Day 6 Dispatch (7/2) – Columbia City, IN to Ft. Wayne, IN

Morning at the Days Inn in Warsaw and while my hotel has been set up, I’m wondering how to get my bag—the large piece of luggage out of which I live for the month—will get to Ft. Wayne. At the front desk is a young man, his name is Scott, with a big smile only half-filled with teeth. I smiled back.

Sheila, Uprendra’s wife and co-operator of the hotel, had called me down to the desk and she, with a bright smile too, handed me an envelope. With a bow of her head, she said, “Please take this, it is something small, but we hope it will help you with your trip.” I thanked her and wondered if I should refuse what was likely a cash gift. Of course, the walk would not be possible without donations, but then again, they were clearly living on the edge, and had already helped immensely and graciously. Later when I opened the envelope and found $20, I shook my head in amazement at the generosity of people, whatever they’re circumstances may be (Uprendra and his family, as mentioned in the last dispatch, are uninsured and get some of their medicines from ‘free samples’ donated by their brother, a retired physician).

Scott was standing there watching the proceedings. Not knowing whether he had time or a card, I decided to ask: “You wouldn’t happen to be able to take my bag to the hotel in Ft. Wayne, would you?”

“Sure,” he replied, in a calm cheerful voice and after some discussion, we agreed that he’d take the bag (and me) to Ft. Wayne and then drive me back to my walking point at Columbia City. It’d be $40 for the whole deal which was a win-win situation because he was unemployed and I needed to get my back to the next stop. And, as we drove together, he had stories to tell …

Scott: “I’ve been unemployed and don’t have no insurance. But, I’ve been pretty healthy, ‘cept my teeth here—gotta work on that sometime.” I nodded. His girlfriend called (this was a common occurrence as she seemed to call every five minutes). “But the difficult story is with my girlfriend. She works part-time and also no insurance. She makes too much for HIP (Indiana public assistance program) so that’s that. A few months ago, she had a kidney stone and the local hospital wouldn’t take care of her so they sent her to Indianapolis. The pain was so bad and she ended up having some operation there.” He said that there was no way they could pay any of the bills being that they were barely making ends meet. We drove by the trailer park that was their home and he told me how they were lucky, that the next trailer park up in Columbia City had been recently hit by a tornado and a few homes destroyed. Throughout the trip Scott was glowingly optimistic. But as he was about to drop me off, his face turned sour. “Tell those knuckleheads in Washington to get with it out there.”

The walk was long and relatively uneventful—endless fields tapering off into the horizon, curious cows, heavy clouds above. The road was straight and true, sometimes so straight as to be unreal. One surprise was a road off the Lincoln Highway called “Butt Road.” Reaching the Days Inn up near the Interstate, I checked in, unpacked and stopped downstairs for coffee and to talk with the family. Here are some of their stories.

Trushar: Last December he fell down in an ice storm and, as it turned out, broke his left wrist. He has no insurance and waited a week to have it eventually seen by a family friend, who was a doctor. By this time it had gotten quit swollen. They ended up spending about $500 for various x-rays, the visit to the doctor was free, but he was told that if it had gotten worse, the surgery for it would cost about $25,000. If that came to pass, the family had decided that Trushar (who is a U.S. citizen) would go back to India to have the surgery.

Hina: Hina’s one of the workers at the hotel—doubles up as back-up front desk and housekeeping. In fact, it seemed like everyone had a hand in all aspects of the operation. Hina’s had what she called a “muscle lock” in her neck which sounded to me like a cervical muscle spasm, perhaps even a herniated cervical disk. Hard to tell. In any case, she’s had no insurance and hasn’t seen a doctor or been to a hospital for it. She remains in pain, housekeeping work is hard, and this is making it harder. She looks warily around. I know that this hotel staff is like family, and they likely wouldn’t fire her for a situation that is undoubtedly compromising her productivity. But in a crueler world (which is quite common), she’d be out, replaced by someone else healthier, but also without insurance. Hina, in a way, is lucky.

© 2009, Ogan Gurel, MD

ogan@walk4healthcare.org

Voice of the People: Jorge (Warsaw, IN)

The most telling story came to us in a Mexican store down the street. I spoke with one of the counter people, who wished not to be identified. She told us that she did have insurance (through her husband) and that she was happy with the system and that she would not change anything. Then, next to the register, I noticed a posted sign with a picture of a young boy in a hospital bed pleading for $100,000 to help with a kidney transplant.

Doesn’t that tell it all?

Voice of the People: Uprendra in Warsaw, IN

Being self-employed, and that business was not so good this year, Uprendra cannot afford health coverage. He is not insured, nor is any of the staff. And, he has diabetes and gets his insulin, when he can, as free drug samples from his brother, who is a retired doctor. I was humbled by his generosity, the complimentary room, and even more, the $20 donation, his wife (and hotel co-operator) Sheila, gave me when I checked out the following morning.

Voice of the People: Krystal in Warsaw, IN

Meeting Krystal in front of the Courthouse on Center Street, I explained my walk, its purpose. Krystal asked how many pairs of shoes I have and so I showed her the extra pair strapped in a bag to my backpack and told her of the several more in the luggage at the hotel. And we that, we began talking about healthcare. “Insurance rates are sky high,” she told me, lamented further that, “like I was talking with my doctor, you almost have to call the insurance companies to get the approval for what drugs you can prescribe—insurance companies are driving the show … they give the discounts or I think they’re in the cahoots with some of the drug companies. They say ‘Oh, we’re having a special on Lipitor' and so they push Lipitor.” We talked about the pharmaceutical companies and that drug costs just seemed to be too high.

Day 5 Dispatch (7/1) – Bourbon, IN to Warsaw, IN

Writing this dispatch three days after the first of July, it feels as if it were years ago (and certainly many miles and a state away as I am now, as of this writing, in western Ohio). The walk began with Keith (the taxi driver I mentioned in yesterday's post) and I talking my bag to the next hotel in Warsaw (many thanks to Uprendra and the Days Inn for a free night’s stay!). Keith brought me back to Bourbon to begin the long walk along New US-30. The plan called for me to meet up with Katie of Grassroots Media (many thanks to that wonderful group!) to shoot some documentary video of the walk towards Warsaw and hopefully tape some interviews with people.

The air was cool and refreshing but as the wind was still, the truck fumes (new US-30 is a major highway) lay stagnant and choking, I stopped four miles down at the 19 & 30 in Etna Green. From there I decided to head along Old US-30, running parallel south of New 30 and much more scenic and less carbon monoxide-laden . But before leaving (and after a breakfast pizza), I had a chance to speak with Brian—the owner of the 19 & 30 gas station & restaurant.

Brian: “I believe government should not be in healthcare,” he said, though he added that he’d like to see some regulatory changes to actually increase competition, ensure personal responsibility and decrease prices. “The system is sure not working,” he told me.

And so I took off for Etna Green and, reaching Old US-30 headed east. Four miles later I was in Atwood—a small town where you could throw a stone (if you were good) from one end of the town to the other. There I met with Katie where we shot video of the walk, did, in fact, meet with several people along the way and in Warsaw. At one of the truck stops, Harold, a tanker driver, eyed me and with curious interest. I told him about the walk and asked, “What’s your story?”

Harold: Gruff but friendly, and with a face that oozed sincerity, Harold answered, “The insurance—80/20, but my wife is totally disabled so she’s on the Medicaid … and I got a $5,000 deductible! Every year, it just tears me up. We get good care over there at Lutheran in Ft. Wayne but it’s outrageous. When the doctor gives a regular prescription—not the generic stuff, and the pharmacist automatically gives you the generic, makes you sick and then you have to go back to the doctor to get the right stuff to send to the pharmacist, that don’t make no sense.” I asked Harold if he had any choice of insurance or if he had to take this type of insurance. “There’s no choice,” he told me. Indeed ...

Reaching Warsaw, I spent some time contemplating the War Memorial (officially the Kosciusko County War Memorial). As some may know, I was inspired to do this Walk for many reasons among which were the shockingly selfish arguments I began hearing from industry lobbyists and other groups over in Washington in efforts to derail healthcare reform. What ever happened to the notion of a greater good and self sacrifice—principles for which the hundreds of men and women listed on this memorial paid the highest price of devotion.

And so, with somber thoughts in mind, we headed farther into town along Lake Street. There we met a smartly dressed man—Scott.

Scott: He said that, “There should be less government involvement. I really think it should be left in the hands of the people.” He added that he used to work in the orthopedic device industry (there are many in Warsaw). “What I feel that would do, if healthcare was nationalized, is that it would undervalue the products they are making. In the end, I think it would work out as what they would lose in sales, they would get in volume, but I really feel that the healthcare scenario needs to be left to people, not the government.”

The most telling story came to us in a Mexican restaurant down the street. I spoke with one of the counter people, who wished not to be identified. She told us that she did have insurance (through her husband) and that she was happy with the system and that she would not change anything. Then, next to the register, I noticed a posted sign with a picture of a young boy in a hospital bed pleading for $100,000 to help with a kidney transplant.
Here's the sign ...

Doesn't that tell it all?

So the videographer and headed back up Lake street where I met with Krystal in front of the Warsaw courthouse.

Krystal: I explained my walk, its purpose. Krystal asked how many pairs of shoes I have and so I showed her the extra pair strapped in a bag to my backpack and told her of the several more in the luggage at the hotel. And we that, we began talking about healthcare. “Insurance rates are sky high,” she told me, lamented further that, “like I was talking with my doctor, you almost have to call the insurance companies to get the approval for what drugs you can prescribe—insurance companies are driving the show … they give the discounts or I think they’re in the cahoots with some of the drug companies. They say ‘Oh, we’re having a special on Lipitor' and so they push Lipitor.” We talked about the pharmaceutical companies and that drug costs just seemed to be too high.

And from here I finally arrived at my hotel—The Warsaw Days Inn. There I met the manager, Uprendra, who graciously offered a complimentary room and who told me his story. His pleasant and always smiling wife, Sheila, joined in the discussion.

Uprendra: He does not have insurance—nor does heila, or any of the staff. He has diabetes and gets his insulin, when he can, as free drug samples from his brother, who is a retired doctor. It was an interesting sidelight to the discussion I had with Krystal about pharmaceutical drug costs. Pharmaceutical marketing costs billions of dollars a year and includes not only the ubiquitous television ads but also the free samples that Uprendra takes. Of course, for him, it is very helpful … but don’t you think it’s a bit (to understate the matter) inefficient? I’ve talked to Republicans and Democrats alike on this trip and, I think the common agreement is that this healthcare system, in its varied manifestations, just does not make much sense …

© 2009, Ogan Gurel, MD

ogan@walk4healthcare.org