On the front line of healthcare debate
“Do you want to see the tooth?” Dr. Mehrdad Makhani asked me Friday morning at the free clinic being staged inside Inglewood’s Fabulous Forum. “Come. I’ll show you.”
Jenny McLean, 36, opened her mouth and Makhani aimed a little flashlight in there.
“You see here?” he said.
The area around a back tooth was red and swollen, and McLean’s eyes were teary with discomfort. She’d endured the pain for more than a year because she’s had neither insurance nor the money for a dentist since losing her job as a social worker.
It was a story repeated hundreds of times last week at the Forum, where a nonprofit called Remote Area Medical had brought in volunteers to treat legions of the uninsured.
“Here, look at this,” said Makhani, pointing to a second tooth that would have to be extracted and yet another that needed a root canal.
Makhani pointed me to another dentist. “Talk to him. He’s worked in Brazil.”
That would be Joseph Chamberlain, a Westwood dentist who said he’s done charity work in Brazil, but not in conditions like this.
“They have a nice system of public hospitals and clinics,” he said.
But don’t patients have to wait for treatment?
“Yes,” Chamberlain said. “But not like this. Not for a year.”
Stan Brock, who founded RAM in 1985 to bring medical care to Third World countries, told me that in 1992 he began getting requests to do the same work in the United States.
“The people we’re seeing here have teeth as bad as the people in the Upper Amazon,” said Brock, who used to tangle with wild beasts on “Mutual of Omaha’s Wild Kingdom.”
It would be nice if we could send Brock to the nation’s capital and have him grab the vipers and hyenas by their necks until they work out a healthcare reform plan. But Brock has a better idea: The nation’s leaders should instead come spend a day at one of his clinics and learn a thing or two.
He pulled out a chart showing that at his last medical jamboree, in Virginia, volunteer dentists performed 4,304 tooth extractions in two days, among various other medical procedures.
“President Obama was just down the road somewhere a couple days later, talking about healthcare,” Brock said. “I think it would have been a lot more interesting if he came to our clinic.”
Eugene Taw, an ear, nose and throat specialist with the Buddhist Tzu Chi Free Clinic in Alhambra, was one of many Forum volunteers who has worked in other parts of the world. Yes, he said, there are far too many parallels between the uninsured in the United States and the residents of impoverished Third World nations.
At the Forum, his patients included a diabetic amputee who had not been able to buy his medicine for months, a retiree who couldn’t afford an X-ray for a lung problem, and a 30ish female diabetic with a kidney ailment so serious that Taw called for an ambulance to take her to a hospital.
“This is great for helping people in need,” Taw said of the Forum clinic. “But it’s not a good way to do healthcare.”
Diabetes and hypertension require regular maintenance, Taw said, rather than occasional urgent trips to an emergency room after the patient deteriorates and the treatment is more expensive. By some estimates, Taw said, 85% of the estimated 47 million uninsured Americans are members of working families. So why not divide the cost of their health insurance evenly among employer, employee and the government?
Taw said he’d seen the Friday headline in The Times about the latest cut in California’s Healthy Families Program budget, which means nearly 670,000 children could lose medical coverage by next June. A disaster in the making, he said. Yes, and Brock told me the biggest difference between the Third World and the United States is that in our country, children have had far greater access to doctors.
The huge turnout each day at the Forum made it clear that although Southern California has quite a few free medical and dental clinics, there aren’t enough to handle the demand. Among those waiting patiently for help was Walter Samwel, a 70-year-old Vietnam vet from Gardena who has been putting off a root canal for two years.
I asked Samwel why he didn’t go to the VA and he said they’re swamped with recently returning vets, and more severe dental problems take priority. He had arranged time off from his part-time job as a maintenance man at a Long Beach senior center to come to the Forum, but this was his third attempt to get help. The first two days, his number was too high, and the dental clinic shut down before he was called.
Would his Medicare cover the dental work?
No, he said. There’s lots it doesn’t cover.
There’s something shamefully wrong, I told him, when a man who served his country overseas for seven years can’t get basic dental care.
“This is true,” Samwel said, “but nobody wants to hear it.”
Across the Forum, Adrienne Teeguarden was waiting for her first eye exam in 2 1/2 years. Since her layoff as a clothes designer, she’s been working as a part-time nanny and can’t afford health insurance or glasses.
Greg Pearl, an optometrist who has done medical relief in Mexico and South America for Volunteer Optometric Services to Humanity, said it’s outrageous that vision and dental care are not in most U.S. insurance plans and are rarely part of any conversation on healthcare reform.
When I asked him about differences in the patients he sees overseas and in clinics such as the one at the Forum, he had a quick answer.
“Here, the patients speak English.”
I can’t say I was surprised by the spectacle at the Forum, but with each of two visits, I knew I was witnessing the perfect distillation of an unconscionable societal failure. Whether the answer includes the public option Obama has pitched, or the clampdown on obscene insurance company profits proposed by a doctor friend of mine in Wednesday’s column, a civil society has no excuse for not finding a better way.
“I don’t have the answers,” said Makhani, the dentist who insisted I look closely at his patient’s ailing mouth. “I’m not a politician. But I have people here with infected teeth, gums, abscesses. I saw a lady bus driver who lost her job and she’s walking around here crying. Her tooth is infected, she’s in pain and she can die from this. This is disastrous. This is a Third World country and people need to come and see this.”
Like hundreds of other volunteers at the Forum, including roughly 20 dentists simultaneously working on patients while many, many more waited their turn, Makhani had but one motive.
“Why do I do this? What do you think? Look at the need,” he said. “What would you have done? Just look at the need.”