By Angela E. Pometto
Herald Staff Writer
(From the issue of 12/2/04)

There are 49 million Americans who don’t have health insurance, according to Deacon Bill Grimes, a physician from the New Hope Clinic in Owingsville, Ky. Since jobs with benefits are scarce in Appalachia, there are a variety of non-profit clinics to care for the sick poor.

Grimes worked at St. Clare Medical Center in Morehead, Ky., for 27 years. A lady came in coughing up blood after waiting six months because she couldn’t afford medical treatment. She died six months later.

"We have a right to be healthy," said Grimes, deacon at St. Julie Parish in Owingsville.

The New Hope Clinic, now in its fourth year, sees more than 1,500 uninsured patients. Because the volunteer physicians and nurses work other jobs, the clinic is open only two days a week. They see about 40-50 patients per day, and each is charged only $35. Every other Saturday, the clinic opens for patients with diabetes and for psychological counseling.

The small building was an empty, run-down store before the community came together to renovate it. It costs $350,000 a year to run the clinic and grants provide two-thirds of the costs.

"The journey has become, for us, a solution to the problem," Grimes said, adding that he feels blessed.

While working at St. Clare Medical Center, Grimes witnessed a crisis in the medical profession.

"Patients in hospitals feel depersonalized and processed," he said. Caregivers are rewarded for being efficient and producing measurable results — making more money — without any regard for the care of the person, Grimes said, adding that New Hope clinic tries to reverse that by caring for people first.

Another non-profit clinic, the Paint Lick Family Clinic, also cares for uninsured, but it receives no federal funds.

"As long as I can remember, I’ve always wanted to be a doctor in an area where I felt needed," said Dr. John Belanger, director of the clinic.

His first job was with a federally funded health care center for the uninsured. In the beginning, it was an ideal place, but the clinic began to grow and Belanger ended up in an administrative position, which he did not enjoy. The center also began charging more for their services — on average $65 per visit. This made it much harder to help the people that most needed help.

"I started daydreaming about how to do things better," Belanger said. He began envisioning a new location, a smaller place where he would be the only doctor with the ability to break free from the established systems like Medicare.

In his administrative office, Belanger visualized a small clinic with a western-looking front and an office with a view over the rolling hills of Kentucky. The town of Paint Lick also came to mind. In response to these vivid images, he and his wife, Sarah, took a road trip to Paint Lick. When they arrived, Belanger was shocked to find the clinic with a western front he’d been dreaming about.

They were able to purchase and remodel the building so it would be suitable for a doctor’s office that now serves 5,000 people.

One of Belanger’s goals was that his clinic be self-sustained and not dependent on grants or federal aid. There is no billing department. People pay what they can pay when they can pay it. While the average salary of a family practitioner is $140,000, Belanger pays himself $35,000. The remaining money becomes part of the budget to help pay for other expenses.

"While sacrifice is important, this never felt like it was a sacrifice," said Belanger, a parishioner at St. Clare Church in Berea.

"Our mission is to provide excellent health care, even to those who can’t afford anything," he said. He makes sure what he prescribes is attainable to the patients, adding that generic brands offer an affordable option.

"Much of what a doctor gives to people is wellness," Belanger said. "There is something intangible that happens to you in a doctor’s office."

Transportation is another problem for the poor in the Appalachian Mountains. There are no subways, buses or taxis. The nearest town is often 20-30 miles away on curvy mountain roads. To solve this problem, Missionary Sister of Mary Sister Bernie Kenny started a clinic on wheels that serves eight communities in southwestern Virginia.

It began as a small bus, but it has grown to a large Winnebago equipped with three exam rooms and a staff of four. Filling up the massive gas tank every two to three weeks, usually costs between $60 and $90.

Sister Kenny has been doing this work for 20 years. "I will retire one day, but not yet," she said.

According to Jo Ella Dales, one of the licensed nurse practitioners, the Bon Secours St. Mary’s Health Wagon cares for patients with varying needs from diabetes and cholesterol problems to pre-natal care and physicals for kids.

"We have everything needed to operate a regular clinic," said Dales, adding that they care for anyone who walks in the door without income requirements.

The Health Wagon travels every day except Friday when they clean and do paper work. The work day ends when the last patient leaves.

"Healing is a mutual exhange," Sister Kenny said. "It’s a heart to heart sharing of God’s love."