Cover America Tour: Free clinic treats the chronically uninsured

On Tuesdays, folks start arriving at the Cabrini Clinic in the Corktown neighborhood of Detroit at 4 p.m., and by 5 p.m., when the first patient is called in, the waiting room is already full.

Two Tuesdays ago, the first people to show up were the Lawrences, big and little. Twenty years between them, Little Lawrence is only 3 but—years ahead of himself—was already talking about what he’ll do when he turns 18 (get his ear pierced). Big Lawrence, aka "Dad," 23, was there for his regular checkup and to get his monthly supply of diabetes medication.

Under the watchful and compassionate eye of Sister Mary Ellen Howard (right), the clinic is a safety net for the uninsured in Detroit, which she says now number about 200,000. While this one place can't possibly help them all, about 25 to 30 people in need would be seen on this evening, as they have been for nearly 175 years.

Since the doors first opened to aid victims of the cholera epidemic in 1834, the clinic has been a helping hand for many of Detroit's poor residents in need of medical care. Through the boom and bust of the city’s auto industry, urban riots, wars, and depressions, this place has found a way to stay alive and serve the people who need its help the most, giving it the well-deserved distinction as the oldest free medical clinic in the U.S.

Today people come with the usual ailments, says Sister Mary Ellen. Last Tuesday one person was there with leg pain, another for a cough that wouldn't go away. But the three that talked to us were seeking help for chronic illnesses, and without any health insurance they came to the only place they could get care to keep their illnesses in check.

In addition to Big Lawrence was Michelle, 52, born with a heart condition that she tries to manage with regular checkups at the clinic. But one unexpected lapse recently sent her to the emergency room, and she had to stay at the hospital for a week. She left with a $38,000 medical bill. Rosemary, another diabetes patient, comes for free meds from the clinic and tries to mitigate her condition as best she can by paying close attention to her diet.

The statistics on chronic illnesses and conditions in the U.S. are staggering—7 percent of Americans, like Big Lawrence and Rosemary, now live with diabetes. It’s one thing to try to manage diabetes with good medical coverage, but it’s entirely different to do daily battle with the disease with no insurance.

Particularly eye-opening was a visit with Laurel of Commerce Township, Mich., not far away from the Cabrini Clinic in downtown Detroit. Laurel is living uninsured with epilepsy. Fifty years young, this now-disabled nurse should have regular doctor visits to monitor her condition and make the proper adjustments to her medications. Instead, she goes without any care. In constant fear of crippling medical bills, she’s considering getting a medical alert bracelet that says "Epileptic—do not call emergency services. I am uninsured."

It becomes an exponentially bad equation that, even with the utmost of caution, will almost always have the same result: (chronic illness) x (no insurance) + (complications) – (quality care) = emergency room.

For the lucky ones in the Detroit area, the Cabrini Clinic is a factor that can alter the equation a little, at least for a while. But when a chronic illness takes a turn for the worse, even the generous care at the clinic can’t offer a safety net to catch a $38,000 emergency-room fall.

—Meagen Bohne, Campaign Organizer

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