Transcript Page 2

NARRATOR: YVONNE KING’s FRIENDS AND NEIGHBORS LEARNED OF HER STRUGGLE.  A MEMBER OF THE CHURCH OF JESUS CHRIST OF LATTER-DAY SAINTS, ONE OF YVONNE’S CHURCH LEADERS TRIED TO HELP.

Yvonne King
My bishop called me in; he called me in, so I met with him in his office and he told me "I'm really astounded that you haven't had any further testing after having had your cancer.  It's very important that you follow up on that".  I told him "it's because I've had no insurance" he says "well we're going to find a way", he says "I've got people working on it so we can find a way to get a colonoscopy done" and this has been probably six or seven months ago.  He put people in charge of trying to find it and as of yet I haven't heard anything and everybody's just shaking their head going "nobody will do it. We don't know what to do". I never give up hope.  I probably should have a long time ago but I can't.

NARRATOR: BUT IT CAN BE decidedly DIFFICULT TO KEEP YOUR CHIN UP.

Gay Peckham
Well when they turn you away it's embarrassing and humiliating and you wonder where you're going to turn, wonder where you're going to turn.

Gale Peckham 
Yeah I tried seeing doctors and I'd get turned away without any insurance, it was like "go away, you haven't got any insurance and we can't see you"

NARRATOR: GAY AND GALE PECKHAM ARE FAMILIAR WITH THE DIFFICULTIES OF FINDING MEDICAL CARE WHEN YOU’RE UNINSURED.

Gay Peckham
It's frustrating, very frustrating.  It makes you want to give up. 

NARRATOR: BUT THE PECKHAMS CAN’T GIVE UP.  GALE HAS DIABETES, AND HE NEEDS TO CONSTANTLY MONITOR HIS BLOOD SUGAR AND INJECT INSULIN. THE COST OF TEST STRIPS AND MEDICINE ADDS UP.  BUT THE PRICE OF NOT TREATING DIABETES IS EVEN HIGHER.

Gay Peckham
And there’s been times Gale's gone without medication because the house payment had to be made.

Gale Peckham
It's scary, knowing that you've got a major problem and you don't want to have an ambulance come pick you up in the morning.  So you just hope for the best. Quite a few times they've had the paramedics come out here and revive me and haul me to the hospital and that.

Joe Krella
So typically you find that those individuals do in fact delay receiving care even if they are symptomatic in some fashion. And then when they do access the healthcare system, again, predominantly through the emergency department, their condition has increased to the point where it potentially is chronic and life threatening and again, very expensive to treat.

Anyone who’s looking for care and who may fall through the cracks relies on the emergency department to get their care. The problem is they have access to the system in the most expensive and probably inefficient way, and then don't have opportunity for follow up or continuity of care.

Jane Powers, R.N.
It is common for us to see many non-urgent, problems in the emergency because the patients are either unable to get care, unable to get into care, unable to afford care or have not planned for care. (Has this ever happened to you before? No? Okay. Do you have any medical problems such as diabetes, asthma, high blood pressure? Yeah. You do.)

NARRATOR: NURSE JANE POWERS AND DOCTOR MANSOOR EMAM KNOW ALL TOO WELL WHAT CAN HAPPEN WHEN CHRONIC ILLNESSES GO UNTREATED. WORKING IN COTTONWOOD HOSPITAL’S MURRAY, UTAH EMERGENCY ROOM, THEY SEE THE UNINSURED COME THROUGH THE DOORS EVERY DAY.

Jane Powers, RN
I think that if you don't see it for yourself it's hard to believe it.  We live in America, this is the land for all of the abundancy and we have a lot of waste here. But there's also a lot of need.  We don't need to go to Calcutta to see the need, the desperate need.  It's here.

Mansoor Emam, M.D.
And you get these folks stabilized, you give them, you know a few days of medications until they get in to see a physician to take care of them, but they had no place to go. Simply, there was no available free clinic for these folks who are not homeless to go to get that continued care.

NARRATOR: SO DR. EMAM PURSUED FUNDING AND RESOURCES TO START HIS OWN CLINIC FOR THE WORKING POOR—-PEOPLE WHO HAD JOBS AND WERE ABOVE THE POVERTY LINE, BUT HAD NO ACCESS TO NON-EMERGENCY HEALTH CARE. AND IN TWO-THOUSAND FOUR, HE OPENED THE MALIHEH [ma-LEE-uh] FREE CLINIC.

Mansoor Emam, M.D.
Maliheh means comfort and beauty in Persian, in Farsi. Which is very fitting for the type of the clinic we run.

NARRATOR: FOR DR. EMAM, THE CLINIC IS THE REALIZATION OF A LIFELONG DREAM.  AS A YOUNG BOY IN SOUTHERN IRAN, HE WITNESSED MUCH SUFFERING.

Mansoor Emam, M.D.
That motivated my desire to someday become a physician and provide basic healthcare or access to healthcare for patients who otherwise don't have that privilege.

NARRATOR: AND IN THE HALLS OF THIS CLINIC THE QUESTION RETURNS: DO WE HAVE A RIGHT TO HEALTH CARE?

Mansoor Emam, M.D
Well I would like to see that at some point the access to healthcare changes from a privilege to a right for basic healthcare, for all of our citizens and residents of this country. But that's a goal I'm sure is easier to say than to accomplish obviously, but nations with a lot less resources than us have been able to do it.

(“Mild or?” “The cough is really severe, it wakes me up”.)

Mansoor Emam, M.D.
And so the way this clinic works and the way we establish this clinic is for patients who are working poor and they're under-served, they have no access to healthcare, they have chronic illnesses and they need healthcare providers to take care of their long-term problems.

Gay Peckham
It's been a lifesaver for us.  It's helped us out, oh, more than you could ever know. 

Gale Peckham
The first time I went there I was on edge.  You know because I figured I'd go through the door, get up there fill out the paperwork and they'd look at it and come and tell me "well you make too much and we can't see you - you've got too much.  Go away".  And that's what I really expected and when they didn't do that, it blew me away. I was in total shock because for me to go ask somebody for help, well it don't happen. 

Jane Powers, R.N.
One of things when we first started this clinic we felt that we were always behind the ball, so to speak.  We couldn't get ahead because these people had waited so long for care, many of them having gone without their diabetic medications for months to a year. Their blood sugars were out of control.

(PECKHAMS AT CLINIC I don’t need any lancets I just need test strips. I got plenty of them).

Gay Peckham
Oh it's really God sent!  Without them paying for the medication we wouldn't be able to be on the medications that we're on.

Dr. Eman (Before I forget there are a couple of forms that I need you to sign to get the medicines from the patient assistance program.)

NARRATOR:  THE CLINIC PARTNERS WITH RETAIL CHAINS AND PHARMACEUTICAL COMPANIES TO PROVIDE LOW COST OR EVEN FREE MEDICATION TO PATIENTS.

The clinic SUPPLIES OVER ONE million dollars a year in donated medicine.

Mansoor Emam, M.D.
Yeah that was one of my motivations from my ER experience that you will see somebody, you give them a prescription and then they simply can't afford the prescription so therefore you really didn't provide a meaningful service. If they were ill and could not pay for the antibiotics then, it would have been the same if they didn't actually see you.

Jane Powers RN
We can help people control their illness, learn about their illness, give them the empowerment to say “if I do this then I am going to feel better and I'm not going to be in a situation where I'm going to need the emergency care” and that's what I see we're doing here.

NARRATOR: THE CLINIC ALSO PROVIDES LIMITED DENTAL CARE AND CARE FROM SPECIALISTS. OVER TWO HUNDRED-FIFTY HEALTHCARE PROVIDERS VOLUNTEER THEIR TIME AT THE CLINIC. BUT THE CLINIC HAS ITS LIMITATIONS, AND THE WAITING LIST TO SEE A DOCTOR AT MALIHEH IS OVER THREE MONTHS LONG.

(See you in two months. Alright Dr. Thank you.)

Mansoor Emam, M.D.
As I mentioned you know, we get 600 to 800 calls a day and we see 60 patients to 80 patients.  What happens to the other, you know 600 to 700 patients?  Where do they go?  Where do they get their care?  It's obvious that you know we could have four of these clinics in this valley, seven days a week and we still would not meet the need. There's no question people care but do we do enough, have we done enough?  I think the answer is pretty obvious.

Amy Geroso, M.D.
What brings you to the clinic today?

Yvonne King
I wanted to see about getting a referral going for a colonoscopy.

Amy Geroso, M.D.
Ok, so you got something informing you that you needed a colonoscopy a year ago?

Yvonne King
Not a year ago, six years ago.

Amy Geroso, M.D.
Six years ago! Oh, ok, six years ago!

Yvonne King
Laughs: yes, a long time ago.

NARRATOR: YVONNE KING IS ONE STEP CLOSER TO A COLONOSCOPY.  SHE’S SEEING DR. AMY GEROSO AT THE INTERMOUNTAIN NORTH TEMPLE CLINIC IN SALT LAKE CITY TO SEE IF SHE QUALIFIES FOR ASSISTANCE.

(Yvonne: no I haven't been able to obtain medical insurance in all this time so (okay) I haven't had one. (Okay))

Amy Geroso, M.D.
The best way to get you referred to somebody is through the Health Access Project. It’s called HAP. And they have a panel of specialists; specialty physicians that provide charity care for patients that qualify.

(Yvonne: oh, okay, that sounds good.)

Amy Geroso, M.D.
Well, you know, she had cancer so she could have the cancer return. 

(Just take some big breaths in and out)

Amy Geroso, M.D.
Well I think it's really important for her to have a primary care provider.  You know, she hasn't had a physical, or any preventive medicine kinds of, of testing in the last 6 or 7 years.

 (INTERVIEWER: so what's next, what's the next step for you?)

Yvonne King
To set up for a complete physical with a regular physician and to apply for a program where they can do the referral for the colonoscopy. I think there's the possibility for a few more hoops, but I think it's a very real possibility this time.

NARRATOR: FOR YVONNE KING—ONE MORE STEP DOWN A VERY LONG ROAD.