Editor’s Note: The barriers to getting health care can be bad enough in urban areas, where poverty, lack of insurance and cultural divides are serious barriers to care. But if you live in rural parts of California there’s a serious barrier of a different kind: distance. As part of our first-person series “What’s Your Story?” we hear from Kelly Frost of Redding about how the care you need may be hours away from your home.
Being on dialysis is tough enough without having to travel two or three hours each way just to get to the clinic. But when you live in the far reaches of Northern California, that is exactly what you must do. I sometimes sit with my wife when she does her dialysis treatment. We are lucky because we live only about 10 minutes away from the clinic in Redding. But every morning, the “remotes,” people who live on farms or in rural towns, climb into the mini-vans and come from Trinity County to the west; Mount Shasta, Weed, and Alturas to the North; and some from as far away as Susanville, near Reno.
They get up in the middle of the night, travel several hours, sometimes in bad weather, sit for treatment for three hours, and go home. Then in two days they do it all over again. When the weather turns, or there is an accident which closes the interstate, the problem compounds. Sometimes, they can’t get to Redding, or worse yet, they get here and can’t get home. Packing a lunch and three days of meds is standard fare for most. You’ve got to think ahead. Have a plan, a place to stay until the roads open. The dialysis center has some funds to help with a motel or a meal, but not much. Not for everyone, and not for more than a day.
Some are lucky to have family nearby, but not the others. They have to fend for themselves, and some are in wheelchairs or otherwise can’t get around. Better have some money for a room. And with most of them on Medi-Cal that’s not easy.
The social worker tells me that missing a treatment or two can also be extremely dangerous. Fluid overload, shortness of breath, nausea. Even death if you miss too many. It’s a bad deal. Some consider moving to Redding to be closer to the clinic or stay near family. Others can’t afford to move. Others just like the rural lifestyle and feel they couldn’t make it in the big city.
I never thought of Redding as the big city, but I suppose when it’s the only place to have dialysis for several hundred miles in each direction, it is. And with the only hospital around that can deal with their chronic condition it makes living so far away hard as well. What if they need to get to the ER? An ambulance could take several hours. A helicopter? That takes time too. And money. Medi-Cal pays for those who qualify. But some are paying $50 or more each way. And those who drive are paying even more than that. Plus the cost of meals.
A lot is made of the virtue of giving people more choices in health care. Usually they’re talking about insurance plans, deductibles and such. But in this part of California, choice has a different meaning, as in ‘you don’t really have one’ when you or a loved one is ill. You do what you have to do, go where you have to go, even if that means going very far and doing what you never dreamed you’d have to do.
Listen to Kelly Frost on The California Report: