Rachel Pearson writes for the Texas Observer about some of her (harrowing) experiences volunteering for St. Vincent’s House, a student-run free clinic in Galveston, TX:
I am now a director of the free clinic. It’s a volunteer position. I love my patients, and I love being able to help many who need primary care: blood pressure control, pap smears, diabetes management. We even do some specialty care. But the free clinic is also where some people learn that there is no hope for the chemotherapy or surgery that they need but can’t afford. When UTMB refuses to treat them, it falls to us to tell them that they will die of diseases that are, in fact, treatable.
St. Vincent’s ends up with the uninsured patients that a nearby hospital is legally required to stabilize but not treat. Many of these patients fall into the Medicaid coverage gap, a gap that is a million Texans strong and won’t be closing with the Affordable Care Act.
They once sent us, from the ER, a man with a broken arm. They put the arm in a splint and referred him to us. What did they expect us to do—orthopedic surgery? Put on a cast? We don’t even have an x-ray machine.
I do not think that these referrals are an official policy. Rather, they are the work of doctors and nurses trying to do something for patients who have been refused care through the financial screening process at the hospital. Former St. Vincent’s leader Dr. Merle Lenihan has described the clinic as a “moral safety valve.” It protects UTMB from confronting the consequences of the state’s refusal to provide care.
Among those consequences are the deaths of the poor. As Howard Brody, director of the Institute for the Medical Humanities, has shown, 9,000 Texans per year will die needlessly as a result of our failure to expand Medicaid.