Oct. 12--While the access, cost and quality of health care coverage provided to Southwest Virginians vary significantly among different demographics, there is a pervasive skepticism of actually seeing meaningful health care reform.
Be it a family of four with employer-based insurance, a health care provider, a Medicare recipient or an uninsured middle-aged free clinic patient, all say they are concerned about access to affordable health care and doubtful government or a new president can offer a plausible solution.
"I know something needs to be done, but what exactly is a hard one to answer," said Carol McCoy, a 72-year-old Roanoke native who spends at least two days a week volunteering at the Lewis-Gale Medical Center information desk.
"It's really going to take a long time. ... I think the cost of drugs is outrageous and the cost of health care is outrageous."
While she said her health coverage is fine between Medicare and a supplemental policy, she sees her family and neighbors struggling.
Despite knowing that both presidential candidates have called for starkly different ways to reform health care, of the nearly two dozen people interviewed for this article, the vast majority said the plans were simply political ploys to get votes and are unlikely to become reality.
Among the differences, Democratic candidate Barack Obama would increase federal regulations and provide mandated coverage for children, while Republican candidate John McCain would reduce both state and federal regulations and give more choices on where to buy health insurance.
"I have not seen anything yet that has convinced me that this is something they can do and will do," said Mindy Berchfield, a married mother of two children living in Alleghany County. "There needs to be total reform from the bottom level up."
A physician assistant working at the Alleghany Highlands Free Clinic said while something needs to be done, he's not basing his presidential vote on the health care policy.
"I think it's getting enough attention, people recognize the problem, I just don't think there is a good solution yet," said Brent May, who plans to cast a vote for McCain.
"It's such a huge problem and when you think about finding some plan or some solution for the millions of uninsured people or underinsured ... I just don't know, that's a lot."
It's that wariness over the political sincerity of health care reform that caused many to say that the topic would not decide their vote.
Other broader topics like the economy, war, a "need for change" and a need for an "experienced leader" were much more likely to be the reasons for supporting a particular candidate. Several people simply said they didn't plan to vote in the election.
Berchfield said she would vote, but didn't say which candidate she supported.
She also said her family is "blessed" even though she recently used money intended for a water bill to cover the cost of an emergency tooth extraction for her 10-year-old son.
Berchfield's family has health insurance through her husband's job. But a recent call from her son's school sent her driving 75 miles to West Virginia to see a pediatric dentist.
When Berchfield made the appointment, she thought the dentist office participated in her insurance plan. It wasn't until she arrived that she discovered it didn't and she was stuck with a charge of $180 that had to be paid prior to treatment.
"That was shocking," she said. "I had not gone prepared to pay, but I wasn't going to let my kid suffer with a toothache."
Finding another dentist in an area that is already in dire need of more dentists was not an option.
Still, Berchfield said others in her community are in worse predicaments when it comes to affording and accessing health care.
Free clinic in demand
The Alleghany Highlands Free Clinic has seen its patient population triple since 2003, and it continues to see about eight new patients a week, said Luanne Osborne, the clinic's executive director.
"We've seen just an explosion in requests for services, and I know there is much more of a need than we even see," Osborne said.
"Statistically, we know there are about 20 percent uninsured in our area. We don't see nearly that number because we see only the ones who are ill."
The clinic opened in 1998, and when Osborne took the helm five years ago, she said there were 363 patients. In 2007, the patient population was nearing 1,000 people, she said, adding that she hasn't had a chance to look at numbers for 2008.
Much of the growing demand at the free clinic is related to the closing of various mills in the county.
"Every time a plant closes, we know we are going to start seeing new patients within a month or so," said Wanda Nicely, an administrative assistant at the clinic, adding that two major plants employing hundreds in the community have closed this year alone.
That's how Velma Jeffries, 53, became a patient.
On March 9, Jeffries lost her job at Parker Hannifin when the Iron Gate manufacturing site closed.
Without a paycheck or benefits, Jeffries also lost her insurance. She said she couldn't afford to pay for health insurance through the provisions of the Consolidated Omnibus Budget Reconciliation Act, the federal program that allows former employees to continue coverage by paying the premiums in entirety.
On July 6, Jeffries was bitten by a pit bull. Without insurance, she didn't attempt to get treatment for the deep puncture wounds in her right ankle.
"That was the main thing on my mind, I didn't have insurance and I didn't know what to do," she said.
It wasn't until July 23 that she stumbled into the clinic. Her wounds were infected and in the following days she was hospitalized twice for treatment.
Jeffries said she plans to vote for Obama, but not necessarily because of his health care reform plans.
"It's just when I do hear him speak, he is more believable," Jeffries said.
Still, she said she hopes Obama can help bring about a change that will improve health care access for everyone.
"The clinic is great, don't get me wrong," she said. "But they need to make it [health care] more affordable for us who lose our jobs and a whole lot easier for the lower class, working person to afford health care."
The idea that working people deserve quality health care appears to be a persistent theme.
"It's just an overall fairness issue," Berchfield said. "Our community is one that values hard work. I'm a firm believer if a person works and puts forth an effort they should get insurance that is dependable."
Costly private insurance
Besides the ranks of the uninsured, and stories like that of Berchfield's, there are concerns about the high cost of prescription drugs and the struggle to balance high premiums verses high deductibles.
In many cases, people are linking the growing economic downturn in parts of Southwest Virginia and the national economic crisis directly to the cost of health insurance.
"I think something needs to be done about the shape of our economy and the shape of health care," said Paul St.Clair , who lives in Roanoke County with his wife and daughter.
"I think they definitely go together. I don't think that's going to happen any time soon, though."
St.Clair is a sales associate at a small, family-owned business in Vinton. Health insurance is not provided through his employer, so he and his wife have shopped around for private health insurance.
At one point, the couple was paying about $1,000 a month for insurance. While they have switched to a new plan that costs about $500 a month, they have a $5,000 deductible.
"It's getting harder for people to get approved for health insurance, too," said Casey St.Clair, Paul's wife, adding that they have been denied for maternity insurance because of complications Casey had during her first pregnancy.
The couple have a 2-year-old daughter, and Casey is pregnant with their second child. She was able to find maternity insurance eventually.
Paul St.Clair said he thinks that something should be done to allow small companies, like the one he works for, to pool together and purchase larger health plans.
Both of the St.Clairs said they were unlikely to vote in the election and that they don't believe any real health care reform is imminent.
If they were to vote, they said they both preferred McCain.
Without much confidence in true reform, Casey St.Clair said she sticks to controlling what she can.
"I'm not one of those moms who runs to the doctor every time her child gets the sniffles," she said. "If it can be treated over the counter then that's what I do.
"Otherwise I make sure we eat good, get enough rest and try to stay healthy so we don't have to pay those costs."
$2,500 refundable tax credit for individuals, $5,000 for families, to make health insurance more affordable. No mandate for universal coverage.
Supports relaxing federal restrictions on financing of embryonic stem cell research.
Opposes abortion rights. Has voted for abortion restrictions permissible under Roe v. Wade, and now says he would seek to overturn that guarantee of abortion rights.
Has supported expansion of the federal death penalty and has voted to prohibit the use of racial statistics in death penalty appeals.
Mandatory coverage for children. Aim for universal coverage by requiring employers to share costs of insuring workers and by offering coverage similar to that for federal employees.
Supports relaxing federal restrictions on financing of embryonic stem cell research.
Generally favors abortion rights, but opposes late-term abortions, with an exception for the mother's life and health.
Supports the death penalty for crimes for which the "community is justified in expressing the full measure of its outrage."
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