“It’s not my skill that cures them, it’s God’s will,” says the India-born Chaudhuri, pointing his hands toward the sky as he sits in the cluttered cubicle-size clinic he has carved out of his garage. “I tell my patients, ‘If you are looking for a doctor, go back; if you are looking to be healed, you’ve come to the right place.’”
Subash Madra and his wife, Savita, swear by Chaudhuri. On a recent day, the couple had made the 300-mile round trip from their home in Sacramento to seek a cure from Chaudhuri for a litany of health issues they say they suffer from. Subash works as a security guard; Savita works at Mervyns. Neither has health insurance. Chaudhuri charges them $20 each per visit, which includes the cost of medicines. That’s well worth the long drive, Subash and Savita say, because the medicines are infallible.
The Madras assert that they would have made the trip to Chaudhuri’s clinic even if they had insurance. But many of the hundreds of thousands of people in the United States who go to alternative health care givers—even those with dubious credentials—choose that path for lack of insurance. Health insurance remains an unobtainable luxury to more than 43 million U.S. citizens. In California, the world’s sixth-largest economy, there are an estimated 12 million people who are uninsured, “a third of them clearly poor,” noted Dr. Anmol Mahal, president of the California Medical Association, as he outlined plans of the India Community Center (ICC) at Milpitas, Calif., to open a free medical clinic some time this year. Indian-American doctors have agreed to donate their skills to the clinic.
“This is the richest country in the world and yet, millions of people here don’t have access to health care,” lamented Dr. Arshia Arjumand who, until recently, worked at the Tri-City Health Care Center in Fremont, Calif. “There’s something worse than a Third World country within the U.S.”
Community clinics such as the one where Dr. Arjumand worked are often the only primary health-care facilities available to the underinsured and the uninsured. And even though these clinics never ask their clients about their legal status, not every immigrant knows this. Often, fear of being reported “keeps them from going to community clinics,” Arjumand said.
With federal officials increasingly cracking down on undocumented workers, immigrant rights activists expect those fears to increase. Last November, under a new federal policy, the automatic entitlement to health insurance through Medicaid was taken away from children born in the United States to illegal immigrants. And under the health-care plan Gov. Arnold Schwarzenegger unveiled last January, undocumented residents will not be covered. “You can’t blame them for being scared,” Arjumand said.
Chinese immigrants, and increasingly others, flock to traditional health-care practitioners in acupressure and acupuncture clinics, as well as to herbalists.
“The people who come here are mostly uninsured or underinsured,” said acupuncturist Pamela Olton, who is a clinic instructor at the American College of Traditional Chinese Medicine on Connecticut Avenue in San Francisco. Additionally, two days a week Olton supervises an ear clinic on the institute’s De Haro Street campus. “Most of our patients are part-time workers, or students, or the elderly.”
The “suggested donation” for a half-hour treatment session, which includes a steaming cup of herbal tea, is $3. The collection cup quickly fills up.
San Francisco resident Myriam, who wanted only her first name to be used, said her jobs as a lifeguard and swimming instructor do not provide her with health insurance. “It’s great we have this place,” she said, as she sat with about a dozen needles sticking out of her ears at the De Haro facility.
Some Latino immigrants in the San Francisco Bay Area are drawn to the inexpensive treatments offered by sobadores (massage therapists) andhueseros (chiropractors), some of whom operate out of their homes or small storefronts without the right credentials or licenses.
The rising cost of health care has contributed to a rapidly fraying public sector system. Nearly 50 percent of California’s hospitals are operating in the red. For the majority of Americans, employer-related insurance is still the main source of coverage. But each year, more employers are dropping or scaling back on health coverage. According to the California Health Care Foundation, the state has lower rates of employer-based coverage than the rest of the nation. This forces its uninsured to seek out places that offer free or low-cost primary health care.
“Increasingly, smaller employers don’t offer the level of benefits they used to,” observed Prof. David E. Hayes Bautista, professor of medicine and director of the Center for Study of Latino Health and Culture at UCLA’s School of Medicine.
For $8 an hour, China-born, 43-year-old Lucy He, who immigrated to the United States 13 years ago, works for an advertisement company in San Leandro, Calif. Even though she puts in 40 hours a week, her boss has kept her on a “temporary worker” status, she said, as she sat one recent day in the waiting room of the Oakland-based Asian Health Services medical center with her 9-year-old son. She knows her boss will dock two hours off her salary for taking time off from work for this hospital visit. That’s why “I don’t come here until I try home remedies,” he said. “I come here only when it gets serious.”
“If I were in their shoes, I would do the same thing,” Dr. Arjumand asserted. “If I had a silent killer, I would say forget it. I’ll keep working until I can no more.”
Shakila Rehman (not her real name) is a part-time pre-school teacher in the East Bay. Since she and her husband, who works for a shoe store, immigrated to the United States four years ago from their native Sri Lanka with their daughter, then six, the two have had no health insurance. Although the couple is eligible for Medi-Cal, Rehman said it covers only pregnancies and emergencies.
When her husband went to Alameda County’s Highland Hospital with an ear infection recently, he missed almost a day’s work on his first visit, and several hours of work on two subsequent visits because of the long waits he had to endure. To crown it all, Highland zapped him with a $700 bill. Rehman said the only way they can pay it off is by cutting back on food and gas, and suspend for a while the “small checks’ she has been sending her tsunami-hit relatives each month back home in Sri Lanka.
“Not having health insurance in the U.S. is no different from not having eyes,” Rehman said.
Scores of mostly South Asian immigrants throng to the free health clinics periodically sponsored by such organizations as the ICC, a multi-use facility in Milpitas, as well as to those sponsored by Hindu and Sikh temples, and mosques. At these clinics, doctors volunteer their time to check the blood pressure of visitors, or measure their cholesterol and blood sugar levels.
A survey done by the ICC indicates that the free health-care clinics are the only access to health care for scores of uninsured Indian-American seniors, according to ICC marketing manager Sunita Sohrabji.
“Even the undocumented come to the free camps we hold in our gurudwaras (Sikh temples,” said Avtar Singh, general secretary of the Indo-American Cultural Organization, who runs a Mountain Mike’s pizza franchise in Hayward, Calif. “We provide the doctors and visitors with interpreters.”
Singh, along with his wife, Surinder Kaur, a lab technician at Kaiser Hospital in Fremont, Calif., has in recent years organized a number of free health-care camps at gurdwaras (Sikh temples) in Hayward, Fremont, and El Sobrante, where visitors come “without fear” for a check-up, partake of the free food (langar) gurdwaras provide day and night, and leave with a free coupon for a diabetic home kit, courtesy of Kaiser.
Come July, San Francisco’s health-care landscape is expected to change when Mayor Gavin Newsom’s health access program (HAP) will begin to be phased in. Under it, all 82,000 of the city’s uninsured—documented and undocumented—will be eligible for health care. Costs of the program are contained by emphasizing preventive care and chronic disease management.
Viji Sundaram is New America Media’s health editor.