Not long ago I met Charles, a fifty-four-year-old man living in a poor Cleveland neighborhood. He had run out of his blood pressure pills and he had no money to buy more. His arm was tingling and his vision blurry. He was dizzy, he said. Charles had come to a makeshift clinic set up in an old Catholic school, run by a woman who partners with student nurses to offer preventive care to people who receive almost none. The nurses said his blood pressure had hit the danger zone and they called EMS. Charles refused to go to the hospital. He kept asking me: “Who’s going to pay for it? Who’s going to pay?” Rose Marie Egensperger who runs the clinic on a shoestring, explained: “Folks have lived with symptoms so long their health isn’t their first thought. For 90 percent of the people the major concerns are money and how am I going to get home.” This time Charles lucked out—he got new pills from another clinic he had been to before. Who knows what will happen when he runs out again?
At a school across town, I talked to Kevisha, a bright, articulate eleven-year-old who described everything that was wrong with her teeth—three cavities that needed filling; a rotting, broken tooth that a dentist had dug out; the root canal she had no money to pay for, and the bridge she needed to keep her other teeth from crowding into the empty space. Students from a local dental program were sealing what teeth they could to prevent more cavities. When they were done, she looked up and asked, “Are you coming back, or are you all through?” Kevisha had already sensed that they would not be back, hwoever, and she knew the deal. She said she had a Medicaid card, but it doesn’t buy a $3,000 bridge. “She’ll never get that tooth replaced,” the supervising dentist said. “We can get her the fillings. But there’s no reimbursement for the bridge, no pro bono care for needs that extensive.”
So far, the coverage of the health care issue in the presidential campaign has focused on the bare, dry facts of candidates’ proposals, and there have been plenty of stories like the one The Plain Dealer of Cleveland published before the Ohio primary that gave thumbnail sketches of their plans. Such stories employ all the buzz words—penalties, tax credits, incentives, affordable insurance. But stories about people like Charles and Kevisha have largely been missing, at least in the context of what the proposals would mean for them. That’s curious. During the two years that Bill Clinton’s health plan was debated and dissected, people stories populated the news columns, and ordinary Americans could get some idea how they would fare under his proposal. This time, though, reporting has pretty much followed the candidates’ script. Reporters have been stenographers—diligently punching out the words candidates say rather analyzing how those words will affect and even transform people’s lives.