Analysts and commentators tend to frame our health care discussion in the big picture. How many people are covered, how many are not covered, that sort of thing, playing with numbers in the multimillions.
The Providers, a documentary airing at 10 p.m. ET Monday in the PBS Independent Lens series (check local listings), takes the valuable tack of focusing on a small number of individuals inside the health care system.
Directors Laura Green and Anna Moot-Levin visit the town of Las Vegas, New Mexico, not to be confused with Las Vegas, Nevada, and conclude parts of the system are in serious condition.
Little seems glamorous in Las Vegas, New Mexico, where the average annual income is around $15,000, and the opioid addiction rate is among the highest in the country.
It’s the kind of small town young people leave, meaning the population is also growing older, with the attendant increase in medical problems.
For all those reasons it’s not a terribly attractive place to practice medicine, so Las Vegas and the whole surrounding area of Northeast New Mexico – El Centro – faces a chronic shortage of medical caregivers.
In an effort to address that issue, which sadly is not unique to that particular area, insurance companies helped fund six pilot programs called ECHO (Extension for Community Healthcare Outcomes) , which would provide medical services of all kinds to everyone.
The Providers focuses on three caregivers: physician’s assistant Matt Probst, Nurse Practitioner Chris Ruge (top), and family physician Leslie Hayes.
Among other things, they make house calls, and since the El Centro area covers 22,000 square miles, we follow Ruge on a number of road trips.
We see some patients in the late stages of terminal diseases like cancer. We see more patients with debilitating conditions like alcohol-induced liver problems or pain from untreated infected teeth. We also see young mothers who just need routine care for their infant children.
The problem, evident from the start, is that there aren’t enough medical personnel or facilities to treat all patients in a timely manner.
The fact that more frequent, earlier and preventative treatment would resolve many medical issues before they became critical presumably is why insurance companies would fund a program like ECHO.
Still, Hayes points out that even when health care is available, there remain crucial areas of disagreement that can disproportionately affect a town like Las Vegas. Many primary care physicians will not treat opioid addiction, for instance, viewing it as a separate health issue. Hayes disagrees because addiction affects so many other areas of health.
Probst, a Las Vegas native whose father was a debilitated addict for much of his life, has helped start health care clubs in local high schools. One reason: Turnover among medical practitioners is a big problem in the El Centro district, and turnover drops dramatically among workers with local roots.
That’s a good sign. A less good sign is that many of the ECHO programs were not renewed after their pilot term expired.
Whatever the prognosis for American health care in the larger picture, there clearly are many places like Las Vegas, New Mexico, where the simple day-to-day basics already feel tenuous.
It’s frustrating to everyone that in a country and at a time when medicine has never been more sophisticated or more effective, too many people still are kept from its benefits.