The first time Earnest Cook visited the French 500 Free Clinic in Gallia County, he arrived two hours early to beat the crowds. He was very sick. Earnest’s blue eyes flash with recollection of this visit and he describes his illness with an ease characteristic of his relaxed personality.
“I couldn’t even hold my head up," he recalls. Despite a history of heart attacks, the flu virus was the only reason he went to the clinic that day. Now Earnest goes on the last Thursday of every month, the only day the clinic is open, to get his blood pressure and cholesterol levels checked.
“I found out they were a great bunch of people. Like Dr. Nugget, who came out of retirement at 76 years old, and I thank God for his expertise and eagerness in wanting to come out and help somebody," Earnest says.
He lost his job 25 years ago at Meridian and went from a $42,000 annual salary to no income at all. “When they shut the doors I lost all my benefits, all my insurance, everything." He was unemployed for several years before finding a job as a truck driver for L&L Scrap Metal in Gallipolis.
According to the U.S. Census Bureau, the percentage of people covered by employment-based health insurance decreased to 55.3 percent in 2010 from 56.1 percent in 2009. The number of people covered by employment-based health insurance decreased to 169.3 million from 170.8 million. In 2010, the number of uninsured people increased to 49.9 million in 2010 from 49.0 million in 2009, while the number of people covered by government health insurance increased to 31 percent (95 million) in 2010 from 30.6 percent (93.2 million) in 2009.
Earnest says he does not have the $125 it costs per visit to see the heart doctor at the local hospital, but says he can go to the free clinic and the doctors help him there. "They cared about me and saw that I got better," he says.
For many uninsured adult residents of Gallia County, the French 500 Free Clinic is the only accessible health care facility in the area. While some alternative, low-cost health care facilities exist nearby, such as Ohio Quickcare in Gallipolis, they are not free. Yet the Free Clinic is only open for two hours once a month, on a first come first serve basis.
“With the salary I get making $500 a week, I’d just be doing nothing but working for paying insurance. By the time I payed all my other bills and things, you wouldn’t have nothing. You wouldn’t have no money for groceries."
The clinic provides everything from routine physicals to sick visits for colds or pneumonia. However, the clinic is limited in supplies and volunteers, so they cannot do blood work or x-rays at their location. In these cases, the patients are referred to local practices or hospitals.
Joann Elliot has worked at the Free Clinic for over three years and says that, while they see some patients like Earnest who come back for monthly blood pressure checks, "This is more of an urgent care type of situation, where you try to take care of whatever is wrong with the patient."
"When you don’t have nothing and your health is bad and you don’t have nobody to turn to and you gotta go somewhere and they won‘t see you at the hospital because you don’t have insurance," Earnest says, "I know what that is firsthand. And that’s the reason why I go up to the clinic."
Earnest says the cost of insurance would be $150 a week for him and his wife.
“With the salary I get, making $500 a week, I’d just be doing nothing but working for paying insurance. By the time I paid all my other bills and things, you wouldn’t have nothing. You wouldn’t have no money for groceries," Earnest says.
Without the Free Clinic, Earnest says he would have to go the emergency room, but it would mean another bill he could not afford. Before moving back to Gallia County, he had to file for bankruptcy because of mounting bills from Holzer’s Hospital and high mortgage payments on his home.
“A lot of children would not participate in Special Olympics if we didn’t come and provide the physicals."
Dr. Isabel Pino
“I lost my home. I owed the doctor $10,000 from putting that stent in there, but I didn’t have a job so it took all my life savings I had. I moved in this place here and it was condemned and I had to fix it up to even live in it.“
Earnest has had two heart attacks since 2011. The doctors at the Free Clinic referred him to the hospital again last year for another stent. Earnest had another heart attack at the hospital and received yet another stent. Earnest says the Free Clinic saved his life.
“I have been sick [since] the first of the month and had to wait all month to go. But you just have to wait and do what you gotta do... I thank them for helping me get through [this] life," Earnest says.
He says that in today’s health care environment, tax dollars from people who cannot afford health insurance go toward paying for the insurance of the more affluent. The upcoming presidential election will determine the reformation of the health care landscape to come.
“We’re just the same as they are, they get their healthcare paid for, we pay for theirs, and they don’t have to worry about it. The president don’t have to worry about his healthcare, we pay for it," Earnest says.
According to Cincinnati News website, if President Obama’s universal coverage health care plan is upheld by the Supreme Court, almost everyone will be required to have insurance. Under this law, insurers would be prohibited from denying insurance to people who are ill and tax-credits for middle-income and low-income people will lower expensive insurance premiums. Medicaid would be expanded to help people that cannot afford insurance.
While these proposals focus largely on fixing financial problems to accessing health care, in some cases affordability is not the only barrier. In Huntington, West Virginia, the national organization known as the Children’s Health Fund collaborated with the Department of Pediatrics at the Joan C. Edwards School of Medicine at Marshall University to create a mobile pediatric clinic. The wide blue bus houses a full-fledged pediatric clinic with two private exam rooms and a middle section with a long, blue vinyl couch serving as a lobby.
“There are many factors that make a project like this one necessary," says Dr. Isabel Pino, the director of the West Virginia Children's Health Project. “You can look at geography as being one, lack of access to care; which can be due to lack of insurance or lack of transportation.“ In this relatively low-income area of West Virginia, “You have a lot of people who may have insurance but don’t have a doctor nearby, or [they have] parents who are working and can’t take off from work to take their child to the doctor. So, all of those are barriers to accessing medical care and a project like ours helps to tear down those barriers," says Pino.
While the mobile clinic does not make house calls, the bus parks at local schools and provides routine checkups, sick visits, and even annual physicals for the Special Olympics. “A lot of children would not participate in Special Olympics if we didn’t come and provide the physicals," Dr. Pino says.
The Children’s Health Fund is a nonprofit organization like the Free Clinic, but the West Virginia Children’s Health Project bills for its services because they see children who have Children’s Health Insurance Program (CHIP) coverage or Children’s Medicaid. Dr. Pino says the mobile clinic tries to help improve access to these programs by always carrying CHIP applications on the bus.
However, parents who live without insurance in circumstances similar to Earnest’s end up having difficulty supporting their children’s health, even with the help of these federally funded programs. Earnest’s adult daughter is beyond the age to qualify for children’s coverage options, but Cook says she gravely ill.
“How can you fix it when there ain’t nothing there?"
“She’s been all the way down through the clinic, all the way down through the hospitals. Can she get any help? No,“ Earnest says.
Earnest represents the American family that can only access health care at certain stages in life, and then once adults or once without a job, not at all. He wonders what the election will fix about health care when there is nothing available to him and his daughter to begin with.
“How can you fix it," he says, "when there ain’t nothing there?"
Story © Madison Stephens
Video © Kyle Grillot © Ross Brinkerhoff