Charity Founded To Help People In Remote Areas Obtain Basic Medical Care Sets Up Shop In The United States

Getting your basic health care from a charity organization isn’t just for people in remote areas anymore, according to 60 Minutes. Meet RAM — Remote Area Medical — a charity founded to bring basic health care: vision, dental, and mammograms, for example, to remote parts of the world. What remote areas are they working in now? Try Knoxville, Tenn.

So, who comes to RAM? The uninsured, yes, but the underinsured are in line as well. Like Marty Tankersley. He drove 200 miles to have a tooth pulled because he’d been in pain for weeks and couldn’t afford to see the dentist. Marty has also had two heart attacks and no follow-up care, because it’s just too expensive.

The Tankersleys live in Dalton, Ga., and fall into the underinsured category. Marty’s a truck driver and has major medical insurance through his employer. But the deductible is $500, really unaffordable. And the dental insurance costs too much.

No one really knows how many Americans are underinsured like the Tankersleys.

“He’s the lucky one he could drive the 200 miles. He’s the lucky one who got to see people today and get hooked in. There are tens of hundreds of thousands of people like him,” Isaacs [a volunteer and an internal medicine specialist at the University of Virginia] said.

U.S. Health Care Gets Boost From Charity [60 Minutes]


Edit Your Comment

  1. TechnoDestructo says:

    See, everyone? The Free Market will provide!

  2. Bladefist says:


    People who reject the idea that “government has a responsibility to reduce income inequality” give an average of four times more than people who accept that proposition.



  3. bohemian says:

    I would love to see more lower cost direct options for basic health care. It seems the more you involve insurance companies and huge for profit systems the higher the price of care goes.

    I have always wondered if it would work for a group of people to basically buy a doctor in some sort of coop fashion where you paid an annual fee and that went towards the doctor salary, small office and basic equipment.

  4. B says:

    Makes sense to me. i can’t imagine a place more remote than Knoxville Tennessee.

  5. TechnoDestructo says:


    I’m more about rejecting the idea that the government has a responsibility to INCREASE it.

  6. For those who don’t have time to read the whole aticle. RAM is pretty amazing.

    “RAM operates on a shoestring budget of about $250,000 a year. Yet, last year, it treated 17,000 patients.”

  7. battra92 says:

    @Bladefist: Exactly! Saying “let the government handle it” is just a way out of helping.

    @bohemian: Yeah, I’ve wondered that too. Like you could buy a membership to a certain doctor or something for your basics.

  8. vumastr says:

    Per 60 Minutes, since they originally ran the story in early March, RAM has received more than $2.5 million in donations. Good to see an effective, positive use for television journalism.

  9. TechnoDestructo says:


    Oh, and I think the point here is that it shouldn’t come down to charity.

  10. jamesdenver says:

    Great! I hope someone sends this to

  11. theodicey says:


    Gotta love your charitable giving “study” by moustache expert John Stossel.

    Assuming his experiment was even well controlled (it’s not) –you know why San Franciscans don’t give to the Salvation Army? Because they’re high overhead, homophobic, and have a history of religious indoctrination. There are a lot better charities out there; why would liberals give to a particular charity just because they’re in Christmas movies?

    Even his overall giving statistics are completely flawed, because 55% of all American giving is to churches, and (1) a lot of that are basically compulsory dues payments, like Mormon tithing; and (2) most of that goes to church overhead and maintenance. Take that away, and it liberals are far more generous to people and institutions who actually need help.

  12. Bladefist says:

    @TechnoDestructo: Sure it should. It’s pretty simple. It’s not in the constitution that the government provides it. You are responsible for your own health costs, whether you go towards insurance, or pay out of pocket. If you’re into Entitlement, you’re in the wrong place.

    Thankfully for some unfortunates, there are generous people out there who are willing to help out with their time and money.

  13. Bladefist says:

    @theodicey: Okay, show me some links? Nothing wrong with critiquing my citations, but provide some of your own.

  14. ironchef says:


    and arguably most funds that end up in churches hands are funneled into religious self promotion, operations, and salaries. When ever they do dole out a benefit, it’s usually to try to make converts and PR.

  15. Angryrider says:

    This is sad. It takes a charity with a “shoestring budget” to give health care to thousands of uninsured people, when a Government with billions to waste decide to use it on something else.

    Bravo RAM. Now begin the onslaught of hatred for their push of communist, er socialized health care.

  16. Bladefist says:

    @ironchef: That’s beside the point. That’s true for most organizations. Every worthwhile organization has an “Executive,” and that person often makes 6 figures.

    I am looking at individuals. If I donate $100 dollars to RAM, I am doing my part. Obviously everyone wants their money to ultimately make it to people who need it. But in reality, there are real life costs. The people who work these jobs have bills too.

  17. Bladefist says:

    @ironchef: To further my point:

    * Marsha J. Evans, President and CEO of the American Red Cross, was paid $468,599 in salary and benefits in fiscal 2003. (Source: BBB Wise Giving Alliance)

    * Brian Gallagher, President and CEO of United Way, was paid $432,709 in salary and benefits in fiscal 2003. (Source: Charity Navigator)

    * W. Todd Bassett, National Commander of the Salvation Army, was paid (along with his wife, who also works for the organization) $94,091 in salary and benefits in 2003 (including house and car). (Source: Fayetteville Observer)

  18. failurate says:

    It’s not in the constitution that the government is to provide schools either. Or roads. Or parks.

    I see health care as something similar to schools. The whole of us does better when the mass of us are educated/healthy.

  19. failurate says:

    I take back the roads part… as they were established for postal reasons.

  20. pal003 says:

    @failurate: Nicely said.

    Great positive here – “Since we first broadcast this story, Remote Area Medical has received close to $2.5 million in donations from 60 Minutes viewers”

    But the positive shouldn’t be about Donated medical care.

  21. am84 says:

    Sad. This shouldn’t be happening in America. Or anywhere, really, but especially here.

  22. Televiper says:

    I’m all for personal responsibility. But, people shouldn’t be held personally responsible for not having the necessities that are unattainable to them. A $500 deductible for something you’re expected to draw from regularly, for things often out of your own control, is asinine and punitive.

  23. timmus says:

    I was just at my doctors office 2 hours ago… the staff was telling a 50ish woman checking out that she needed to go to the ER to get treated, and she was crying saying she couldn’t afford it. She was telling the staff she was already deep in medical bills. I left there feeling depressed. This health care system is just awful.

  24. bohemian says:

    @theodicey: I don’t consider giving to a Church to be a charitable contribution unless it is going specifically to some sort of charity work with the general public. Private health clubs in a church do not fly as charity, at least not with me.

    I quit giving to the Salvation Army years ago for the same reasons Theodicey stated. I would rather give to something more direct and less bigoted.

  25. bohemian says:

    @Bladefist: IIRC the person who runs our food pantry makes about $30,000 a year.

  26. SexierThanJesus says:

    @battra92: See, this is all that guys like me want….to at least have conservatives acknowledge that there is a flaw in the system, rather than saying “Can’t afford it? Too bad!! lololol!!”

    Once we get everyone on the same page, we can work towards a solution.

  27. bohemian says:

    @timmus: There was a hospital in Chicago that was having people jailed for not paying their bills. The people in the story didn’t have the funds.

    Most of the small claims and civil litigation in my state is hospitals going after people who can’t pay their medical bills.

  28. ludwigk says:

    Wow, that Stan Brock is a total badass. Basically the crocodile hunter of his time, then flying around the world organizing free health care. Receiving no salary, having no permanent home, and taking showers from a hose in his 70s? That shows some extraordinary resolve.

    I grew up in Knoxville, TN, but I’d imagine that there are hundreds of working poor communities in the US that could benefit from this service.

  29. LVP says:

    It’s amazing what this group does. What this group can do should kick the USA health care industry in the ass. I can understand people making a living but it’s crazy what medical care can cost a typical American.

  30. KitanaOR says:

    Marty Tankersley can afford to drive 200 miles (400 round-trip?), but can’t afford a tooth pulled with insurance?

  31. mike says:

    There was a president that said that where the government fails, their fellow man is more than happy to carry the load. I forget to said it but it’s true.

    It shouldn’t be the government job to feed and cloth you. Private organizations have proven to be more effective than government organizations. That’s why there is so much contracting work!

    On the other hand, why is healthcare so expensive? I have a feeling that it’s a “well, they’ll pay it because they don’t want to die” kind of mentality.

  32. chrisdag says:

    Interesting timing. In small biz, everyone wears multiple hats so in addition to the day job I’m also in charge of benefits for my little company.

    Our health insurance coverage renewal date is tomorrow.

    Until today, our company used to provide the “best” aka most expensive national coverage PPO plan available to all employees and paid all of the monthly costs. It just felt like the right thing to do for everyone.

    However, our 2008 renewal rate quote was more than 30% higher than what we’d been paying in 2007.

    Because of that, the company owners/founders are switching down from the PPO into a regional HMO plan. We are also moving the employees into a PPO that is cheaper on a monthly basis because the employee copay fees and deductible are higher.

    So from a business owner perspective we are treading water — paying the same amount of $$ in 2008 for lesser benefits all around. This is probably only the beginning as healthcare ain’t getting cheaper …

  33. vildechaia says:

    The idea of a “boutique doctor” is, apparently, not a new one. Some months ago, I received a letter from my primary doc that he was leaving his present office, and that, for about a $15,000 payment, I could become one of his patients – one who would have access 24/7, no wait appointments, etc., etc. If I had a spouse who wanted to join with me, that would run an additional $7,500. I have also heard from friends that they’ve heard of this sort of thing, too. Certainly, if a bunch of people could get together and get themselves one of these “boutique doctors,” at a reasonable fee, I might consider joining. As it is now, I’m going to have to find a replacement doc. Yes, I know, easier said than done.

  34. Spookyooky says:

    @timmus: You should have told her to go to the ER and say she was in the country illegally. They would have to treat her then. The only people turned away from the ER are actual Americans.

  35. Daemon_of_Waffle says:

    @bohemian: Northern Exposure did it first.

  36. Trai_Dep says:

    Wow, if only those guys could have access to that top-notch socialized health care that Tony Snow had, and all past and present Congressmen will have until death and our shiny, clever, and just darned handsome current President.
    I’m especially gratified that our President and his party want for us what they have for themselves. Which only makes sense because, y’know, they’re working for us. They wouldn’t want to be, y’know, hypocritical or anything. Nope, not them. Nuh-uh.

  37. mthrndr says:

    @chrisdag: My small business just move to an HSA. In a nutshell, for family coverage, I have a $3,000 flat deductible, with 100% covered after that first deductible. This plan is good for catastrophic coverage, but it is absolutely asinine for preventive care. Before, I had a $20 copay and drug benefits. Now I have to pay out 3 grand before I see any benefits. And what is the premium for this privilege? 600 FUCKING DOLLARS A MONTH. which means I have to pay almost $10,000 in medical costs before I see ANY BENEFIT WHATSOEVER. Apparently, all healthcare is moving toward this. What really irks me is the premium. Fortunately, my wife started a job working for the state, so she and my son are going onto her plan. My premium will then be free (for now) with only a $1,500 deductible. But unless I’m am unable to stand, I am not going to the doctor. thanks, BCBS.

  38. TechnoDestructo says:


    There is a need.

    The market is not meeting it.

    Stop trying to dance around it.

    (Not that health care is really a free market anyway)

  39. SadSam says:


    Yes but you own the money that you save in your HSA and you get a tax break. Don’t you feel better now?

  40. B1663R says:

    it’s not too late… just saying is all…

  41. mthrndr says:

    @SadSam: nope, not this year. that starts january 1. I’m out of friggin pocket until then. fingers crossed, hoping that I stay healthy till then.

  42. TechnoDestructo says:

    @linus: The revolving door of government is why there is so much contracting work.

  43. SexierThanJesus says:

    @linus: If people are getting nailed because of the “well they’ll pay for it because they don’t want to die” mentality, then no….private organizations are not being very effective (in this case).

  44. kadath217 says:


    There’s a serious difference between a nonprofit or NGO paying an executive a high salary (to recruit talent, reward fundraising, etc.) and a church spending money on non-philanthropic works: One is done to fulfill the mission of the charity; the other is diverting money for a completely different mission.

    Besides, you list only a few Execs – whose information is largely available to the public and who are accountable to their Boards. That’s something that most churches bend over backwards to prevent. Most churches don’t let Guidestar or similar organizations look at their books.

    Sorry, but church giving does not necessarily equal charitable giving.

  45. dragonfire1481 says:

    It occurred to me the other day that if something were to happen to me, I do not have enough money at current to even see a doctor for treatment. That’s scary.

    I moved to the U.S. a few months ago from Canada. I didn’t realize until now how much I took the Canadian healthcare system for granted before.

    I do take care of myself and I am working to find a job with insurance but as many can attest to, that’s an uphill battle.

  46. kimdog says:

    I grew up in a rural town about 90 miles from Knoxville, so these people were very familiar to me. My mom was a struggling single mom, but at least she worked for a company that had decent insurance for her and her two kids. If she was trying to make it today, we would have probably been camped out in that freaking line.

    I’ve just been diagnosed with thyroid cancer (scary, but one of the most survivable), and I can’t thank my lucky stars enough that I have excellent health insurance. I work for a medical humanitarian organization that operates internationally, but also believes that their employees have a right to health care. They pay for the entire premium (I don’t contribute anything), and I only have to pay my co-pay of $25 per office visit. So basically, I will come out the other side of biopsy, surgery, radiation, and follow-up care, having payed a couple of hundred dollars.

    It’s luck really, two years ago I was layed off, and out of work for five months. I rolled the dice and didn’t take COBRA. Now, my life choices are limited by the fact I can never be uninsured again.

    This country is seriously fucked up.

  47. @am84: Ain’t that the truth.

    For-profit healthcare does that for you, though.

  48. mzhartz says:

    Anyone else jealous of a $500 deductible?

  49. tno says:

    @SpookyOoky: That’s entirely untrue, no one that presents to an Emergency Department can be turned away for reasons of race, sex, citizenship, ability to pay, or almost anything else. If you know of anyone that has been turned away, I assure you other matters motivated their expulsion, not their citizenship.

    To the rest, I have been involved with the organization, it is truly an astounding accomplishment, and the growth of the organization will be ever more impressive as more care is offered.

    What should be remembered, however, is that this is not necessarily a monetary access issue. These people are often not just too poor for their care. They are too poor to be able to travel to the nearest doctor or specialized facility. Many of the services that RAM provides are preventive, they’re the annual physicals, dental visits, lab work and mammograms that the rest of us can just get into our car and attend. By bringing such services to a “Remote Area,” where it might be a several hours drive to the nearest mammogram center, they’re filling a geographic need as much as a financial need.

    The 60 Minute piece is great, and the attention that RAM is receiving here and elsewhere is well deserved. But the focus of the story should be less about the underinsured and more about the underserved. It makes no difference how good your insurance is if the nearest doctor is 100 miles away.

  50. tno says:

    @MzHartz: I’m with you.

  51. Bladefist says:

    @kadath217: I never said anything about church giving. Every body else was hating on churches. Each Church is different. My Church is full of corrupt assholes, which is why I quit going there years ago. Even as a 13 year old kid, I saw what was going on. There are churches that do good though. And I published what I found, w/o doing 3 months of research. I’m sure a lot of small charities pay their execs even more then some of the big ones. That’s off-topic though. Americans give money. What happens to it, is often BS, but the fact is, Americans can be very generous.

    For everybody else, like I said, if you’re into entitlement, you’re in the wrong Country. It’s not going to happen here.

  52. tno says:

    @kimdog: I’d be interested to know where you grew up, my wife is from Ewing, VA. I understand your predicament, and it is one that afflicts thousands for varying reasons. A recent NPR piece noted that one of the hardest hit populations are young college students. Whether college life is more stressful today than before, more students are turning to the counseling services offered by their schools for help in handling stress. Unfortunately, this carries the weight of a diagnosis. Insurances treat psychological problems as permanent conditions. These preexisting conditions can then become a barrier to further coverage by anyone who has a lapse in coverage, as many recent college grads experience when their coverage under their parents ends and they seek gainful employment. And even without a lapse in coverage, many private insurance companies will still deny coverage for nothing more than a diagnosis.

    Good luck to you Kimdog, our prayers are with you.

  53. tno says:

    @Bladefist: The trouble with calling it an entitlement to provide healthcare to all is, as was mentioned above, everyone benefits from the uninsured getting insured and treated. This is the same as everyone benefiting from being well educated. If fifty million sick Martians showed up here in the States we would have fifty million dead Martians that would have gladly contributed their immense knowledge of all things space travel if only we had given them all some penicillin. This sounds like a ridiculous example but it’s not far off. If everyone that can’t afford insurance and is sick continues to be sick, they will die having been unable to contribute anything to society. If they get insured and get treated, they will get a job and contribute to society, including you.

  54. ludwigk says:

    @mthrndr: I’m in an HSA, but its kind of the opposite. My company funds the account annually, and I draw from it for costs and procedures. Maintenance stuff like checkups is all covered, and deductibles are similar. The HSA handles regular needs for a healthy individual well, but collapses if I need “catastrophic” care. Or maybe I don’t understand?

    I haven’t had to pay anything and my coverage is still through the same providers.

  55. KesCaesar says:

    I have to say in Bladefist vs. Everyone:

    I’m Canadian. The only impediment I see in getting proper healthcare from the US government is that it has proven itself incapable of handling large social programs. Look at federal education, artistic, and social programs – all heavily criticized by every part of the political spectrum. While the Canadian (read:Provincial) system is flawed, it is functional probably due to the populace accepting that they must pay higher taxes and that the population of each province is small compared to the United States, (see: Texas, New York, California, etc).

    If your government proved that it could actually handle such programs, (without privatizing like it did for Medicare, the TSA, and many other large programs which interact with citizens on a daily basis), I would be more inclined to trust it with Universal Healthcare.

    That being said, all evidence shows that, especially in this new slowed economy, something drastic must be done on the behalf of the people who are in need.

    Oh, and ABCnews can kiss my ass- their report on teacher’s unions a few months ago was so appalling I actually wrote in to complain about the calibre of their ‘journalism’.

  56. terminalboredom says:

    I saw this piece last night, and while I applaud RAM, it’s founder, and the doctors that donated their time…I couldn’t help but start noticing there were a LOT of people driving up in brand new cars, wearing flashy name brand clothes, etc. Not to say that there weren’t needy people there, but I just have a hard time watching people who could obviously cut back on conspicuous expenses if they were actually in dire straits take away handouts from those who are truly needy. I understand there are people for whom a work truck IS a legit need in rural America where the story was shot, but around here, I would bet on seeing the parking lot filled with suburban commandos who got in over their head on a commuting vehicle looking for a free handout.

    Before I worked for a company that provided insurance for me, I made DAMN well sure I had my own insurance in case of an emergency. This cost me $200 a month in the late 90’s when I was barely eeking by and had a barely above minimum wage shit job in college. To make up for the expense, I didn’t own a car and used a bus/bike wherever possible, didn’t have a cable/cell/credit card bill, and so on. I understand for people with kids/etc. it’s a lot more difficult, but still…if people would just live within their means (and paying for health insurance is part of that), this would be less of an issue.

  57. timsgm1418 says:

    geez wish my deductible was $500, I find that very affordable

  58. @Bladefist: Yeah, those Quakers, totally not worthwhile with all their Bible-based “shared governance” nonsense. Communists, I tell you! Don’t even get me STARTED on the Mennonites and their touchy-feely brotherly love ….

  59. ironchef says:


    It might be nice to figure out where the money goes for churches but you know…they don’t have to report ANYTHING. It must be nice being exempt from taxes and public oversight or be accountable for the money they collect.

  60. bohemian says:

    @vildechaia: I looked up boutique doctors, it seems to be about the opposite of a patient cooperative that I suggested. Basically it is providing decent healthcare access if you can pay a huge sum of money. It is a pure profit booster for the doctor, but I can see how it might be a more low stress environment for them to work in. It might work if the price is right though, but still doesn’t address catastrophic things. If you had a $3000 deductible and were still buying that insurance plan, paying a doctor the low end of a boutique doctor of $1500 would put you ahead. ThE $15,000 annual fee not so much.

  61. daengh says:

    @bohemian: “I have always wondered if it would work for a group of people to basically buy a doctor in some sort of coop fashion where you paid an annual fee and that went towards the doctor salary, small office and basic equipment. “

    That’s what the small-town doctor was – everyone in town paid part of his fees & he supported himself on that. Then things got Big Medicined.

    Then in the ’80s, that’s what HMOs were supposed to be. You paid a fixed fee & got care. Then things got Big Medicined. Again. Profit uber alles.

    Kinda like our financial system.

  62. bohemian says:

    @daengh: So historically we had forms of sort of socialized medicine before greed and profit stepped in.

    I am old enough to remember when one of our hospitals was still run by some protestant type of nuns. Now it is a mega corp.

  63. Mmmmmmm… Heath insurance… </homer>

  64. Catebb says:

    My husband works for a small non-profit as a social worker for homeless vets. He loves all aspects of his job except the health insurance plan. It would cost $922 a month to cover our family of four. Thats roughly 48% of his takehome salary. How is that acceptable?
    At the moment I am staying home with the new baby, and until I return to work I am uninsured. The irony is I am probably giving myself an ulcer worrying about it!

    With so much insurance tied to employement, it is hard for me to consider it a free market situation. Yeah, yeah, yeah, my husband could leave dream job that gives him so much fufillment. Or we could pay still ridiculous rates for private insurance. Irregardless, we made our choice and are living with it. My point is that the cost of health insurance, let alone health care, is being priced out of reach of many americans. Health insurance should not cost more per month than a house payment!
    Something must change.

  65. AD8BC says:

    I don’t have a problem with charities taking over healthcare for people who truly need it. And there is nothing wrong with accepting charity when you need it.. it’s like there is nothing wrong with using a crutch when you have a broken ankle.

    I don’t want the federal government doing it because of two reasons… the Federalist in me doesn’t want it because it exists nowhere in the constitution that the federal government is supposed to provide anything for us except a common defense — not healthcare, not roads or highways, and not welfare. These items are open for the states to cover, if they so wish. And you are free to move state to state without papers if you don’t like your current state. States can outlaw or allow abortion. States can outlaw or allow gay marriage. The federal government really should not have anything to do with it. Federal taxes should be dirt cheap.

    The second reason I don’t want government run healthcare is that the federal government, under both Democratic and Republican rule, has pretty much failed at everything it has attempted to regulate. Healthcare would be a mess, rich people would end up buying their own doctors, poor people would be left with the government care, it would be like today only worse…

    and I am a conservative who realizes the current system is flawed…. I just don’t think the government can do it. Let the charities try it.

  66. battra92 says:

    @SexierThanJesus: I don’t think anyone is saying the American system is perfect, but I certainly don’t want a big government mess like Canada and Europe has. There are plenty of horror stories from there and many cross the border to get MRIs and what not here in the States.

    The problem is, people are really feeling like taking care of their health is an option and not a need until it gets really bad.

  67. samoq says:

    I saw this story back in March, and sent a donation. Then I watched it again last night and was just as touched- and donated again. I only wish I had a skill that they could use- I’d volunteer.

    Truly a very good organization, but how very sad and infuriating that it is necessary.

  68. kable2 says:

    thats the broken American health care system for ya. Someday you guys might be lucky enough to get a system like we have in Canada.

  69. mthrndr says:

    @ludwigk: yeah, that does sound opposite. My company will put $30 / month into the account (when it starts) – but as you know that barely covers the cost of the syringe they use to draw blood. we’re on the hook for 3 grand, no matter what it is (though after jan 1 it will be pre-tax). after that, everything is covered. so, a good year in this plan is one in which, say, you have a baby a month or so after plan renewal. then you have deductible-free healthcare for the rest of the year. The plan isn’t the end of the world, but for a $600/month premium (as I pay) for family, they could at least throw in a copay for a PCP, maybe a middle-tier drug benefit. it’s better than no insurance (bcbs negotiates rates with providers) but still- it’s depressing.

  70. citabria says:

    According to Wikipedia, the Knoxville Area has a population of over 650,000 people. If that is considered rural, I wonder what they call those dying towns with less than 30,000 that are all too common throughout the South?

  71. brian25 says:

    Good job Consumerist. This 60 minutes episode aired about 6 months – 1 year ago… waaay old.

  72. cmdrsass says:

    @kable2: It might take about 20 years to implement, though. Hey wait – isn’t that about how long you have to wait for a band-aid?

  73. bohemian says:

    @AD8BC: If the US operates as you seem to want it to expect to see an increase in people moving to Canada and Europe. But it won’t be the downtrodden doing it. It will be the professional and highly skilled that are frustrated with backwards nonsense and see a better way elsewhere, you know, in the modern world.

  74. battra92 says:

    @bohemian: Well considering in 2004 and 2000 we heard similar cries of a mass exodus and no one left at all, well let’s just say that I don’t believe it.

    America is the one place on earth you can’t run away from to find a better place. We’re the last line.

  75. pollyannacowgirl says:

    We are ALL SCREWED. I don’t know too many people who would come out all right if they suffered a catastrophic illness or accident. Even my very wealthy MIL was hit hard by my FIL’s illness and death. And they had the best health insurance possible. It still cost dearly. If you get sick or hurt, you are screwed unless you are a millionaire.

  76. swimmey says:


    “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

    There it is in black and white: “promote the general Welfare.”

  77. lamorevincera says:

    @kimdog: My thoughts are with you, and I wish you the best.

  78. failurate says:

    @AD8BC: I made that mistake too… roads are actually in the constitution. Article 1 section 8.

    “To establish Post Offices and post Roads”.

    There are 27 amendments to the Constitution… a 28th wouldn’t kill us.

  79. tno says:

    @terminalboredom: There is an ultimately small subset of the uninsured that are essentially the electively uninsured. Some of these people are even those who have subscribed to boutique doctors but carry no catastrophic coverage. This subset of the uninsured is often young and relatively healthy, believing that insurance is not for them because they are healthy and young. When a medical issue presents itself, even one so minor as a tooth ache or other such ailment, these people are terribly unprepared and often find themselves seeking these sorts of charitable gifts. I don’t make this point to condone this sort of activity, but to point out that educating Americans about the risk of being uninsured is vital to the system.

  80. tno says:

    @bohemian: The other issue with a boutique doctor is that it often only gives you access to the doctor, not other facilities. So, you might still end up paying for x-rays and other matters that require follow up, and if you ultimately need to go see a specialist, that might also end up coming out of pocket. Boutique doctors are a nice idea, but really only practical for people who will never visit their doctor for anything other than their annual physical and a cold.

  81. tno says:

    @Catebb: This sort of employer provided coverage (reasonable employee rates, unreasonable family rates) are tied to the desire of a business to encourage turnover (preventing any employee from ever making much more than entry level) and attracting younger, unmarried employees who won’t know to ask for more benefits. This happens at my work (a small rural county government) that pays $6000 annually in premiums for health insurance for each employee (a pretty exorbitant group fee) but forces employees wishing to cover their family to pay for the entire cost out of pocket, so in a similar situation, a family of four might cost an additional $18000 for family coverage. Needless to say, with just my wife and I it is cheaper for her to get coverage through a private insurer, but once we start having kids, it could get very complicated.

  82. tno says:

    @AD8BC: I appreciate your pragmatism in not using the usual conservative argument that the free market will find a way to cover everyone, it won’t. The problem with allowing charities to handle it is that their scope can only be so large before they become impossible to manage properly. Think above to the quotes regarding charities and their highly paid execs, eventually the free market will require that these charities act like big corporations and then the donors to these organizations become disenchanted that half a million dollars of their contributions are going to pay for a single persons salary. Can big government fix this? Maybe. Does this involve highly complicated health care structures? No. Catastrophic coverage is almost wholly regarded as all that is necessary to drastically change the cost of healthcare. Thanks to the comorbidity of poverty and chronic debilitating conditions that lead to catastrophic events, a huge percentage of those people that suffer catastrophic events are unable to pay for them. As a result everyone that suffers a catastrophic event pays more for their treatment. This then puts the capability to pay for catastrophic events beyond even the insured. After so many cases of hospitals aggressively going after patients who have not paid their bills, most health care organizations have gone to compassionate billing, they’ll send the bills, and make the threats but ultimately never do more than file a report with a credit agency. Even still, health care costs lead the charts of reasons for bankruptcy. And all the unpaid money trickles down so your next physical costs more than it should to make up for all of the patients that can’t afford their heart attacks. That’s a trickle down economy that hurts everyone, regardless of how much you make or who you are. Catastrophic coverage could change all of this.

  83. tno says:

    @citabria: Knoxville is one of several urban/rural bastions that dot the area surrounding the Appalachians. The aspect your missing from the article is that the patients drove hundreds of miles for this event. And if you look at RAM’s schedule you’ll see places like Wise, VA or Grundy, VA/TN. These are small towns in a big rural region that has some of the worst geographic access to health care. When RAM has its large event later this month, the 12,000 patients that will be treated will have traveled huge distances from some of the poorest homes in the nation. The Knoxville location is a convenient homebase for the organization.

  84. LincolnK says:

    Rather than the botique/coop doctor setups mentioned, this seems like a good way to go:


    It’s a one-doctor private operation (looking to hire another) that doesn’t take any 3rd party payments- private insurance, medicare, etc, although you can submit a claim to your insurer on your own if available.

    Services provided are paid for at the time they are given. I think typical office visits are around $35 total. This way people can afford to go to the doctor for routine visits, and people can buy catastrophic insurance coverage than doesn’t break the bank.

    He’s also located in rural Tennessee, and his client base is mostly uninsured/underinsured people in the area.

  85. jimconsumer says:

    But the deductible is $500, really unaffordable.

    I’m sorry, but I’m positive this is bullshit. $500 is unaffordable? How much are their car payments? How much is their house payment? Cellular bill? Cable TV? Internet? Do they own a computer, stereo, television, other electronics? How often do they eat out? Are they living on rice and beans, or eating steak from time to time?

    You show me a person who tells me they can’t afford $500 a year and I’ll show you a person who is lying. I can turn any budget inside and out and I’ve got money that says they’re blowing a hell of a lot more than $500 a year on unnecessary items.

    The cost of medical care in the United States is not the problem, it’s the “gimme” attitude. People feel they’re entitled to free medical care and they find ways of convincing themselves they can’t afford it. I know a “poor” family who is on state medical care because they “can’t afford” it. They have two car payments and a $120,000 house that they had no business buying, as well as plenty of toys for the children, including a recently build $2,000 doll house out back (no, I’m not exaggerating). But they can’t afford medical care. Bullshit.

    Priorities, people.

  86. Squeezer99 says:

    $500 is unaffordable? WTF?

  87. snowygal18 says:

    Fully insured, but I will be donating $10 for each doctor visit I go on as a kind of thanks.

    @Squeezer99: $500 is unaffordable for a lot of people, especially if it’s per doctor’s visit. Let’s say you have a funky mole. That’s up to $500 for the GP, up to $500 for the dermatologist, and up to $500 for the biopsy. Your tiny mole has now become $1500, and if you have cancer…well.