Oakland, Calif. – Her dark blue hoodie pulled over her head, and wearing many layers of clothing, 25-year-old Justice (who would give only her first name) stood shivering in the cold night air last Friday, waiting for the gates of the Oakland Coliseum to open.
She would have to wait for another five hours for that to happen and another three-and-a-half hours from then to get a token that will ensure her a spot in a dentist’s chair on Saturday. It was the start of a first-come-first-served, four-day medical, dental and vision clinic in the Coliseum.
The wait, asserted Justice, who lives on food stamps in San Francisco, would be well worth it.
“I have a tooth that is rotting and several that are infected and I am in pain,” said the young African American woman, drawing on a cigarette. “I went to San Francisco General some time ago and told them I could die if my teeth are not checked and they told me, ‘Ninety-four dollars, please.’ I turned around and left.”
California’s Third World Health Care
Scores of people also waiting at the Coliseum gates—some carrying tents and plastic chairs and many wrapped in blankets—shared heart-breaking stories because they were either had no health insurance or policies that fail to cover care they need. Many simply couldn’t afford basic medical services. But they were hopeful that their medical needs would be met at the clinic.
It was the 640th such clinic in the United States alone since 1992, and the fourth in Northern California offered by a former Amazon bush pilot, author, TV personality and British philanthropist named Stan Brock.
Through his Remote Area Medical (RAM) Foundation, Brock and his army of volunteer medical professionals have staged scores of such clinics worldwide since he set up his nonprofit in 1985.
Last week, about 3,400 people thronged Sacramento’s Cal Expo for a chance to get dental surgery, eye care — including free glasses – and routine medical checkups.
The California Association of Oral and Maxillofacial Surgeons (CALAOMS) and the Buddhist Tzu Chi Foundation cohosted both clinics.
Neither Oakland nor Sacramento are exactly “remote” areas, but “we had all these budget cuts in California that eliminated so many services that there seemed such a need for this,” observed Pamela Congdon, executive director of CALAOMS, as she and Brock walked around the Coliseum stopping to chat with many of the 450 volunteers.
“It is a sad but telling situation that a volunteer health clinic developed to serve isolated and impoverished areas in Third World nations finds so much demand in the largest state of the richest country,” observed Anthony Wright, executive director of the California-based nonprofit, Health Access.
“Yet Californians are more likely to be uninsured and more likely to either not afford coverage or be denied for pre-existing conditions than residents of other industrialized countries, or most other states,” he added.
Dental Care Critical to Health
In 2009, cash-strapped California eliminated dental and vision care from its MediCal program, the state’s name for the federal-state Medicaid program for the indigent and those with disabilities. More than 3 million low-income, disabled and elderly adults in California depended on DentiCal, said Alicia Malaby, director of communications at the California Dental Association, which fought hard to prevent the cuts.
“Studies have shown that oral health is tied to overall health,” she said, and therefore, not something that should be given short shrift. But DentiCal, she said, has always been “chronically underfunded.”
“The elimination of adult DentiCal services ‘saved’ the state $109 million and caused the loss of $134 million of federal matching funds,” Malaby went on. She noted, “The state also cut $3 million from programs that provided protective dental sealants for low-income children in schools. The cuts were devastating, and we’re now seeing the effects.”
The 2010 Patient Protection and Affordable Care Act (ACA), the new health care reform act, has several provisions that speak to oral health, especially that of children, said Cara James, director of the Disparities Policy Project at Kaiser Family Foundation in Washington, D.C.
“Probably most important is the inclusion of pediatric oral health in the essential health benefits package that is to be offered by all qualified health plans in the exchanges,” James said. The state-run exchanges being created under the new law are online marketplaces intended to allow people to buy affordable insurance.
But under the federal Medicare program for seniors and people with disabilities, beneficiaries—who probably need it most—will continue to receive no dental care benefits from the ACA, according to Jack Cheevers, public information officer with the U.S. Centers for Medicare and Medicaid Services in San Francisco.
Wall-to-Wall Patients
It was wall-to-wall patients at the Coliseum Saturday, the bulk of them there for dental and vision care. At around 2 p.m., even though the clinic was well into its eighth hour, there were still 582 patients waiting to get their eyes tested. And nearly 700 people had signed up that day for dental work, Brock said.
“I haven’t had an eye test in three years,” said Oakland resident Sandy Chandler, 47, a MediCal patient. She said she and her two daughters were also planning to get a routine medical examination at the clinic.
Chandler said she has all along worked as an inventory specialist for several companies in the Bay Area, but none of them offered her health insurance. So she has been managing with generic reading glasses, which give her “blurry vision” and headaches.
Such drugstore glasses are not corrected for difference in each eye as prescription glasses are, and the strain they cause can worsen vision over time.
“I hope I will be able to see again after I am fitted with a new pair of prescription glasses,” Chandler said.
In another part of the cavernous Coliseum auditorium, Oakland resident Roberto Molina, 34, an immigrant from Mexico, had just had his teeth cleaned and was heading to the medical unit to find out why the bottom of his feet hurt. He is uninsured and doesn’t qualify for any federal health care programs.
Molina said his $1,200-a-month wages delivering newspapers has kept him from seeking medical and dental services.
Cecilia Smith, 61, described herself as “unemployed and underinsured.” Her skimpy disability checks don’t allow her to go for regular eye checks, she said, causing her to suffer frequent headaches from eyestrain.
“I am so grateful to all these angels for helping people like me,” Smith said.
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