Home Social Issues Health Care in Kilgorvia; RAM comes to Lee County

Health Care in Kilgorvia; RAM comes to Lee County


Lee County Hospital photo 140912LeeCountyHospital_zpsc51ee543.jpgSpending just moments with Dr. Joseph Smiddy is a cascade of chilling water for those claiming faith in the American health care system. What a lot of people proclaim as the best medical system in the world isn’t delivering for many with the greatest need right here in Virginia.

“It’s not just that they can’t afford any sort of insurance that might be available to them under the Affordable Care Act. It’s that this is a horribly underserved region in terms of medical resources.” – Henry Schuster, 60 Minutes producer (at 3:17)

Organizers of an expeditionary Remote Area Medical (RAM) clinic just outside of Jonesville, Virginia expect something on the order of 600 patients today and tomorrow. This is the first of this kind of event in Lee County, set up in and around the airport that sits further west than Columbus, Ohio and Detroit, Michigan, far removed from Richmond. Sadly, this constitutes primary care for many residents. When I arrived yesterday as a volunteer, 22 hours before the first patient would be seen, there were already three carloads of people lined up to ensure they could get one of the specialty services. They know the routine.

Somehow Delegate Terry Kilgore (R-Gate City) avoids discerning scrutiny from his constituency. Even with all that tobacco money he is bringing home, many of those living in Virginia’s poorest county rely upon the generosity of others for any health care at all. The county’s only hospital closed about a year ago.

On September 30, 2013, the Lee Regional Medical Center closed its doors after serving the community for 70 years. With the loss of jobs and decreased access to medical care, the residents of Lee County have been deeply impacted by the hospital’s closure. – Lee County Hospital Authority

Old and new Health Wagons photo 140912NewandOldHealthWagons_zps83ef3fff.jpgThe Health Wagon is the only regular option for health care for many in six Virginia counties; even counties with hospitals. There has been some good news about the Health Wagon even since the last RAM event in Wise County: they have a brand spanking new truck! The old RV, featured on 60 Minutes (note that the ads in the video straighten out after a couple of minutes) last spring will not go into full retirement; they will eke out every last drop of utility by rolling it to RAM and similar events.

There were a good number of RAM volunteers including the local high school football team members in their “Generals” game jerseys. They didn’t have a game this week so they were prime for this mission. Medical students from VCU-MCV pitched in. Most of the RAM setup volunteers, one from as far away as Bethesda, Maryland, cited having some of their “families’ people” living nearby or in similar circumstances.

The Washington Post had a reporter and photographer there and a cameraman from NBC News spent time with those who had lined up at the gate a day early. One of the RAM regulars told me she recognized the Post reporter as a regular at the Wise County event. There were some local officials who walked through looking like they felt out of place.

Back to Dr. Smiddy. He seemed irritated that the demand for services like RAM or the Health Wagon might be reduced to hot button phrases like “Medicaid gap.” The issue looms so much larger for him. Smiddy has practiced in the region for 41 years. What he sees is that we are sicker than we have ever been with lung and chronic obstructive pulmonary diseases, diabetes, hypertension, obesity, asthma, and dental problems. Our health has improved in the area of heart disease because of all the stints. So there is some improvement in health from modern medical care and imaging technology. “And we have wonderful practitioners.”

But, Smiddy continues, people who have Medicare or Medicaid face other obstacles. They simply don’t have the co-pays; they don’t have a ride; they don’t have a provider; nobody will take their insurance, Medicare, Medicaid, whatever. There’s geographic isolation; they are separated from health care from causes like the hospital in Jonesville being closed. So, yes, there’s a crisis in health care: people are in the gap; they are in the donut hole. People have insurance but there’s a $5,000 deductible before the insurance ever kicks in.

Kilgorvia photo 140912KilgoreCountryMkt_zps60a87f0a.jpg “We have more people staying away from the doctor. They are just dying at home.” People with serious illnesses are not going to the doctor because they are out of the payment system.

“America…I work in several countries…America is the only country in the world where you get sick and lose your home. There’s not another country like that.

And everybody says, “Oh, you’re sick in Lee County, just drive over to Holston Valley’s (Kingston, Tennessee) emergency room.” They’re either going to throw you out or they’re going to get money; a lot of money. It’s not going to be what it ought to be. It’s not the real answer. So it’s complicated, it’s expensive, it’s going to get worse. If Virginia expands Medicaid, if Tennessee expands Medicaid…which is doubtful…they’re going to do a little version of it, but it’s not going to reach many people.

The main thing that RAM does, is you look out and they’re real people.  They have real names and real faces and you don’t see them if you don’t come to this type of event.” – Dr. Joseph F Smiddy, Treasurer, Central Appalachia Health Wagon.

Wonder if the Earl of Kilgorvia will attend this event.

  • Mallsus2

    Kilgore, somewhere deep down inside, recognizes the shame of his blocking Medicaid and is one of the main sponsors of RAM even though he has it within his power to make RAM unnecessary. It’s also really nice that he has put his full-fledged support behind the push to get a new hospital in Lee County that roughly 70% of the population will have to go into massive debt or bankruptcy to use as a direct result of his position on Medicaid expansion. No, you won’t see him anywhere near RAM in Lee County the same as Wise. If he showed up he would have faced questions about Medicaid that his ideological position cannot answer.

  • va_lady2008

    bends toward justice, or so Martin Luther King, Jr., told us.  The trouble is that it takes too damned long. I’m married to a decent Republican, of the strong national defense, pay your bills, and live and let live variety.  I’m the MOTHER of the same thing.  I got my Medicare card in the mail last week, so I am not a spring chicken.  I had hoped that before I shuffle off to the next dimension, it might just possibly be realistic that I could vote for a Republican.

    Wrong answer.  Despite everything, I see racism, homophobia, misogyny, and nativism not embraced and accepted, but celebrated,  triumphing and literally destroying everything that America ought to stand for.

    I’m an old lady, hence in part my Nom d’Internet, but jeeze, I though at least some of this would be gone before I croaked of old age.

  • kjp

    …especially about an often forgotten part of Virginia. It  is true that RAM happened, and that it happened west of Jonesville. But you do need to strive for accuracy here, and in one particular the article is terribly inaccurate. The hospital that closed last year was not in Jonesville, but in Pennington Gap, just a few miles up the road from Jonesville. This is not being pedantic; it’s just a request that you provide the same attention to detail in the far, far west that you would insist upon in the area of, say, Arlington or Richmond. The error simply shows that no one actually went to Pennington Gap–or even to Jonesville–to see the old hospital and check out the story. It wouldn’t have taken long to see the old hospital and get the facts straight, about 15 minutes, all told.

    That said, the decision to close the hospital in Pennington was a decision made entirely by the outside corporation that had recently purchased the hospital and even more recently did an extensive remodel. What made it even more maddening was that the corporation claimed that Obamacare did the hospital in, when in fact they seem to have made the remodeling decisions based on the Medicaid income they would have coming in, an estimate that failed to take into account the legislative roadblocks that made that impossible. This became a case of not having the cake, not eating it, but getting to blame the cake’s absence on the guy who would have brought the frosting. I only hear about the re-start petition from various fourth hand sources, but it sounds like the difficulty has been the reluctance of the corporation to let go of the property. Yep, corporate medicine, the greatest health care system in the world. …Not.