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Scenes From the Open Clinic

The Insurance Industry’s Pre-Existing Condition: Greed

by PAUL KRASSNER

Although Coachella Valley in Southern California has become synonymous with music festivals, Goldenvoice, the company that produces those events, also helped sponsor the first massive four-day health clinic this year. Free medical, dental and vision care was provided to nearly 2500 uninsured patients at the Riverside County Fairgrounds.

According to the California Healthcare Foundation, this state now has the largest number of people without health insurance — 6.9 million –- more than any state in the country. More than 20% of Californians remain uninsured. Employees in businesses of all sizes are more likely to be uninsured in California than any other state. About 60% of the uninsured population are Latino.

Pamela Congdon, president of the Remote Area Medical’s California affiliate (RAM CA) and Volunteer Coordinator, told me that “The California Association of Oral and Maxillofacial Surgeons (CALAOMS) helps sponsor RAM CA. They allow us to use their office, use our staff, including myself and our Associate Director, without any charges.

“I work for CALAOMS, and when I asked if they would help us bring RAM in Northern California, they agreed. Stan Brock asked me to start the affiliate — RAM CA –- which ran the clinic in Coachella. Please say that the clinic is run by the greatest group of volunteers.”

Indeed, over 1200 general and healthcare professionals volunteered to provide more than 10,000 individual services with more than $1,000,000 in value. Over those four days, twelve hours a day, an estimated 600 custom pairs of eyeglasses were cut, 750 medical exams administered, and 1300 dental patients treated.

There were 615 general volunteers, 395 dental professionals, 60 vision professionals, and 190 medical professionals of all kinds. There were 1766 dental patients, 1435 medical, and 798 vision. One patient hadn’t seen a doctor for seventeen years. Of the 2419 patients, 1796 were Latino. Oh, yes, and 234 stuffed animals were handed out to children.

One patient sent this message: “My name is Jennifer and I wanted to say thank you from the deepest of my heart! I found out about RAM in Indio at 11 p.m. on Thursday. By 2:30 a.m., I had made my way across the valley, and joined in line with the rest of the people you helped. Not a SINGLE person I interacted with was anything but kind, courteous, and understanding. No one judged us for being there, no one thought we were a burden.

“I had all of my wisdom teeth pulled, something I avoided due to an overbearing phobia of dentists in general. Both my dentist and the dental assistant were comforting, and made the procedure almost painless, and fast. I am almost in tears as I write this email, due to the overwhelming gratitude I have for everyone involved in this amazing project that has changed and saved so many lives, including my own.”

*   *   *

I’m writing this in the middle of the Open Enrollment time frame, during which my wife Nancy and I finally signed up for a Medicare Advantage plan. Stemming from an old police beating, I use a cane to walk from room to room, and a walker outside the house. The new healthcare plan includes free access to a gym, and I picture myself using my walker on a treadmill. That image reminds me of a New Yorker cartoon depicting a group of people on stationery bicycles in a park.

In the process of enrolling in the Medicare Advantage plan, we were told that we would have to pay a penalty because we hadn’t joined a Medicare (or any other “creditable”) prescription drug coverage. We were never informed about that requirement, which began in 2006.

Since we’ve always avoided taking prescription drugs, we never felt the need for it. I called the Health Insurance Counseling Advocacy Program and learned that the penalty would be $32 for each of us. That means $64 every month for the rest of our lives. It seems somewhat absurd and unfair that we could be penalized for not taking any prescription drugs.

Ironically, “This penalty is required by law and is designed to encourage people to enroll in a Medicare Drug Plan when they are first eligible,” yet we had no way of knowing there was such an option to consider. Another irony is that Medicare doesn’t cover any dental procedures, even though rotten teeth and gums can cause internal illness that Medicare does cover.

I asked RAM CA volunteer Dr. Peter Scheer, a world-renowned oral surgeon, about that. His response: “In regard to Medicare and covering dental needs, it has always been an issue. Medicare stands strong in only providing benefits for services that are deemed medically necessary and has always excluded anything related to dentistry, surgical or restorative.

“Yes, there are situations where a patient may have an atrocious dental infection that can become life-threatening if not treated. The times where this situation really hits a grey area is when the patient also has other medical issues that may be affected by the infection or contributing to it. Unfortunately, most instances we come across are a decrease in the quality of life due to a poor oral condition rather than a life-threatening event.”

However, a research team from Columbia University’s School of Public Health has just released the results of a three-year study of 420 men and women, concluding that the improvement of gum health can help slow the development of atherosclerosis, the build-up of cholesterol-rich plaque along artery walls, which can lead to heart attacks and strokes.

Meanwhile, Goldenvoice has invited RAM CA to return next year. I asked Pamela Congdon, “Will the Affordable Care Act affect that event, or is it too early to tell?” She replied, “The ACA won’t affect the event in terms of people needing service. We are going to have the Borrego Community Health Foundation there to help people sign up for the ACA.” As inspiring as this year’s four-day free clinic has been, in a truly compassionate culture, there would be no need for its existence.

But the insurance industry has a pre-existing condition known in technical terminology as greed. Not to mention the pharmaceutical industry; the annual turnover of revenue for prescription drugs by the top ten companies is estimated to be worth $700-billion dollars. In my new Medicare Advantage Enrollment Kit, there are listed a few thousand prescription drugs, from Abacavir to Zyvox. Okay, now cue that soothing voiceover to recite all their side effects, from anal leakage to zits.

As for me, I owe my longevity to never taking any legal drugs.

Paul Krassner publishes the infamous Disneyland Memorial Orgy poster. His latest book is an expanded and updated edition of his autobiography, Confessions of a Raving, Unconfined Nut: Misadventures in the Counterculture, available at paulkrassner.com and as a Kindle e-book. He is a contributor to Hopeless: Barack Obama and the Politics of Illusion (AK Press).  He can be reached at his website: paulkrassner.com.

A version of this essay originally appeared on Alternet.