Massive makeshift mobile clinic provides healthcare to uninsured, but uphill battle remains in world's richest country.

Chiquita Followay has no reason to be happy. Some would say she has every reason to be downright livid.

But far from it, she is relieved, bordering on euphoric.

After receiving a coveted entry ticket to a Remote Area Medical (RAM) clinic early Saturday, Followay had three teeth extracted and received two cortisone shots in her arthritic knees.

She plans to have four more teeth extracted Sunday if she can convince her younger sister to stay in Charleston one more day.

For the first time since she was 16, the 62-year-old retired nurse does not have a working car, forcing her to rely on family to drive her 60 miles (100 kilometers) to the state capital from Kenova.

“If it weren’t for these clinics a lot of these people would not have any healthcare, have no glasses, have no dental care,” Followay said, her white sweater dotted in blood from her dental operation.

Followay was one of more than 500 patients who went to Charleston in the hopes of receiving the free medical care they otherwise would not be able to access.

Nearly all of the patients Anadolu Agency spoke to spent the frosty night in their cars, some arriving as early as Friday afternoon, hoping to secure a spot in the two-day medical clinic that seems on the first glance out of place in the United States.

RAM’s clinics are far more akin to operations in refugee camps and isolated communities abroad than a service Americans in major cities are forced to flock to for health care.

In fact, the medical non-profit was originally envisioned as a service for far-afield communities in the developing world, not for major population centers in the world’s wealthiest country.

That changed in 1985 when RAM’s founder was asked to help a small community in rural Tennessee.

After organizing nearly 900 clinics that have spanned cities across the U.S., Stan Brock said the millions of Americans he has helped “simply can’t afford to go to the dentist, and they simply can’t afford to go to the eye doctor just to get a pair of glasses so they can function.

“This is a huge problem,” he says.

The makeshift hospitals fill a major void in the American healthcare system.

At the clinic Saturday and Sunday, RAM performed 88 tooth extractions, gave out 274 pairs of glasses and provided 232 other medical services to those in need. In all, RAM said its services for the weekend were valued at $221,000.

Nearly all of the more than 400 people who worked in Charleston, which was one of RAM’s smaller operations, were volunteers. If they had been paid they would have been compensated $197,000.

The clinics and similar services are direly needed for many who either lack health insurance altogether or vision and dental coverage.

Following the passage of former President Barack Obama’s Affordable Care Act, commonly known as “Obamacare”, the uninsured rate plummeted from 17 percent to 11 percent in 2016, but millions remain uncovered.

More than 28 million lacked coverage in 2016, according to the Kaiser Family Foundation.

Many at the Charleston clinic were low-income families, mirroring the demographics of those who continue to lack coverage despite Obamacare’s mandate that individuals purchase insurance.

Virginia Brooks drove 400 miles (643 kilometers) from Lagrange, North Carolina, with her adult son and special needs niece, arriving at 5 p.m. Friday.

“I don’t have the insurance to get what I need and I found out today my son has extremely high blood pressure, which we did not know,” she said after she and her niece received pairs of new glasses, and her son underwent tooth removal surgery.

Like Followay, Brooks’ son returned Sunday to have additional teeth pulled but faces long-term challenges related to hypertension.

Just a week after President Donald Trump removed government subsidies to help low-income Americans help pay for health insurance, Brooks doubled-down on her support for the populist president.

“I believe in Donald Trump. He’s going to make America great again,” she said, echoing his campaign slogan, while she voiced strong opposition to proposals to shift the U.S. to a single-payer universal healthcare system.

“Look at Canada. The waiting list in Canada to go to the doctor for weight loss surgery for people who are obese can take years,” she said. “Let people buy their own insurance like it used to be. Government don’t need to control our insurance.”

Her views were in the vast minority in Charleston. Of the dozens of patients asked by Anadolu Agency if they favor government-funded universal health care, Brooks was the only one who rejected the proposal.

Still, all agreed something has to change, even if they disagreed on what should be done.

Among 11 high-income nations, the Commonwealth Fund private foundation ranks the U.S. health care system as the worst performing, and the World Health Organization (WHO) places America 37th among all countries for healthcare efficiency, behind Oman, Malta, Dominica, Costa Rica, Andorra and even Greece.

The low rank in contrast to America’s vast resources “shows we’re inefficient with our dollars,” said Dr. Randy Swain, who practices medicine in the Charleston area and came to the weekend clinic to lend a hand.

“Unfortunately, the healthcare dollars aren’t spent wisely -- not in prevention and mass vaccinations, stuff like that. It’s dollars going where they maybe shouldn’t,” he said, pointing to drug companies over-pricing their wares and inflated salaries for insurance company executives.

Republicans have spearheaded efforts to “repeal and replace” the Affordable Care Act, but the nonpartisan Congressional Budget Office (CBO) has assessed each of those now defunct proposals to contribute to, rather than reduce, the number of uninsured by as much as 24 million in the next decade.

A recent bipartisan effort would simply keep the number of uninsured unchanged, according to the CBO.

Central to any movement toward reform has to be getting politicians to realize the effects their policies are having on Americans, said Brock, the RAM founder.

“Senior members of the government need to come and see operations like this,” he said, longing for a time when RAM’s services are no longer needed.

“I look for the day when I can concentrate my troops in places like sub-Saharan Africa, and Yemen and the South Sudan, and not be doing it here in the world’s richest country.”

There is a long road ahead before that day comes to pass. RAM has six more clinics planned across the country before year's end.

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