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zoom RSS 無料医療に長蛇の列/米国医療事情 医療制度改革

<<   作成日時 : 2009/08/22 00:25   >>

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 多くは新しい歯を求めて来たが、血圧チェック、マンモグラフ、予防注射、痛みの鍼治療に来た者もいる。南ロサンゼルス近郊は医療が不充分な地域であり、近くでできると知らせが来れば直ちに広まる。
 地域に移動医療を提供するNGOが企画し、2日目の水曜日は夜中過ぎから数千人が並び、無料の歯科、内科、眼科の治療が行われた。
 巨大なMASHユニットのような一度マドンナがショーを開いたことのあるアリーナフォーラムのフロアに歯科治療椅子が並べられた。8日間の日程を組んだが、1日目に1,500人が訪れ、500人の治療ができなかったという状況だった。無料治療への大きな反応は、オバマ政権による医療制度改革案への恐怖と怒りとしてタウンミーティングに押し寄せた数百人のアメリカ人と同じく当然の結果でもある。高い失業率、貧困層へのメディケイド医療の削減、高い医療費免責額と自己負担額などを反映している。ここにきた多くの人は無保険だが、他の多くは保険はあっても必要な治療が受けられないという。
 主催者Stan Brockは、組織がめざすのは医療討論ではなく、25年あまりやってきたことを続けているだけで、必要な慈善事業だという。先月はオバマ大統領がバージニア州を訪問する数日前にイベントを開催し注目を得た。以前にハリケーンカトリーナの後にニューオリンズを含む中規模都市でサービスを提供したが、大都市圏では一度もなかった。地域の歯科と検眼士のボランティア不足に悩まされている。
 カリフォルニア州は先月、歯科と眼科のMediCalでのカバーを止め、貧困層の子ども対象のプログラムに上限を設定した。これにより数千人が治療保障を失った。
 国内最大の無料医療イベントとなり、アリーナと供給品は無料で提供されたものだという。他の経費はグループが資金集めをして得たものである。火曜日に、95回の抜歯、470個の充填、140組のめがね、96のパパニコロースミア、および93の結核テストを含めて、ボランティアは約600人の患者に1,448のサービスを提供した。数百人のボランティアの医師、歯科医、検眼士、看護婦など、8日の最終日までに8,000人の患者に奉仕することを期待されている。
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消防車で無料歯科クリニック/米国歯科医療事情
http://kurie.at.webry.info/200903/article_41.html
ケンタッキーの歯/米国歯科医療事情
http://kurie.at.webry.info/200712/article_43.html
移動歯科クリニックで'Mountain Dew Mouth'を治療する/米国歯科医療事情
http://kurie.at.webry.info/200902/article_30.html
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Thousands Line Up for Promise of Free Health Care
By JENNIFER STEINHAUER
Published: August 12, 2009
http://www.nytimes.com/2009/08/13/health/13clinic.html

Ruth Fremson/The New York Times
People receiving free dental treatment at The Forum in Inglewood, Calif., on Wednesday. More Photos >

INGLEWOOD, Calif. ― They came for new teeth mostly, but also for blood pressure checks, mammograms, immunizations and acupuncture for pain. Neighboring South Los Angeles is a place where health care is scarce, and so when it was offered nearby, word got around.

For the second day in a row, thousands of people lined up on Wednesday ― starting after midnight and snaking into the early hours ― for free dental, medical and vision services, courtesy of a nonprofit group that more typically provides mobile health care for the rural poor.

Like a giant MASH unit, the floor of the Forum, the arena where Madonna once played four sold-out shows, housed aisle upon aisle of dental chairs, where drilling, cleaning and extracting took place in the open. A few cushions were duct-taped to a folding table in a coat closet, an examining room where Dr. Eugene Taw, a volunteer, saw patients.

When Remote Area Medical, the Tennessee-based organization running the event, decided to try its hand at large urban medical services, its principals thought Los Angeles would be a good place to start. But they were far from prepared for the outpouring of need. Set up for eight days of care, the group was already overwhelmed on the first day after allowing 1,500 people through the door, nearly 500 of whom had still not been served by day’s end and had to return in the wee hours Wednesday morning.

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. The bleachers of patients also reflected the state’s high unemployment, recent reduction in its Medicaid services for the poor and high deductibles and co-payments that have come to define many employer-sponsored insurance programs.

Many of those here said they lacked insurance, but many others said they had coverage but not enough to meet all their needs ― or that they could afford. Some said they were well aware of the larger national health care debate, and were eager for changes.

“I am on point with the news,” said Elizabeth Harraway, 50, who is unemployed and came for dental care. “I think the president’s ideas are awesome, and I believe opening up health care is going to work."

Stan Brock, Remote Area Medical’s founder and among the many khaki-wearing volunteers in the arena, said his organization’s intent was not to become part of the health care debate, but to do what it had done for nearly 25 years: offer charity to people in need. Still, the group attracted attention last month when President Obama visited Bristol, Va., just days after it held a health care event in nearby Wise, Va.

“My position on the Obama plan is that I am delighted to see so much focus on the health care issue," Mr. Brock said. “There is incredible focus on what we do, but that is not my doing."

In the past, Remote Area Medical has also provided services in mid-sized American cities, including New Orleans after Hurricane Katrina, but had never tried an operation in such a large metropolitan area. Mr. Brock said the considerable logistics were made possible with the help of Don Manelli, a film producer, but he said he was disappointed in the dearth of volunteers among local providers ― specifically dentists and optometrists ― which made it hard to provide services for all comers.

Ana Maria Garcia, who works for Orange County, has health insurance that covers her husband and 3 1/2-year-old daughter, but her dental deductibles are too high for them all to get care, she said.

Ms. Garcia’s husband, Jorge, who was laid off from his custodial job last October, arrived from their home ― a 90-minute drive away ― at 4 p.m. on Tuesday to get the family’s spot in line.

But the Garcias’ number never came up, so they slept in their car for a few hours and lined up again early Wednesday morning, awaiting a chance to get root canals and cleanings that Ms. Garcia figured were worth thousands of dollars. They made a friend in the bleachers outside, who gave the family some coffee and hot biscuits for breakfast.

“Regardless if you are employed or not,” Ms. Garcia said, “everything in California is expensive, and so I can empathize with everyone here. Looking at this crowd, I think this is what people fear health care is going to be with reform. But to me it also shows the need.”

Last month, the state dropped its dental and vision coverage for MediCal enrollees, and has since capped enrollment in the state’s health insurance program for children of the working poor. Thousands of people across the state lost their coverage in the middle of complex, multimonth procedures and have found themselves at a loss.

Sammie Edwards, a retired welder, was in the middle of getting dentures made when his care ran out, he said. A friend at a food bank clued him into the free clinic. “A lot of older people are caught in the midst of this,” Mr. Edwards said.

Begun in 1985 as a mobile health clinic serving undeveloped countries and later rural America, Remote Area Medical provides various medical services through units to people who are largely unable to gain access to health care. Officials from the organization said they believed that this week’s event in Los Angeles constituted the largest free health care event in the country, with the arena and all supplies and services provided free to the group. Other expenses were covered by the group’s fund-raising.

On Tuesday, volunteers provided 1,448 services to about 600 patients, including 95 tooth extractions, 470 fillings, 140 pairs of eyeglasses, 96 Pap smears and 93 tuberculosis tests, the organizers said. Hundreds of volunteer doctors, dentists, optometrists, nurses and others are expected to serve 8,000 patients by the end of the eight days.

For those willing to endure the long waits, the arena was like a magical medical kingdom, where everything was possible once a person got through the door. Mike Bettis, who runs security for a nightclub in Hollywood, and his fiance'e, Lourie Alexander, who cleans homes, said they usually went on Craigslist, exchanging a home cleaning for a dermatology appointment.

By Wednesday, the couple had gotten between them dentures (him); a breast exam, Pap smear and general physical (her); and acupuncture (both).

“What I liked about it was that everyone was so sweet,” Ms. Alexander said. “You know when you haven’t seen a doctor in so many years you have a lot of questions.”

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突然失礼致します。
この記事、LA timesの一面にでかでかと載っていたのを覚えています。無料の供給、ボランティアの医師、、、、無保険者・低所得者への無料サービスが、結局は我々一般人の負担となって返ってくるのです。低所得者から取れない分、アメリカの医師は普通に通院する一般人に好きなだけ請求してきます。保険会社と医師との契約があり、契約内では患者自己負担額の上限が設定されていますが、契約外の場合は全額自己負担です。取れるところから取る、、、医療だけでなく何でもそうなのがアメリカですね。
、、、と保険業界人として、今のアメリカ医療問題のニュースには目が離せません。
すりあら
2009/09/10 10:40

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無料医療に長蛇の列/米国医療事情 医療制度改革 医師の一分/BIGLOBEウェブリブログ
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