Where would more people show up?
A congressional town-hall meeting in Clarkston where the participants come to rail against health care reform?
Or MASH-style delivery of medical, dental and vision services held in Lewiston for people whose health care needs outstrip their ability to pay?
Operating out of an abandoned school in Knoxville, Tenn., Remote Area Medical was launched in the early 1990s to bring medical volunteers to needy people in Latin America. Today, it spends 60 percent of its time in the United States.
RAM just finished a week's work at the Forum in Inglewood, Calif. It was the organization's first venture into an urban center and it was overwhelmed. Thousands of people looking for help got in line.
"The enormous response to the free care was a stark corollary to the hundreds of Americans who have filled town-hall-style meetings throughout the country, angrily expressing their fear of the Obama administration's proposed changes to the nation's health care system," writes New York Times reporter Jennifer Steinhauer.
The closest RAM anticipates coming to this part of the country is Fort Duchesne, Utah, where it will serve the Northern Ute Tribes Reservation this week.
But what would an army of doctors, dentists and vision care providers find here?
Plenty of people in need.
Even before the recession struck in earnest, 216,000 Idahoans lacked coverage and 770,000 people in Washington were uninsured.
Then there are the underinsured, people with high deductibles or large co-payments who don't seek the care they need.
Recipients of Medicaid or Medicare may be unable to find a doctor or dentist willing to work for what the government pays.
In Asotin and Nez Perce counties, lack of health care providers triggered a federal designation, which in turn provided an opportunity for Community Health Association of Spokane's Lewis and Clark Health Center in Lewiston.
In the month since it opened, that clinic has seen more than 300 people. Half lack health insurance. Another 28 percent have Medicaid and 18 percent rely on Medicare. The clinic is booked through the end of September. Before the year is out, it expects to serve close to 5,000 patients.
Terry Reilly Health Services in Nampa served 29,000 people last year. Two thirds of them had no insurance. Medicaid and Medicare clients accounted for 22 percent. People with private, presumably inadequate, insurance generated 12 percent of the patients.
Anecdotally, you'll hear stories of people who haven't seen a doctor in five years. These are not patients who irresponsibly ignore their health. They just haven't had health insurance since leaving the coverage they had as children. Or they're in their 30s or 40s and work for companies that couldn't afford health policies. Or they've lost their jobs and with those jobs went employer-funded insurance coverage.
All of which tells you this: a RAM venture in northern Idaho or eastern Washington would be greeted by lines of people eager for a chance to obtain as a gift the kind of medical attention they would receive as a matter of right in any other developed country. - M.T.
