‘What new law?’

Updated
 
A dentist extracts a tooth from an uninsured patient at a mobile clinic in Sewanee, Tenn.
A dentist extracts a tooth from an uninsured patient at a mobile clinic in Sewanee, Tenn.
Associated Press

At a certain level, it’s tempting to think Americans who lack health insurance and/or access to affordable care would be a powerful political force. We’re talking about tens of millions of people – spanning nearly every demographic – who lack access to basic medical services. If these folks were a voting bloc, they’d have the power to shift major elections.

But as Jon Chait noted this morning, “[P]eople without health insurance are politically weak. They lack political organization, and many … lack even the awareness that there was this big health-care law that gives them help.” Chait was referring to a rather remarkable new article from Alec MacGillis, who reported on a clinic in Sewanee, Tennessee.

As Robin Layman, a mother of two who has major health troubles but no insurance, arrived at a free clinic here, she had a big personal stake in the Supreme Court’s imminent decision on the new national health care law.

Not that she realized that. “What new law?” she said. “I’ve not heard anything about that.”

Layman was one of 600 people who on a recent weekend came from across southeastern Tennessee for the clinic held by Remote Area Medical, a Knoxville-based organization that for two decades has been providing free medical, dental and vision care in underserved areas. Most everyone had spent the night in their parked cars, to get a good spot in line. Daybreak found them massed outside the turreted stone gymnasium of the 150-year-old college, the University of the South, some still wearing pajamas or wrapped in blankets, waiting quietly for the 6 a.m. opening of the doors.

It was Remote Area Medical’s 667th clinic. But this one came at an unusual moment: as the Supreme Court deliberates whether to uphold the health care law that will have a disproportionate impact on the sort of people served by the organization.

Implementation of the Affordable Care Act is staggered. The struggling families who showed up at this free clinic will benefit greatly from the law, but not until the law is fully in place in 2014. Of course, if Republicans on the Supreme Court or Republicans in Congress kill the law between now and then, these same struggling folks will lose the benefits they do not yet have.

But MacGillis found that many of those relying on the clinic aren’t even aware of the help that may be on the way. They stand to lose the most, but they often don’t vote and tend to live in “red” states anyway. These folks in Tennessee are generally ignored – by their own Republican representatives and even by the media (the Washington Post was going to run MacGillis’ story, but decided it seemed favorable towards health care reform).

But the clinic’s very existence only helps reinforce the need for “Obamacare.”

Indeed, seeing the uninsured sleep in their cars so they try to get care at such a clinic quickly reminded me of Wendell Potter. Remember him? It was three years ago last week when Bill Moyers sat down with Potter, a former executive at a major health insurance company, who later became a whistleblower, explaining the way the industry “put profits before patients.”

Asked what prompted his change of heart, Potter said he visited a health care expedition in Wise, Virginia, in July 2007. “I just assumed that it would be, you know, like booths set up and people just getting their blood pressure checked and things like that,” he said. “But what I saw were doctors who were set up to provide care in animal stalls. Or they’d erected tents, to care for people…. I’ve got some pictures of people being treated on gurneys, on rain-soaked pavement. And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care.”

Potter added that families were there from “all over the region” because people had heard, “from word of mouth,” about the possibility of being able to see a doctor without insurance. He asked himself, “What country am I in? It just didn’t seem to be a possibility that I was in the United States.”

He warned that insurers and those who profit from the dysfunctional systemic mess would do everything possible to kill Obama’s proposed reforms, and Potter was right, they did. Fortunately, they also came up short.

At least at the time, that is.

If the Democratic health care reform law dies an unceremonious death at the hands of five Supreme Court justices next week, I’ll be thinking about those folks at the free clinics, and the fact that the opportunity to put things right for them will have come and gone.

Affordable Care Act and Obamacare

'What new law?'

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