Trying to secure medical aid is a lottery in more ways than one for many US citizens with no insurance, reports Lara Marlowefrom Arlington, Virginia
FOR 45 million US citizens and residents without medical insurance, surviving an accident or illness is a lottery.
Twice a month on Tuesday mornings, at the Arlington Free Clinic, obtaining healthcare is, quite literally, a lottery.
The clinic was founded in 1993 by doctors who’d been caring for needy patients for free. It is funded by an annual gala dinner, private donations and grants from foundations. Some 160 physicians volunteer one day a month to care for residents of this town, across the Potomac River from Washington.
Until 2008 the clinic was able to help all comers. But with so many people losing jobs – and their insurance – in the recession, demand has doubled. “Anyone who thinks there’s no problem with healthcare in America should come and watch our lottery,” says Jody Steiner Kelly, the clinic’s administrator.
Prospective patients begin queuing in the snow about 8.30am for the 10.30am lottery. At 9.30am, the clinic doors open. Eighty people clutch photo identity cards, proof of residence in Arlington, and evidence they live below the poverty line. The clinic does not ask about their immigration status. Many are from Latin America, so an interpreter translates Steiner Kelly’s instructions into Spanish.
Each participant in this life-and-death lottery receives a letter of the alphabet. Only one quarter of their letters will be drawn. Once they are accepted by the clinic, they receive long-term care – for free. So the lottery losers keep trying.
Most are immigrants who have never had insurance. I spoke to Mexicans, Bolivians, Guatemalans, Hondurans and Salvadorans, a Mongolian, a couple from Bangladesh and a half dozen Ethiopians.
These people are America’s hewers of wood and drawers of water; lorry drivers and cleaning ladies who must choose between paying rent and buying food or seeing a doctor.
Because he is blond, blue-eyed and middle class, Christian Halvorsen (58), stands out in the crowd. Yesterday was his third failed attempt at the healthcare lottery.
Halvorsen worked as a restaurant manager for 35 years, but lost his job in 2007. His former employer allowed him to keep his medical insurance for a time, until he moved from Pennsylvania to Virginia to live with his brother.
Halvorsen spends $700 (€508) monthly on medicine, and his brother doesn’t charge him rent.
Complications from diabetes led to nerve disorders in Halvorsen’s hands and feet. He had one toe amputated, and is losing his eyesight.
“I saw a physician a couple of months ago, for $80,” he says. “But I couldn’t afford the $400 he asked for lab work. I need a laser procedure for one eye, and that costs $1,000.”
He applied for medical insurance in Virginia, but was refused because of his pre-existing condition.
Forbidding insurance companies from rejecting clients on the grounds of pre-existing conditions is a principle of President Barack Obama’s floundering healthcare reform.
The root of the problem, says Halvorsen, is that “the whole system is based on making profits”.
Obama will convene a healthcare summit with Republican and Democratic leaders on February 25th, but Halvorsen holds little hope. “Even if they passed the present Bills, it won’t take effect until 2013. And if they force the insurance companies to accept pre-existing conditions, what will the premiums be like?”
Marian Smith (52), lost her last job as a cleaning lady at Virginia Hospital a year ago. She wants to be tested for diabetes, which afflicts her father and cousin. Her $174 a week unemployment benefits have just been curtailed, after three extensions.
“What do they want me to do? Live in the street?” she asks. “If the economy doesn’t get better, people will start robbing and killing . . .
“I worked all my life, with children, in restaurants, motels, hospitals, conventions, the Verizon Centre ,” Smith continues. “It doesn’t seem right that I can’t get insurance.”
An African-American, she says she is certain that President Obama will succeed.
“I have faith in him. It’s the Republicans who’re trying to put a hold on this stuff.”
Two cases left a deep impression on Steiner Kelly. “About six years ago, an extremely poor Hispanic immigrant family brought their 19-year-old son on a stretcher. He had a tumour on his heart, which caused an aneurism on his brain. He couldn’t walk or talk.
“He comes every week for physical therapy, and he’s made tremendous progress. I don’t know what would have happened to him without the clinic.”
The other case is less fortunate – that of an American who lost a good job, and medical insurance with it, and was then stricken with Guillain-Barre syndrome, which causes paralysis.
“He ran up $70,000 in debts before we took him,” says Steiner Kelly. “He’s a good example of people who thought it would never happen to them.
“So many people in this country are so close to that . . . People don’t realise how terrifying it is not to have insurance.”