We are so far from done with healthcare reform in this nation. This infuriating, heartbreaking, essential story by Eli Saslow in The Washington Post demonstrates that better than any recitation of healthcare statistics you'll hear. It's about two of the people in rural Tennessee living on the edges of society with chronically ill health.
"Urgent needs from head to toe," a social worker wrote for Lisa and Stevie Crider before their trip to a Remote Area Medical clinic that was setting up shop for 48 hours to try to make a dent in the gaping needs of the state. "Lacking primary care and basic medication. They have fallen into the gap." That gap is the one created when Chief Justice John Roberts decided to get political in his Supreme Court Affordable Care Act decision and allow states to refuse to expand Medicaid. Tennessee refused, and in the last decade the state has lost "14 percent of its rural physicians and 18 percent of its rural hospitals."
Something like 2.5 million residents in the state don't have regular access to medical care, putting them among the 50 million rural Americans who are in the same boat. The decision by red states to refuse expansion meant they also lost some federal funding for rural hospitals, because that funding was shifted under the law: Medicaid payments under expansion would have provided that funding instead, the law reasoned law. That kind of reasoning doesn't sway Republicans.
The RAM clinic wasn't equipped to handle the health crisis Lisa Crider was experiencing, so it called an ambulance for her, leaving her with a $3,000 emergency room bill she's not going to be able to pay, from a rural hospital that can't really afford to continue to provide treatment for all the uninsured patients who continue to show up for lifesaving care. Crider was stabilized, her care taking precedence over that of Stevie, who is also dealing with painful, chronic, and serious conditions, including congenital heart problems. She returned to the clinic the second day, and had to prioritize between "another checkup with a doctor, a mammogram, a lung scan and a prescription for new glasses." They decided on the new glasses, because everything else could reveal further health problems that the pair can't afford to have treated. Ignorance is far from bliss, but less mind-numbingly depressing for people with little hope. "It's a problem you can actually take care of," Stevie said.
The clinic moved on to the next town and the next raft of Lisas and Stevies who haven't had regular health care for decades. And as long as our current healthcare system persists, there will be Lisas and Stevies. If Trump and the Republicans have their way, there will be a lot more of them.