Some Emerging Patterns

I've now had the opportunity to interview ten women who currently live at Tent City 3. All have been incredibly kind and open, which is especially noteworthy since they're speaking with a stranger about personal health needs. And while each person's story differs- how they've ended up in TC3 and what their personal health care needs are- there have been some emerging patterns.
To maintain confidentiality, I don't want to share any of the personal stories for fear of such an experience being tied to one of the ten women but I can share some general themes that aren't necessarily surprising but are wholeheartedly saddening.

1. No income means waiting for months:  While there are numerous clinics that provide sliding scale fees, often going as low as $15 for a visit, this amount, if you're someone without SSI, Medicaid or GA-U, and you have an annual income of $0, the nominal $15 co-pay is too much. There are a handful of clinics that will not refuse treatment regardless of one's ability to pay, or they use Charity Care funding, bringing a bill down to nothing. But, these are the clinics where you frequently encounter a waiting list for new clients or a several month waiting period for an appointment.When faced with these two challenges, I can imagine why it's often far more appealing to head straight to the ER, where you couldn't be refused treatment.

This is not meant, in any way, to disparage the work being done at each of Seattle's clinics for the low-income. Rather, this work sounds tremendous and should be replicated. Rather, I believe that such an occurance further clarifies the barriers the homeless face and how dire the need actually is.
2. The ER provides primary care: I remember talking to voters throughout the 2007-2008 campaign cycle, trying to get folks onboard with a vague plan for universal healthcare as proposed by then Senator Obama.  For those ardently opposed, the talking points would always involve the token, "Because we don't have coverage for all Americans right now, folks are using hospital emergency rooms as their primary care resources, and you, as a tax payer, are footing the bill." 

I assumed this to be true- the Talking Points Masters wouldn't lie- but with 10 interviews now accomplished, there hasn't been a single woman who hasn't mentioned the ER as her resource when faced with illness. Most avoid any kind of health care due to lack of insurance or income, but when they have some type of ailment that they believe needs treating, some type of ailment that I would definitely pop into my regular doctor for, they take a bus ride over to one of the area's hospitals. They simply have no other option and they haven't had access to enough preventative care to prevent such a need in the first place.

3. Walgreens Glasses: There is a desperate need for vision care yet no one seems to have been able to find it for little to no cost. Instead, many women shared that they've just purchased $1 reading glasses at Walgreens, which may help slightly but do very little to conquer the constant headaches or need to squint.

4. Dentures: There's a dental van that comes to TC3 about once a month and is able to pull out people's problem teeth or complete fillings as needed. It's a great service but it leaves folks in the lurch for other much-needed dental care.  More specifically, I continued to hear about dentures; there's several women in their mid-40s and 50s who wear dentures and need repairs. But no one seems to offer denture work for low income individuals.



Thanks Congressman Ryan but your budget proposal
is just going to result in more preventable visits to the ER

It might have been the cycle of Indigo Girls songs on my Ipod this morning that put me in a more frustrated-than-usual by social inequities and injustices mood, but the unmet needs just don't seem like what folks should have to encounter in the United States in 2011. There's a lot of great services in existence, and noble attempts at alleviating suffering and limiting the reach of poverty, but I can't help but grow more and more frustrated about the continuing political debate regarding PPACA funding. No, the ACA isn't a panacea but it's surely a start.  Those holding up the legislation's enactment with cost concerns should really have to go and speak to these women. They should have to tell them personally, "I'm sorry you can't chew your food because of an infected absess in your mouth but we just can't afford to help you."