Roughly one in three Americans say they have cut back on food, borrowed money, or reduced utility use to afford health care, a Gallup poll found. At the same time, federal policy moves have lowered prices on some drugs even as Affordable Care Act marketplace premiums rose in places, and Medicaid faced deep cuts. About 3 million people have already lost coverage, and estimates project that number could reach 10 million within three years — pressures that have renewed attention on Remote Area Medical (RAM), the volunteer charity that began by parachuting doctors into South American jungles and, in the 1990s, refocused on Americans shut out of care by cost. We returned to a RAM pop-up to see how it serves people in need.
On a bitter February morning in Knoxville, Tennessee, the parking lot filled before dawn. Many people had driven hundreds of miles; because RAM can only treat a limited number of patients over a weekend, people often line up days ahead. Sandra Tallent drove 200 miles, arrived Wednesday at 4:30 p.m., and slept two nights in her car so she could get dental work — insurance was not an option. When asked how she would have handled her dental problems without RAM, she said simply, “I wouldn’t.”
Nearby, Dave Burge spent the night in his truck hoping to receive a full set of dentures. An uninsured drunk driver had struck him years earlier and a later workplace accident re-fractured his jaw. After surgeries and roughly $140,000 in medical bills, he returned to work but could not afford dental care. Some employers assumed he lost his teeth to meth. Asked what he would have done without RAM, he answered, “Suffer. No other way around it. They’re life changing.”
Over the clinic weekend in Knoxville the line reached about 1,200 people across Friday, Saturday and Sunday. Brad Sands, a former paramedic and RAM clinic coordinator, guided patients through the process. RAM welcomes everyone: no insurance required, no judgment. About half the people who come have no insurance; many of the others have plans they cannot practically use because of high co-pays and deductibles. Dental, vision and hearing care are commonly excluded from coverage, creating large, persistent gaps.
Chris Hall, who first volunteered with RAM at age 12 and is now the organization’s CEO, said roughly 65 percent of patients request dental services, 30 percent request eye exams and glasses, and only about 5 percent seek medical care. In addition to extractions, fillings and dentures, RAM screens for blood sugar and blood pressure and conducts breast and skin cancer checks, among other services. Depending on its size, a weekend clinic typically costs RAM between $100,000 and $500,000.
Most funding comes from individuals: more than 81 percent of supporters are small, often monthly, donors. Those dollars are stretched by donated clinic space, supplies and volunteer time. At the Knoxville event alone, 887 volunteers — medical professionals and students from about 30 states — turned out. Volunteers pay their own travel costs and give their time; many say the experience renews their faith in people.
Dentists encounter desperate choices. Glen Goldstein, a New Jersey volunteer, described patients who want teeth removed because they cannot afford restorative treatment or long-term maintenance. “I tell them some teeth can be saved,” he said, “and they say, ‘I don’t care. Please take them out.’” On occasion dentists remove multiple or full sets because patients see no realistic path to ongoing care.
RAM traces its mission to pain relief to its founder, Stan Brock, an Englishman who once walked nearly a month in the Amazon in search of care. He began RAM using an Army surplus C-47 and later shifted focus to Americans who lacked access. After a 2008 television story about the charity, $4 million in donations and a surge of volunteers allowed RAM to grow from roughly a dozen clinics a year to about 90. Brock ran the organization with intense dedication, took no salary, and died in 2018.
Volunteering often becomes a family affair; Goldstein’s relatives have returned repeatedly. Many volunteers say they gain as much as the patients do.
Technology has shortened some procedures. Connor Gibson, a 22-year-old engineer, uses digital design and 3-D printers to make dentures in roughly an hour. Gibson sometimes sleeps in the trailer where the printers run to keep machines going. He describes the “mirror moment” when patients first see themselves with restored teeth and the emotional release that follows: stress loosens and people visibly relax.
Those moments happened repeatedly in Knoxville. For Dave Burge, a new set of teeth brought a renewed sense of normalcy. Sandra Tallent cried when she saw her restored smile and thanked the volunteers who had provided what she otherwise could not afford. Over that weekend, RAM treated more than 500 patients directly, relieved pain for about 700 people and restored 24 smiles.
With insurance increasingly out of reach for millions, RAM moves on quickly to its next city, trying to make health care in America a little less remote.
Produced by Henry Schuster and Sarah Turcotte. Broadcast associate: Michelle Karim. Edited by Joe Schanzer.