best product and the cheapest place to go." He laments situations where the sick don't go to the doctor over fear of the costliness, and says that by having a set number of patients who "subscribe" to his service, he's able to provide personal care without the wait, and without necessitating any laymen's decision over whether or not a condition warrants a doctor's attention. It's already paid for and it's quick.
Based in Mt. Pleasant, the Palmetto Project comprises several preventative programs and provides a network of inexpensive doctors. At www.SCHealthCare.org, patients can enter their zip code and the service they need, and a list appears of the affordable clinics in their area, along with hours, whether they accept Medicaid, and eligibility requirements. When a doctor like Albenberg chooses not to use insurance, they save the fees they would owe to the company, and are able to offer their service at an "untaxed" rate. In Charleston, the Franklin C. Fetter Health Clinic on Nassau Street is the most frequently recommended affordable clinic.
Carrie Whipper is the program coordinator for Heart and Soul, another outreach of the Palmetto Project. At primarily African-American churches and community centers, she takes blood pressure readings to identify those persons most susceptible to stroke. She shares simple information about the dangers of high salt intake and the benefits of walking and regular physical activity. "We want these church communities to embrace the concept of wellness and promote it," says Whipper. "The goal is for people to support each other in making healthy changes."
Successful preventative care is clearly the most simple, localized way to avoid the headache of entering the nightmare of health insurance claims. To this end, MUSC operates a Mobile Health Unit that visits communities across the Lowcountry to offer cancer screenings on board their high-tech RV/laboratory. "When the doctors have to deliver bad news, we have a counselor there who's going to help the patient with every step," says Hollings Cancer Center Director of Outreach Services Debbie Bryant. "Over and over, patients have said they feel more comfortable on the unit than they would in a hospital setting."
Children are undeniably the most troubling sector of uninsured citizens, a plague that Burke Middle School's Freedom School program hoped to alleviate in Charleston through a Hoops for Health event last week. Attracting youths with an open gym day, they distributed Medicaid applications and provided information about teen pregnancy prevention and becoming a bone marrow donor. "Medicaid forms get sent home with students from school, but they often aren't returned," says Lauren Buckowsky, site coordinator for the Freedom School. "We're trying to break the cycle of the uninsured."
The release of Sicko and the ongoing presidential campaigns have pushed health care reform to the forefront of the American consciousness. Before the Democratic debate on Monday, a group of citizens gathered outside to call on the candidates to present their health care plans by August 1, and a cohesive, feasible blueprint will be a necessity for election in 2008. Although sweeping reform from the top is crucial to end a decrepit system that places monetary value on a person's life, the Lowcountry is also rich with medical professionals dedicated to inspiring healthy lifestyles and making care available and affordable.
Do you have a health care story to share? Be it a horror tale of dealing with corporate giants or a blessing from a local provider, share it in the comment section of this story online at www.charlestoncitypaper.com, where you can also find contact information for the organizations listed here. Also check The Truffula Seed on our blog page for updates to this story over the course of this week.